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Harrington RM, Kristinsson S, Wilmskoetter J, Busby N, den Ouden D, Rorden C, Fridriksson J, Bonilha L. Dissociating reading and auditory comprehension in persons with aphasia. Brain Commun 2024; 6:fcae102. [PMID: 38585671 PMCID: PMC10998352 DOI: 10.1093/braincomms/fcae102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 01/10/2024] [Accepted: 03/21/2024] [Indexed: 04/09/2024] Open
Abstract
Language comprehension is often affected in individuals with post-stroke aphasia. However, deficits in auditory comprehension are not fully correlated with deficits in reading comprehension and the mechanisms underlying this dissociation remain unclear. This distinction is important for understanding language mechanisms, predicting long-term impairments and future development of treatment interventions. Using comprehensive auditory and reading measures from a large cohort of individuals with aphasia, we evaluated the relationship between aphasia type and reading comprehension impairments, the relationship between auditory versus reading comprehension deficits and the crucial neuroanatomy supporting the dissociation between post-stroke reading and auditory deficits. Scores from the Western Aphasia Battery-Revised from 70 participants with aphasia after a left-hemisphere stroke were utilized to evaluate both reading and auditory comprehension of linguistically equivalent stimuli. Repeated-measures and univariate ANOVA were used to assess the relationship between auditory comprehension and aphasia types and correlations were employed to test the relationship between reading and auditory comprehension deficits. Lesion-symptom mapping was used to determine the dissociation of crucial brain structures supporting reading comprehension deficits controlling for auditory deficits and vice versa. Participants with Broca's or global aphasia had the worst performance on reading comprehension. Auditory comprehension explained 26% of the variance in reading comprehension for sentence completion and 44% for following sequential commands. Controlling for auditory comprehension, worse reading comprehension performance was independently associated with damage to the inferior temporal gyrus, fusiform gyrus, posterior inferior temporal gyrus, inferior occipital gyrus, lingual gyrus and posterior thalamic radiation. Auditory and reading comprehension are only partly correlated in aphasia. Reading is an integral part of daily life and directly associated with quality of life and functional outcomes. This study demonstrated that reading performance is directly related to lesioned areas in the boundaries between visual association regions and ventral stream language areas. This behavioural and neuroanatomical dissociation provides information about the neurobiology of language and mechanisms for potential future treatment interventions.
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Affiliation(s)
- Rachael M Harrington
- Department of Communication Sciences and Disorders and Center for Research on the Challenges of Acquiring Language and Literacy, Georgia State University, Atlanta, GA 30310, USA
| | - Sigfus Kristinsson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29208, USA
| | - Janina Wilmskoetter
- Department of Health and Rehabilitation Sciences, Medical University of South Carolina, Charleston, SC 29464, USA
| | - Natalie Busby
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29208, USA
| | - Dirk den Ouden
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29208, USA
| | - Chris Rorden
- Department of Psychology, University of South Carolina, Columbia, SC 29208, USA
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29208, USA
| | - Leonardo Bonilha
- School of Medicine Columbia, University of South Carolina, Columbia, SC 29208, USA
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Busby N, Newman-Norlund R, Wilmskoetter J, Johnson L, Rorden C, Gibson M, Roth R, Wilson S, Fridriksson J, Bonilha L. Longitudinal Progression of White Matter Hyperintensity Severity in Chronic Stroke Aphasia. Arch Rehabil Res Clin Transl 2023; 5:100302. [PMID: 38163020 PMCID: PMC10757197 DOI: 10.1016/j.arrct.2023.100302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Objective To determine whether longitudinal progression of small vessel disease in chronic stroke survivors is associated with longitudinal worsening of chronic aphasia severity. Design A longitudinal retrospective study. Severity of white matter hyperintensities (WMHs) as a marker for small vessel disease was assessed on fluid-attenuated inversion recovery (FLAIR) scans using the Fazekas scale, with ratings for deep WMHs (DWMHs) and periventricular WMHs (PVHs). Setting University research laboratories. Participants This study includes data from 49 chronic stroke survivors with aphasia (N=49; 15 women, 34 men, age range=32-81 years, >6 months post-stroke, stroke type: [46 ischemic, 3 hemorrhagic], community dwelling). All participants completed the Western Aphasia Battery-Revised (WAB) and had FLAIR scans at 2 timepoints (average years between timepoints: 1.87 years, SD=3.21 years). Interventions Not applicable. Main Outcome Measures Change in white matter hyperintensity severity (calculated using the Fazekas scale) and change in aphasia severity (difference in Western Aphasia Battery scores) were calculated between timepoints. Separate stepwise regression models were used to identify predictors of WMH severity change, with lesion volume, age, time between timepoints, body mass index (BMI), and presence of diabetes as independent variables. Additional stepwise regression models investigated predictors of change in aphasia severity, with PVH change, DWMH change, lesion volume, time between timepoints, and age as independent predictors. Results 22.5% of participants (11/49) had increased WMH severity. Increased BMI was associated with increases in PVH severity (P=.007), whereas the presence of diabetes was associated with increased DWMH severity (P=.002). Twenty-five percent of participants had increased aphasia severity which was significantly associated with increased severity of PVH (P<.001, 16.8% variance explained). Conclusion Increased small vessel disease burden is associated with contributing to chronic changes in aphasia severity. These findings support the idea that good cardiovascular risk factor control may play an important role in the prevention of long-term worsening of aphasic symptoms.
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Affiliation(s)
- Natalie Busby
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC
| | | | - Janina Wilmskoetter
- Department of Neurology, Medical University of South Carolina, Charleston, SC
| | - Lisa Johnson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC
| | - Chris Rorden
- Department of Psychology, University of South Carolina, Columbia, SC
| | - Makayla Gibson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC
| | - Rebecca Roth
- Department of Neurology, Emory University, Atlanta, GA
| | - Sarah Wilson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC
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Busby N, Wilson S, Wilmskoetter J, Newman-Norlund R, Sayers S, Newman-Norlund S, Roth R, Rorden C, Fridriksson J, Bonilha L. White matter hyperintensity load mediates the relationship between age and cognition. Neurobiol Aging 2023; 132:56-66. [PMID: 37729770 DOI: 10.1016/j.neurobiolaging.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 09/22/2023]
Abstract
To elucidate the relationship between age and cognitive decline, it is important to consider structural brain changes such as white matter hyperintensities (WMHs), which are common in older age and may affect behavior. Therefore, we aimed to investigate if WMH load is a mediator of the relationship between age and cognitive decline. Healthy participants (N = 166, 20-80 years) completed the Montreal Cognitive Assessment (MoCA). WMHs were manually delineated on FLAIR scans. Mediation analysis was conducted to determine if WMH load mediates the relationship between age and cognition. Older age was associated with worse cognition (p < 0.001), but this was an indirect effect: older participants had more WMHs, and, in turn, increased WMH load was associated with worse MoCA scores. WMH load mediates the relationship between age and cognitive decline. Importantly, this relationship was not moderated by age (i.e., increased WMH severity is associated with poorer MoCA scores irrespective of age). Across all ages, high cholesterol was associated with increased WMH severity.
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Affiliation(s)
- Natalie Busby
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA.
| | - Sarah Wilson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Janina Wilmskoetter
- Department of Health and Rehabilitation Sciences, Medical University of South Carolina, Charleston, SC, USA
| | | | - Sara Sayers
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Sarah Newman-Norlund
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Rebecca Roth
- Department of Neurology, Emory University, Atlanta, GA, USA
| | - Chris Rorden
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
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Busby N, Newman-Norlund S, Sayers S, Newman-Norlund R, Wilmskoetter J, Rorden C, Nemati S, Wilson S, Riccardi N, Roth R, Johnson L, den Ouden DB, Fridriksson J, Bonilha L. Lower socioeconomic status is associated with premature brain aging. Neurobiol Aging 2023; 130:135-140. [PMID: 37506551 DOI: 10.1016/j.neurobiolaging.2023.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 06/06/2023] [Accepted: 06/19/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Premature age-related brain changes may be influenced by physical health factors. Lower socioeconomic status (SES) is often associated with poorer physical health. In this study, we aimed to investigate the relationship between SES and premature brain aging. METHODS Brain age was estimated from T1-weighted images using BrainAgeR in 217 participants from the ABC@UofSC Repository. The difference between brain and chronological age (BrainGAP) was calculated. Multiple regression models were used to predict BrainGAP with age, SES, body mass index, diabetes, hypertension, sex, race, and education as predictors. SES was calculated from size-adjusted household income and the cost of living. RESULTS Fifty-five participants (25.35%) had greater brain age than chronological age (premature brain aging). Multiple regression models revealed that age, sex, and SES were significant predictors of BrainGAP with lower SES associated with greater BrainGAP (premature brain aging). CONCLUSIONS This study demonstrates that lower SES is an independent contributor to premature brain aging. This may provide additional insight into the mechanisms associated with brain health, cognition, and resilience to neurological injury.
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Affiliation(s)
- Natalie Busby
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA.
| | - Sarah Newman-Norlund
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Sara Sayers
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | | | - Janina Wilmskoetter
- Department of Neurology, Medical University of South Carolina, Charleston, SC, USA
| | - Chris Rorden
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Samaneh Nemati
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Sarah Wilson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Nicholas Riccardi
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Rebecca Roth
- Department of Neurology, Emory University, Atlanta, GA, USA
| | - Lisa Johnson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Dirk B den Ouden
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
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Hannan J, Wilmskoetter J, Fridriksson J, Hillis AE, Bonilha L, Busby N. Brain health imaging markers, post-stroke aphasia and Cognition: A scoping review. Neuroimage Clin 2023; 39:103480. [PMID: 37536153 PMCID: PMC10412866 DOI: 10.1016/j.nicl.2023.103480] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 08/05/2023]
Abstract
For the past decade, brain health has been an emerging line of scientific inquiry assessing the impact of age-related neurostructural changes on cognitive decline and recovery from brain injury. Typically, compromised brain health is attributed to the presence of small vessel disease (SVD) and brain tissue atrophy, which are represented by various neuroimaging features. However, to date, the relationship between brain health markers and chronic aphasia severity remains unclear. Thus, the goal of this scoping review was to assess the current body of evidence regarding the relationship between SVD-related brain health biomarkers and post-stroke aphasia and cognition. In all, 187 articles were identified from 3 databases, of which 16 articles met the criteria for inclusion. Among these studies, 11 focused on cognition rather than aphasia, while 2 investigated both. Of the 10 studies that used white matter hyperintensities (WMHs) as an indicator of SVD severity, 8 studies (80%) demonstrated a relationship between WMH load and worse cognition in stroke patients. Interestingly, among the studies that specifically investigated aphasia, all 5 studies (100%) demonstrated a relationship between SVD and worse language performance. They also indicated that factors other than brain health (e.g., lesion, age, time post onset) played an important role in determining aphasia severity at a single timepoint. These findings suggest that brain health is likely a crucial factor in the context of aphasia recovery, possibly indicating the necessity of cognitive reserve thresholds for the multimodal cognitive demands associated with language recovery. While SVD and structural brain health are not commonly considered as predictors of aphasia severity, more comprehensive models incorporating brain health have the potential to improve prognosis of post-stroke cognitive and language deficits. Given the variability in the existing literature, a uniform grading system for overall SVD would be beneficial for future research on the mechanisms related to brain networks and neuroplasticity, and their translational impact.
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Affiliation(s)
- Jade Hannan
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA.
| | - Janina Wilmskoetter
- Department of Health and Rehabilitation Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Physical Medicine, Rehabilitation, and Cognitive Science, Johns Hopkins University, Baltimore, MD, USA
| | | | - Natalie Busby
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
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Wilmskoetter J, Busby N, He X, Caciagli L, Roth R, Kristinsson S, Davis KA, Rorden C, Bassett DS, Fridriksson J, Bonilha L. Dynamic network properties of the superior temporal gyrus mediate the impact of brain age gap on chronic aphasia severity. Commun Biol 2023; 6:727. [PMID: 37452209 PMCID: PMC10349039 DOI: 10.1038/s42003-023-05119-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023] Open
Abstract
Brain structure deteriorates with aging and predisposes an individual to more severe language impairments (aphasia) after a stroke. However, the underlying mechanisms of this relation are not well understood. Here we use an approach to model brain network properties outside the stroke lesion, network controllability, to investigate relations among individualized structural brain connections, brain age, and aphasia severity in 93 participants with chronic post-stroke aphasia. Controlling for the stroke lesion size, we observe that lower average controllability of the posterior superior temporal gyrus (STG) mediates the relation between advanced brain aging and aphasia severity. Lower controllability of the left posterior STG signifies that activity in the left posterior STG is less likely to yield a response in other brain regions due to the topological properties of the structural brain networks. These results indicate that advanced brain aging among individuals with post-stroke aphasia is associated with disruption of dynamic properties of a critical language-related area, the STG, which contributes to worse aphasic symptoms. Because brain aging is variable among individuals with aphasia, our results provide further insight into the mechanisms underlying the variance in clinical trajectories in post-stroke aphasia.
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Affiliation(s)
- Janina Wilmskoetter
- Department of Health and Rehabilitation Sciences, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA.
| | - Natalie Busby
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Xiaosong He
- Department of Psychology, University of Science and Technology of China, Beijing, China
| | - Lorenzo Caciagli
- Department of Bioengineering, School of Engineering & Applied Science, University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecca Roth
- Department of Neurology, Emory University, Atlanta, GA, USA
| | - Sigfus Kristinsson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Kathryn A Davis
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Chris Rorden
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Dani S Bassett
- Department of Bioengineering, School of Engineering & Applied Science, University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Electrical and Systems Engineering, School of Engineering & Applied Science, University of Pennsylvania, Philadelphia, PA, USA
- Department of Physics & Astronomy, School of Arts & Sciences, University of Pennsylvania, Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Santa Fe Institute, Santa Fe, New Mexico, NM, USA
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
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Roth R, Busby N, Wilmskoetter J, Schwen Blackett D, Gleichgerrcht E, Johnson L, Rorden C, Newman-Norlund R, Hillis AE, den Ouden DB, Fridriksson J, Bonilha L. Diabetes, brain health, and treatment gains in post-stroke aphasia. Cereb Cortex 2023; 33:8557-8564. [PMID: 37139636 PMCID: PMC10321080 DOI: 10.1093/cercor/bhad140] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/31/2023] [Accepted: 04/01/2023] [Indexed: 05/05/2023] Open
Abstract
In post-stroke aphasia, language improvements following speech therapy are variable and can only be partially explained by the lesion. Brain tissue integrity beyond the lesion (brain health) may influence language recovery and can be impacted by cardiovascular risk factors, notably diabetes. We examined the impact of diabetes on structural network integrity and language recovery. Seventy-eight participants with chronic post-stroke aphasia underwent six weeks of semantic and phonological language therapy. To quantify structural network integrity, we evaluated the ratio of long-to-short-range white matter fibers within each participant's whole brain connectome, as long-range fibers are more susceptible to vascular injury and have been linked to high level cognitive processing. We found that diabetes moderated the relationship between structural network integrity and naming improvement at 1 month post treatment. For participants without diabetes (n = 59), there was a positive relationship between structural network integrity and naming improvement (t = 2.19, p = 0.032). Among individuals with diabetes (n = 19), there were fewer treatment gains and virtually no association between structural network integrity and naming improvement. Our results indicate that structural network integrity is associated with treatment gains in aphasia for those without diabetes. These results highlight the importance of post-stroke structural white matter architectural integrity in aphasia recovery.
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Affiliation(s)
- Rebecca Roth
- Department of Neurology, Emory University, Atlanta, GA 30322, USA
| | - Natalie Busby
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29208, USA
| | - Janina Wilmskoetter
- Department of Rehabilitation Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Deena Schwen Blackett
- Department of Neurology, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Ezequiel Gleichgerrcht
- Department of Neurology, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Lisa Johnson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29208, USA
| | - Chris Rorden
- Department of Psychology, University of South Carolina, Columbia, SC 29208, USA
| | | | - Argye E Hillis
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD 21218 USA
| | - Dirk B den Ouden
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29208, USA
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29208, USA
| | - Leonardo Bonilha
- Department of Neurology, Emory University, Atlanta, GA 30322, USA
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Busby N, Hillis AE, Bunker L, Rorden C, Newman-Norlund R, Bonilha L, Meier E, Goldberg E, Hickok G, Yourganov G, Fridriksson J. Comparing the brain-behaviour relationship in acute and chronic stroke aphasia. Brain Commun 2023; 5:fcad014. [PMID: 37056476 PMCID: PMC10088484 DOI: 10.1093/braincomms/fcad014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 07/23/2022] [Accepted: 03/27/2023] [Indexed: 03/30/2023] Open
Abstract
In stroke aphasia, lesion volume is typically associated with aphasia severity. Although this relationship is likely present throughout recovery, different factors may affect lesion volume and behaviour early into recovery (acute) and in the later stages of recovery (chronic). Therefore, studies typically separate patients into two groups (acute/chronic), and this is often accompanied with arguments for and against using data from acute stroke patients over chronic. However, no comprehensive studies have provided strong evidence of whether the lesion-behaviour relationship early in recovery is comparable to later in the recovery trajectory. To that end, we investigated two aims: (i) whether lesion data from acute and chronic patients yield similar results in region-based lesion-symptom mapping analyses and (ii) if models based on one timepoint accurately predict the other. Lesions and aphasia severity scores from acute (N = 63) and chronic (N = 109) stroke survivors with aphasia were entered into separate univariate region-based lesion-symptom mapping analyses. A support vector regression model was trained on lesion data from either the acute or chronic data set to give an estimate of aphasia severity. Four model-based analyses were conducted: trained on acute/chronic using leave-one-out, tested on left-out behaviour or trained on acute/chronic to predict the other timepoint. Region-based lesion-symptom mapping analyses identified similar but not identical regions in both timepoints. All four models revealed positive correlations between actual and predicted Western Aphasia Battery-Revised aphasia-quotient scores. Lesion-to-behaviour predictions were almost equivalent when comparing within versus across stroke stage, despite differing lesion size/locations and distributions of aphasia severity between stroke timepoints. This suggests that research investigating the brain-behaviour relationship including subsets of patients from only one timepoint may also be applicable at other timepoints, although it is important to note that these comparable findings may only be seen using broad measures such as aphasia severity, rather than those aimed at identifying more specific deficits. Subtle differences found between timepoints may also be useful in understanding the nature of lesion volume and aphasia severity over time. Stronger correlations found when predicting acute behaviour (e.g. predicting acute: r = 0.6888, P < 0.001, predicting chronic r = 0.5014, P < 0.001) suggest that the acute lesion/perfusion patterns more accurately capture the critical changes in underlying vascular territories. Differences in critical brain regions between timepoints may shed light on recovery patterns. Future studies could focus on a longitudinal design to compare acute and chronic patients in a more controlled manner.
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Affiliation(s)
- Natalie Busby
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29209, USA
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MA 21287, USA
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MA 21218, USA
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MA 21287, USA
| | - Lisa Bunker
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MA 21287, USA
| | - Chis Rorden
- Department of Psychology, University of South Carolina, Columbia, SC 29208, USA
| | - Roger Newman-Norlund
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29209, USA
| | - Leo Bonilha
- Department of Neurology, Emory University, Atlanta, GA 30322, USA
| | - Erin Meier
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MA 21287, USA
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA 02115, USA
| | - Emily Goldberg
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MA 21287, USA
- Department of Communication Disorders, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Gregory Hickok
- Department of Cognitive Sciences, University of California, Irvine, CA 92697, USA
- Department of Language Science, University of California, Irvine, CA 92697, USA
| | - Grigori Yourganov
- Advanced Computing and Data Science, Cyberinfrastructure and Technology Integration, Clemson University, Clemson, SC 29634, USA
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29209, USA
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Busby N, Wilmskoetter J, Gleichgerrcht E, Rorden C, Roth R, Newman-Norlund R, Hillis AE, Keller SS, de Bezenac C, Kristinsson S, Fridriksson J, Bonilha L. Advanced Brain Age and Chronic Poststroke Aphasia Severity. Neurology 2023; 100:e1166-e1176. [PMID: 36526425 PMCID: PMC10074460 DOI: 10.1212/wnl.0000000000201693] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 10/31/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Chronic poststroke language impairment is typically worse in older individuals or those with large stroke lesions. However, there is unexplained variance that likely depends on intact tissue beyond the lesion. Brain age is an emerging concept, which is partially independent from chronologic age. Advanced brain age is associated with cognitive decline in healthy older adults; therefore, we aimed to investigate the relationship with stroke aphasia. We hypothesized that advanced brain age is a significant factor associated with chronic poststroke language impairments, above and beyond chronologic age, and lesion characteristics. METHODS This cohort study retrospectively evaluated participants from the Predicting Outcomes of Language Rehabilitation in Aphasia clinical trial (NCT03416738), recruited through local advertisement in South Carolina (US). Primary inclusion criteria were left hemisphere stroke and chronic aphasia (≥12 months after stroke). Participants completed baseline behavioral testing including the Western Aphasia Battery-Revised (WAB-R), Philadelphia Naming Test (PNT), Pyramids and Palm Trees Test (PPTT), and Wechsler Adult Intelligence Scale Matrices subtest, before completing 6 weeks of language therapy. The PNT was repeated 1 month after therapy. We leveraged modern neuroimaging techniques to estimate brain age and computed a proportional difference between chronologic age and estimated brain age. Multiple linear regression models were used to evaluate the relationship between proportional brain age difference (PBAD) and behavior. RESULTS Participants (N = 93, 58 males and 35 females, average age = 61 years) had estimated brain ages ranging from 14 years younger to 23 years older than chronologic age. Advanced brain age predicted performance on semantic tasks (PPTT) and language tasks (WAB-R). For participants with advanced brain aging (n = 47), treatment gains (improvement on the PNT) were independently predicted by PBAD (T = -2.0474, p = 0.0468, 9% of variance explained). DISCUSSION Through the application of modern neuroimaging techniques, advanced brain aging was associated with aphasia severity and performance on semantic tasks. Notably, therapy outcome scores were also associated with PBAD, albeit only among participants with advanced brain aging. These findings corroborate the importance of brain age as a determinant of poststroke recovery and underscore the importance of personalized health factors in determining recovery trajectories, which should be considered during the planning or implementation of therapeutic interventions.
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Affiliation(s)
- Natalie Busby
- From the Departments of Communication Sciences and Disorders (N.B., J.F.), and Psychology (C.R., R.N.N.), University of South Carolina, Columbia; Department of Health and Rehabilitation Sciences (J.W., E.G., S.K., J.F.), Medical University of South Carolina, Charleston; Department of Neurology (R.R., L.B.), Emory University, Atlanta, GA; Department of Neurology (A.E.H.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pharmacology and Therapeutics (S.S.K., C.d.B.), Institute of Systems, Molecular and Integrative Biology, University of Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust (S.S.K., C.d.B.), Liverpool, United Kingdom.
| | - Janina Wilmskoetter
- From the Departments of Communication Sciences and Disorders (N.B., J.F.), and Psychology (C.R., R.N.N.), University of South Carolina, Columbia; Department of Health and Rehabilitation Sciences (J.W., E.G., S.K., J.F.), Medical University of South Carolina, Charleston; Department of Neurology (R.R., L.B.), Emory University, Atlanta, GA; Department of Neurology (A.E.H.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pharmacology and Therapeutics (S.S.K., C.d.B.), Institute of Systems, Molecular and Integrative Biology, University of Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust (S.S.K., C.d.B.), Liverpool, United Kingdom
| | - Ezequiel Gleichgerrcht
- From the Departments of Communication Sciences and Disorders (N.B., J.F.), and Psychology (C.R., R.N.N.), University of South Carolina, Columbia; Department of Health and Rehabilitation Sciences (J.W., E.G., S.K., J.F.), Medical University of South Carolina, Charleston; Department of Neurology (R.R., L.B.), Emory University, Atlanta, GA; Department of Neurology (A.E.H.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pharmacology and Therapeutics (S.S.K., C.d.B.), Institute of Systems, Molecular and Integrative Biology, University of Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust (S.S.K., C.d.B.), Liverpool, United Kingdom
| | - Chris Rorden
- From the Departments of Communication Sciences and Disorders (N.B., J.F.), and Psychology (C.R., R.N.N.), University of South Carolina, Columbia; Department of Health and Rehabilitation Sciences (J.W., E.G., S.K., J.F.), Medical University of South Carolina, Charleston; Department of Neurology (R.R., L.B.), Emory University, Atlanta, GA; Department of Neurology (A.E.H.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pharmacology and Therapeutics (S.S.K., C.d.B.), Institute of Systems, Molecular and Integrative Biology, University of Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust (S.S.K., C.d.B.), Liverpool, United Kingdom
| | - Rebecca Roth
- From the Departments of Communication Sciences and Disorders (N.B., J.F.), and Psychology (C.R., R.N.N.), University of South Carolina, Columbia; Department of Health and Rehabilitation Sciences (J.W., E.G., S.K., J.F.), Medical University of South Carolina, Charleston; Department of Neurology (R.R., L.B.), Emory University, Atlanta, GA; Department of Neurology (A.E.H.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pharmacology and Therapeutics (S.S.K., C.d.B.), Institute of Systems, Molecular and Integrative Biology, University of Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust (S.S.K., C.d.B.), Liverpool, United Kingdom
| | - Roger Newman-Norlund
- From the Departments of Communication Sciences and Disorders (N.B., J.F.), and Psychology (C.R., R.N.N.), University of South Carolina, Columbia; Department of Health and Rehabilitation Sciences (J.W., E.G., S.K., J.F.), Medical University of South Carolina, Charleston; Department of Neurology (R.R., L.B.), Emory University, Atlanta, GA; Department of Neurology (A.E.H.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pharmacology and Therapeutics (S.S.K., C.d.B.), Institute of Systems, Molecular and Integrative Biology, University of Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust (S.S.K., C.d.B.), Liverpool, United Kingdom
| | - Argye Elizabeth Hillis
- From the Departments of Communication Sciences and Disorders (N.B., J.F.), and Psychology (C.R., R.N.N.), University of South Carolina, Columbia; Department of Health and Rehabilitation Sciences (J.W., E.G., S.K., J.F.), Medical University of South Carolina, Charleston; Department of Neurology (R.R., L.B.), Emory University, Atlanta, GA; Department of Neurology (A.E.H.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pharmacology and Therapeutics (S.S.K., C.d.B.), Institute of Systems, Molecular and Integrative Biology, University of Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust (S.S.K., C.d.B.), Liverpool, United Kingdom
| | - Simon S Keller
- From the Departments of Communication Sciences and Disorders (N.B., J.F.), and Psychology (C.R., R.N.N.), University of South Carolina, Columbia; Department of Health and Rehabilitation Sciences (J.W., E.G., S.K., J.F.), Medical University of South Carolina, Charleston; Department of Neurology (R.R., L.B.), Emory University, Atlanta, GA; Department of Neurology (A.E.H.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pharmacology and Therapeutics (S.S.K., C.d.B.), Institute of Systems, Molecular and Integrative Biology, University of Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust (S.S.K., C.d.B.), Liverpool, United Kingdom
| | - Christophe de Bezenac
- From the Departments of Communication Sciences and Disorders (N.B., J.F.), and Psychology (C.R., R.N.N.), University of South Carolina, Columbia; Department of Health and Rehabilitation Sciences (J.W., E.G., S.K., J.F.), Medical University of South Carolina, Charleston; Department of Neurology (R.R., L.B.), Emory University, Atlanta, GA; Department of Neurology (A.E.H.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pharmacology and Therapeutics (S.S.K., C.d.B.), Institute of Systems, Molecular and Integrative Biology, University of Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust (S.S.K., C.d.B.), Liverpool, United Kingdom
| | - Sigfus Kristinsson
- From the Departments of Communication Sciences and Disorders (N.B., J.F.), and Psychology (C.R., R.N.N.), University of South Carolina, Columbia; Department of Health and Rehabilitation Sciences (J.W., E.G., S.K., J.F.), Medical University of South Carolina, Charleston; Department of Neurology (R.R., L.B.), Emory University, Atlanta, GA; Department of Neurology (A.E.H.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pharmacology and Therapeutics (S.S.K., C.d.B.), Institute of Systems, Molecular and Integrative Biology, University of Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust (S.S.K., C.d.B.), Liverpool, United Kingdom
| | - Julius Fridriksson
- From the Departments of Communication Sciences and Disorders (N.B., J.F.), and Psychology (C.R., R.N.N.), University of South Carolina, Columbia; Department of Health and Rehabilitation Sciences (J.W., E.G., S.K., J.F.), Medical University of South Carolina, Charleston; Department of Neurology (R.R., L.B.), Emory University, Atlanta, GA; Department of Neurology (A.E.H.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pharmacology and Therapeutics (S.S.K., C.d.B.), Institute of Systems, Molecular and Integrative Biology, University of Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust (S.S.K., C.d.B.), Liverpool, United Kingdom
| | - Leonardo Bonilha
- From the Departments of Communication Sciences and Disorders (N.B., J.F.), and Psychology (C.R., R.N.N.), University of South Carolina, Columbia; Department of Health and Rehabilitation Sciences (J.W., E.G., S.K., J.F.), Medical University of South Carolina, Charleston; Department of Neurology (R.R., L.B.), Emory University, Atlanta, GA; Department of Neurology (A.E.H.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pharmacology and Therapeutics (S.S.K., C.d.B.), Institute of Systems, Molecular and Integrative Biology, University of Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust (S.S.K., C.d.B.), Liverpool, United Kingdom
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10
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Kristinsson S, Basilakos A, den Ouden DB, Cassarly C, Spell LA, Bonilha L, Rorden C, Hillis AE, Hickok G, Johnson L, Busby N, Walker GM, McLain A, Fridriksson J. Predicting Outcomes of Language Rehabilitation: Prognostic Factors for Immediate and Long-Term Outcomes After Aphasia Therapy. J Speech Lang Hear Res 2023; 66:1068-1084. [PMID: 36827514 PMCID: PMC10205105 DOI: 10.1044/2022_jslhr-22-00347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/23/2022] [Accepted: 11/30/2022] [Indexed: 05/25/2023]
Abstract
BACKGROUND Aphasia therapy is an effective approach to improve language function in chronic aphasia. However, it remains unclear what prognostic factors facilitate therapy response at the individual level. Here, we utilized data from the POLAR (Predicting Outcomes of Language Rehabilitation in Aphasia) trial to (a) determine therapy-induced change in confrontation naming and long-term maintenance of naming gains and (b) examine the extent to which aphasia severity, age, education, time postonset, and cognitive reserve predict naming gains at 1 week, 1 month, and 6 months posttherapy. METHOD A total of 107 participants with chronic (≥ 12 months poststroke) aphasia underwent extensive case history, cognitive-linguistic testing, and a neuroimaging workup prior to receiving 6 weeks of impairment-based language therapy. Therapy-induced change in naming performance (measured as raw change on the 175-item Philadelphia Naming Test [PNT]) was assessed 1 week after therapy and at follow-up time points 1 month and 6 months after therapy completion. Change in naming performance over time was evaluated using paired t tests, and linear mixed-effects models were constructed to examine the association between prognostic factors and therapy outcomes. RESULTS Naming performance was improved by 5.9 PNT items (Cohen's d = 0.56, p < .001) 1 week after therapy and by 6.4 (d = 0.66, p < .001) and 7.5 (d = 0.65, p < .001) PNT items at 1 month and 6 months after therapy completion, respectively. Aphasia severity emerged as the strongest predictor of naming improvement recovery across time points; mild (ß = 5.85-9.02) and moderate (ß = 9.65-11.54) impairment predicted better recovery than severe (ß = 1.31-3.37) and very severe (ß = 0.20-0.32) aphasia. Age was an emergent prognostic factor for recovery 1 month (ß = -0.14) and 6 months (ß = -0.20) after therapy, and time postonset (ß = -0.05) was associated with retention of naming gains at 6 months posttherapy. CONCLUSIONS These results suggest that therapy-induced naming improvement is predictable based on several easily measurable prognostic factors. Broadly speaking, these results suggest that prognostication procedures in aphasia therapy can be improved and indicate that personalization of therapy is a realistic goal in the near future. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.22141829.
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Affiliation(s)
- Sigfus Kristinsson
- Center for the Study of Aphasia Recovery, University of South Carolina, Columbia
| | - Alexandra Basilakos
- Center for the Study of Aphasia Recovery, University of South Carolina, Columbia
| | - Dirk B. den Ouden
- Center for the Study of Aphasia Recovery, University of South Carolina, Columbia
| | - Christy Cassarly
- Department of Public Health Sciences, Medical University of South Carolina, Charleston
| | - Leigh Ann Spell
- Center for the Study of Aphasia Recovery, University of South Carolina, Columbia
| | - Leonardo Bonilha
- Department of Neurology, Medical University of South Carolina, Charleston
| | - Chris Rorden
- Department of Psychology, University of South Carolina, Columbia
| | - Argye E. Hillis
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD
| | - Gregory Hickok
- Department of Cognitive Sciences, School of Social Sciences, University of California, Irvine
| | - Lisa Johnson
- Center for the Study of Aphasia Recovery, University of South Carolina, Columbia
| | - Natalie Busby
- Center for the Study of Aphasia Recovery, University of South Carolina, Columbia
| | - Grant M. Walker
- Department of Cognitive Sciences, School of Social Sciences, University of California, Irvine
| | - Alexander McLain
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia
| | - Julius Fridriksson
- Center for the Study of Aphasia Recovery, University of South Carolina, Columbia
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11
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Sen S, Newman-Norlund R, Riccardi N, Newman-Norlund S, Sayers S, Wilson S, Busby N, Nemati S, Rorden C, Fridriksson J. Abstract 109: Regional Cerebral Hypoperfusion In Patients Recovered From Mild COVID-19. Stroke 2023. [DOI: 10.1161/str.54.suppl_1.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background:
Cerebral hypoperfusion have been described in both severe and mild forms of symptomatic coronavirus disease 2019 (COVID-19) infection. The purpose of this study was to investigate global and regional gray matter (GM) and white matter (WM) cerebral blood flow (CBF) in asymptomatic COVID-19 infection patients compared with age-gender-race matched controls.
Methods:
Cases with mild COVID-19 infection and age-gender-race matched healthy controls, were drawn from the ABC@UofSC data repository. Demographics, risk factors and data from the Montreal Cognitive Assessment (MOCA score) were collected within a week of magnetic resonance imaging (MRI) perfusion image acquisition using pseudo-continuous arterial spin labeling. Mean CBF values for GM, WM and whole brain were calculated by averaging CBF values of standard space normalized CBF image values falling within GM and WM masks. Whole-brain, region of interest (ROI) based analyses were used to create standardized cerebral blood flow maps and further explore differences between the two groups.
Results:
Twenty-eight cases with prior mild COVID-19 infection were compared with 28 age-, gender-, race-matched controls. The MOCA score was similar between cases and controls. Whole-brain CBF (46.7±5.6 vs. 49.3±3.7, p=0.05), GM-specific CBF (64.2±8.9 vs. 67.6±6.0, p=0.10), and WM-specific CBF (29.3±2.6 vs. 31.0±1.6, p=0.03) were noted to be lower in COVID-19 cases as compared to controls. Further analysis identified several brain regions with lower CBF than the CONTROL group colors representing Z-scores shown in the figure. Predictive models based on these data predicted COVID-19 group membership with a high degree of accuracy (85.2%) suggesting CBF patterns as a key imaging marker of mild infection.
Conclusion:
In this study, lower white matter CBF, as well as widespread regional CBF changes identified using quantitative MRI, were found in patients recovered from mild to moderate COVID-19 infection.
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12
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Nemati S, Newman‐Norlund R, Newman‐Norlund S, Sayers S, Busby N, Bonilha L, Fridriksson J. Neuroimaging‐based Biomarkers of Brain Aging in Healthy Older Adults. Alzheimers Dement 2022. [DOI: 10.1002/alz.064909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | | | | | - Sara Sayers
- University of South Carolina Columbia SC USA
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13
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Busby N, Newman‐Norlund S, Sayers S, Newman‐Norlund R, Nemati S, Bonilha L, Fridriksson J. Language Fluency and Premature Brain Aging. Alzheimers Dement 2022. [DOI: 10.1002/alz.063916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | | | - Sara Sayers
- University of South Carolina Columbia SC USA
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14
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Busby N, Newman-Norlund S, Sayers S, Newman-Norlund R, Wilson S, Nemati S, Rorden C, Wilmskoetter J, Riccardi N, Roth R, Fridriksson J, Bonilha L. White matter hyperintensity load is associated with premature brain aging. Aging (Albany NY) 2022; 14:9458-9465. [PMID: 36455869 PMCID: PMC9792198 DOI: 10.18632/aging.204397] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Brain age is an MRI-derived estimate of brain tissue loss that has a similar pattern to aging-related atrophy. White matter hyperintensities (WMHs) are neuroimaging markers of small vessel disease and may represent subtle signs of brain compromise. We tested the hypothesis that WMHs are independently associated with premature brain age in an original aging cohort. METHODS Brain age was calculated using machine-learning on whole-brain tissue estimates from T1-weighted images using the BrainAgeR analysis pipeline in 166 healthy adult participants. WMHs were manually delineated on FLAIR images. WMH load was defined as the cumulative volume of WMHs. A positive difference between estimated brain age and chronological age (BrainGAP) was used as a measure of premature brain aging. Then, partial Pearson correlations between BrainGAP and volume of WMHs were calculated (accounting for chronological age). RESULTS Brain and chronological age were strongly correlated (r(163)=0.932, p<0.001). There was significant negative correlation between BrainGAP scores and chronological age (r(163)=-0.244, p<0.001) indicating that younger participants had higher BrainGAP (premature brain aging). Chronological age also showed a positive correlation with WMH load (r(163)=0.506, p<0.001) indicating older participants had increased WMH load. Controlling for chronological age, there was a statistically significant relationship between premature brain aging and WMHs load (r(163)=0.216, p=0.003). Each additional year in brain age beyond chronological age corresponded to an additional 1.1mm3 in WMH load. CONCLUSIONS WMHs are an independent factor associated with premature brain aging. This finding underscores the impact of white matter disease on global brain integrity and progressive age-like brain atrophy.
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Affiliation(s)
- Natalie Busby
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29201, USA
| | - Sarah Newman-Norlund
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29201, USA
| | - Sara Sayers
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29201, USA
| | | | - Sarah Wilson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29201, USA
| | - Samaneh Nemati
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29201, USA
| | - Chris Rorden
- Department of Psychology, University of South Carolina, Columbia, SC 29201, USA
| | - Janina Wilmskoetter
- Department of Health and Rehabilitation Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Nicholas Riccardi
- Department of Psychology, University of South Carolina, Columbia, SC 29201, USA
| | - Rebecca Roth
- Department of Neurology, Emory University, Atlanta, GA 30322, USA
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29201, USA
| | - Leonardo Bonilha
- Department of Neurology, Emory University, Atlanta, GA 30322, USA
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15
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Schwen Blackett D, Varkey J, Wilmskoetter J, Roth R, Andrews K, Busby N, Gleichgerrcht E, Desai RH, Riccardi N, Basilakos A, Johnson LP, Kristinsson S, Johnson L, Rorden C, Spell LA, Fridriksson J, Bonilha L. Neural network bases of thematic semantic processing in language production. Cortex 2022; 156:126-143. [PMID: 36244204 PMCID: PMC10041939 DOI: 10.1016/j.cortex.2022.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/10/2022] [Accepted: 08/03/2022] [Indexed: 11/20/2022]
Abstract
Semantic processing is a central component of language and cognition. The anterior temporal lobe is postulated to be a key hub for semantic processing, but the posterior temporoparietal cortex is also involved in thematic associations during language. It is possible that these regions act in concert and depend on an anteroposterior network linking the temporal pole with posterior structures to support thematic semantic processing during language production. We employed connectome-based lesion-symptom mapping to examine the causal relationship between lesioned white matter pathways and thematic processing language deficits among individuals with post-stroke aphasia. Seventy-nine adults with chronic aphasia completed the Philadelphia Naming Test, and semantic errors were coded as either thematic or taxonomic to control for taxonomic errors. Controlling for nonverbal conceptual-semantic knowledge as measured by the Pyramids and Palm Trees Test, lesion size, and the taxonomic error rate, thematic error rate was associated with loss of white matter connections from the temporal pole traversing in peri-Sylvian regions to the posterior cingulate and the insula. These findings support the existence of a distributed network underlying thematic relationship processing in language as opposed to discrete cortical areas.
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Affiliation(s)
- Deena Schwen Blackett
- Department of Otolaryngology, College of Medicine, Medical University of South Carolina, Charleston, SC, USA; Division of Speech-Language Pathology, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA.
| | - Jesse Varkey
- Department of Neurology, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Janina Wilmskoetter
- Division of Speech-Language Pathology, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA.
| | - Rebecca Roth
- Department of Neurology, School of Medicine, Emory University, Atlanta, GA, USA.
| | - Keeghan Andrews
- Department of Neurology, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Natalie Busby
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA.
| | - Ezequiel Gleichgerrcht
- Department of Neurology, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Rutvik H Desai
- Department of Psychology, University of South Carolina, Barnwell College, Columbia, SC, USA.
| | - Nicholas Riccardi
- Department of Psychology, University of South Carolina, Barnwell College, Columbia, SC, USA.
| | - Alexandra Basilakos
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA.
| | - Lorelei P Johnson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA.
| | - Sigfus Kristinsson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA.
| | - Lisa Johnson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA.
| | - Chris Rorden
- Department of Psychology, University of South Carolina, Barnwell College, Columbia, SC, USA.
| | - Leigh A Spell
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA.
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA.
| | - Leonardo Bonilha
- Department of Neurology, School of Medicine, Emory University, Atlanta, GA, USA.
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16
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Kristinsson S, Busby N, Rorden C, Newman-Norlund R, den Ouden DB, Magnusdottir S, Hjaltason H, Thors H, Hillis AE, Kjartansson O, Bonilha L, Fridriksson J. Brain age predicts long-term recovery in post-stroke aphasia. Brain Commun 2022; 4:fcac252. [PMID: 36267328 PMCID: PMC9576153 DOI: 10.1093/braincomms/fcac252] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/25/2022] [Accepted: 10/03/2022] [Indexed: 11/30/2022] Open
Abstract
The association between age and language recovery in stroke remains unclear. Here, we used neuroimaging data to estimate brain age, a measure of structural integrity, and examined the extent to which brain age at stroke onset is associated with (i) cross-sectional language performance, and (ii) longitudinal recovery of language function, beyond chronological age alone. A total of 49 participants (age: 65.2 ± 12.2 years, 25 female) underwent routine clinical neuroimaging (T1) and a bedside evaluation of language performance (Bedside Evaluation Screening Test-2) at onset of left hemisphere stroke. Brain age was estimated from enantiomorphically reconstructed brain scans using a machine learning algorithm trained on a large sample of healthy adults. A subsample of 30 participants returned for follow-up language assessments at least 2 years after stroke onset. To account for variability in age at stroke, we calculated proportional brain age difference, i.e. the proportional difference between brain age and chronological age. Multiple regression models were constructed to test the effects of proportional brain age difference on language outcomes. Lesion volume and chronological age were included as covariates in all models. Accelerated brain age compared with age was associated with worse overall aphasia severity (F(1, 48) = 5.65, P = 0.022), naming (F(1, 48) = 5.13, P = 0.028), and speech repetition (F(1, 48) = 8.49, P = 0.006) at stroke onset. Follow-up assessments were carried out ≥2 years after onset; decelerated brain age relative to age was significantly associated with reduced overall aphasia severity (F(1, 26) = 5.45, P = 0.028) and marginally failed to reach statistical significance for auditory comprehension (F(1, 26) = 2.87, P = 0.103). Proportional brain age difference was not found to be associated with changes in naming (F(1, 26) = 0.23, P = 0.880) and speech repetition (F(1, 26) = 0.00, P = 0.978). Chronological age was only associated with naming performance at stroke onset (F(1, 48) = 4.18, P = 0.047). These results indicate that brain age as estimated based on routine clinical brain scans may be a strong biomarker for language function and recovery after stroke.
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Affiliation(s)
- Sigfus Kristinsson
- Correspondence to: Sigfus Kristinsson, PhD Center for the Study of Aphasia Recovery University of South Carolina, 915 Greene Street Columbia, SC 29209, USA E-mail:
| | - Natalie Busby
- Center for the Study of Aphasia Recovery, University of South Carolina, Columbia, SC 29208, USA
| | - Christopher Rorden
- Center for the Study of Aphasia Recovery, University of South Carolina, Columbia, SC 29208, USA,Department of Psychology, University of South Carolina, Columbia, SC 29208, USA
| | - Roger Newman-Norlund
- Center for the Study of Aphasia Recovery, University of South Carolina, Columbia, SC 29208, USA,Department of Psychology, University of South Carolina, Columbia, SC 29208, USA
| | - Dirk B den Ouden
- Center for the Study of Aphasia Recovery, University of South Carolina, Columbia, SC 29208, USA,Department of Communication Sciences and Disorders, Columbia, SC 29208, USA
| | | | - Haukur Hjaltason
- Department of Medicine, University of Iceland, Reykjavik 00107, Iceland,Department of Neurology, Landspitali University Hospital, Reykjavik 00101, Iceland
| | - Helga Thors
- Department of Medicine, University of Iceland, Reykjavik 00107, Iceland
| | - Argye E Hillis
- Center for the Study of Aphasia Recovery, University of South Carolina, Columbia, SC 29208, USA,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MA 21218, USA
| | - Olafur Kjartansson
- Department of Neurology, Landspitali University Hospital, Reykjavik 00101, Iceland
| | - Leonardo Bonilha
- Center for the Study of Aphasia Recovery, University of South Carolina, Columbia, SC 29208, USA,Department of Neurology, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Julius Fridriksson
- Center for the Study of Aphasia Recovery, University of South Carolina, Columbia, SC 29208, USA,Department of Communication Sciences and Disorders, Columbia, SC 29208, USA
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17
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Johnson L, Nemati S, Bonilha L, Rorden C, Busby N, Basilakos A, Newman-Norlund R, Hillis AE, Hickok G, Fridriksson J. Predictors beyond the lesion: Health and demographic factors associated with aphasia severity. Cortex 2022; 154:375-389. [PMID: 35926368 DOI: 10.1016/j.cortex.2022.06.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 04/20/2022] [Accepted: 06/11/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Lesion-related factors are associated with severity of language impairment in persons with aphasia. The extent to which demographic and health factors predict language impairment beyond traditional cortical measures remains unknown. Identifying and understanding the contributions of factors to predictive models of severity constitutes critical knowledge for clinicians interested in charting the likely course of aphasia in their patients and designing effective treatment approaches in light of those predictions. METHODS Utilizing neuroimaging and language testing from our cohort of 224 individuals in the chronic stage of recovery from a left-hemisphere stroke in a cross-sectional study, we first conducted a lesion symptom mapping (LSM) analysis to identify regions associated with aphasia severity scores. After controlling for lesion volume and damage to pre-identified areas, three models were created to predict severity scores: 1) Demographic Model (N = 147); 2) Health Model (N = 106); and 3) Overall Model (N = 106). Finally, all identified factors were entered into a Final Model to predict raw severity scores. RESULTS Two areas were associated with aphasia severity-left posterior insula and left arcuate fasciculus. The results from the Demographic Model revealed non-linguistic cognitive ability, age at stroke, and time post-stroke as significant predictors of severity (P = .005; P = .02; P = .001, respectively), and results from the Health Model suggested the extent of leukoaraiosis is associated with severity (P = .0004). The Overall Model showed a relationship between aphasia severity and cognitive ability (P = .01), time post-stroke (P = .002), and leukoaraiosis (P = .01). In the Final Model, which aimed to predict raw severity scores, demographic, health, and lesion factors explained 55% of the variance in severity, with health and demographic factors uniquely explaining nearly half of performance variance. CONCLUSIONS Results from this study add to the literature suggesting patient-specific variables can shed light on individual differences in severity beyond lesion factors. Additionally, our results emphasize the importance of non-linguistic cognitive ability and brain health in aphasia recovery.
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Affiliation(s)
- Lisa Johnson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA.
| | - Samaneh Nemati
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Leonardo Bonilha
- Department of Neurology, Medical University of South Carolina, Charleston, SC, USA
| | - Chris Rorden
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Natalie Busby
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Alexandra Basilakos
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | | | - Argye E Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Gregory Hickok
- Department of Cognitive Sciences, University of California, Irvine, CA, USA
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
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Spigel D, Spira A, Zamarin D, McDermott DF, Luke J, Heymach JV, Previs R, Sullivan R, Gandhi L, Azrilevich A, Rizvi N, Oft M, Busby N, Izar B. Abstract CT244: A phase 1a/1b study of STK-012, an α/β IL-2 receptor selective partial agonist as monotherapy and in combination with pembrolizumab in advanced solid tumors (NCT05098132). Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-ct244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: High dose intravenous (IV) interleukin-2 (IL-2) induces complete responses in certain cancers, but its use is limited due to toxicities including severe hypotension and capillary leak syndrome (CLS), and the requirement for inpatient administration. Recent approaches to develop IL-2 therapies with an expanded therapeutic index have targeted the dimeric form (β/γ) of the IL-2 receptor, which is predominantly expressed on naïve T cells and NK cells, rather than the high affinity trimeric form (α/β/γ), predominantly expressed on antigen activated T cells and Tregs. Preclinical data support the hypothesis that this “non-α” approach favors activating cells that serve as principal mediators of toxicity (NK cells) over antitumor activity (antigen activated T cells). STK-012 is a pegylated, α/β-IL-2R selective partial agonist engineered to preferentially stimulate antigen-activated CD25+ T cells and avoid systemic NK and naïve T cell activation. In syngeneic tumor models, subcutaneously (SQ) injected STK-012 mouse surrogate demonstrated reduced toxicities and improved efficacy relative to mouse wild-type IL-2 or a non-α IL-2. In cynomolgus monkeys, acute lung inflammation was induced by aldesleukin and non-α-IL-2, but not by STK-012. STK-012 is in development as monotherapy and in combination with pembrolizumab for the treatment of advanced solid tumors.
Methods: This is a first-in-human, open-label, dose escalation and expansion study in adults with advanced solid tumors (NCT05098132). The objectives of this study are to evaluate the safety, pharmacokinetics, immunogenicity, preliminary efficacy, and pharmacodynamics of STK-012 as monotherapy and in combination with pembrolizumab. Dose escalation will follow a standard 3+3 design for STK-012 monotherapy and in combination with pembrolizumab. STK-012 will be dosed SQ weekly, and pembrolizumab will be dosed IV every 3 weeks. Eligible participants for dose escalation include individuals with non-small cell lung cancer, head and neck squamous cell cancer, malignant melanoma, renal cell carcinoma, ovarian cancer, cervical cancer and microsatellite instability-high or mismatch repair deficient cancers who are relapsed/refractory to, intolerant to, or refuse standard of care treatment. Expansion cohorts will enroll participants at selected dose(s) and indications on the basis of dose escalation findings. The primary endpoint of safety includes outcomes such as adverse events and dose-limiting toxicities. Efficacy, a secondary endpoint, will include assessments of tumor response according to RECIST v1.1. Exploratory biomarker assessments will include peripheral and tumor measures of immune cell populations and relevant gene/protein expression. Enrollment in STK-012 monotherapy dose escalation has been initiated.
Citation Format: David Spigel, Alexander Spira, Dmitriy Zamarin, David F. McDermott, Jason Luke, John V. Heymach, Rebecca Previs, Ryan Sullivan, Leena Gandhi, Alex Azrilevich, Naiyer Rizvi, Martin Oft, Natalie Busby, Benjamin Izar. A phase 1a/1b study of STK-012, an α/β IL-2 receptor selective partial agonist as monotherapy and in combination with pembrolizumab in advanced solid tumors (NCT05098132) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr CT244.
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Affiliation(s)
| | | | | | | | - Jason Luke
- 5University of Pittsburgh Medical Center, Pittsbrugh, PA
| | | | | | | | | | | | | | | | | | - Benjamin Izar
- 11Columbia University Irving Medical Center, New York, NY
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Iams W, Kopparapu P, Yan Y, Wong S, Rich T, Dao M, Busby N, Cheng D, Zotenko E, Parsana P, Ju JH, Lovly C. YIA22-003: Quantifying Minimal Residual Disease in Patients With Small Cell Lung Cancer. J Natl Compr Canc Netw 2022. [DOI: 10.6004/jnccn.2021.7145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Wade Iams
- 1 Vanderbilt University Medical Center, Nashville, TN
| | | | - Yingjun Yan
- 1 Vanderbilt University Medical Center, Nashville, TN
| | - Selina Wong
- 1 Vanderbilt University Medical Center, Nashville, TN
| | | | - Mai Dao
- 2 Guardant Health, Redwood City, CA
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Busby N, Halai AD, Parker GJM, Coope DJ, Lambon Ralph MA. Mapping whole brain connectivity changes: The potential impact of different surgical resection approaches for temporal lobe epilepsy. Cortex 2018; 113:1-14. [PMID: 30557759 DOI: 10.1016/j.cortex.2018.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/15/2018] [Accepted: 11/05/2018] [Indexed: 11/16/2022]
Abstract
In neurosurgery there are several situations that require transgression of the temporal cortex. For example, a subset of patients with temporal lobe epilepsy require surgical resection (most typically, en-bloc anterior temporal lobectomy). This procedure is the gold standard to alleviate seizures but is associated with chronic cognitive deficits. In recent years there have been multiple attempts to find the optimum balance between minimising the size of resection in order to preserve cognitive function, while still ensuring seizure freedom. Some attempts involve reducing the distance that the resection stretches back from the temporal pole, whilst others try to preserve one or more of the temporal gyri. More recent advanced surgical techniques (selective amygdalo-hippocamptectomies) try to remove the least amount of tissue by going under (sub-temporal), over (trans-Sylvian) or through the temporal lobe (middle-temporal), which have been related to better cognitive outcomes. Previous comparisons of these surgical techniques focus on comparing seizure freedom or behaviour post-surgery, however there have been no systematic studies showing the effect of surgery on white matter connectivity. The main aim of this study, therefore, was to perform systematic 'pseudo-neurosurgery' based on existing resection methods on healthy neuroimaging data and measuring the effect on long-range connectivity. We use anatomical connectivity maps (ACM) to determine long-range disconnection, which is complementary to existing measures of local integrity such as fractional anisotropy or mean diffusivity. ACMs were generated for each diffusion scan in order to compare whole-brain connectivity with an 'ideal resection', nine anterior temporal lobectomy and three selective approaches. For en-bloc resections, as distance from the temporal pole increased, reduction in connectivity was evident within the arcuate fasciculus, inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, and the uncinate fasciculus. Increasing the height of resections dorsally reduced connectivity within the uncinate fasciculus. Sub-temporal amygdalohippocampectomy resections were associated with connectivity patterns most similar to the 'ideal' baseline resection, compared to trans-Sylvian and middle-temporal approaches. In conclusion, we showed the utility of ACM in assessing long-range disconnections/disruptions during temporal lobe resections, where we identified the sub-temporal resection as the least disruptive to long-range connectivity which may explain its better cognitive outcome. These results have a direct impact on understanding the amount and/or type of cognitive deficit post-surgery, which may not be obtainable using local measures of white matter integrity.
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Affiliation(s)
- Natalie Busby
- Neuroscience and Aphasia Research Unit, Division of Neuroscience and Experimental Psychology, School of Biological Sciences, University of Manchester, UK.
| | - Ajay D Halai
- Neuroscience and Aphasia Research Unit, Division of Neuroscience and Experimental Psychology, School of Biological Sciences, University of Manchester, UK; MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Geoff J M Parker
- Division of Neuroscience and Experimental Psychology, University of Manchester, UK; Bioxydyn Ltd., Manchester, UK
| | - David J Coope
- Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Salford, UK; Wolfson Molecular Imaging Centre, Division of Neuroscience and Experimental Psychology, School of Biological Sciences, University of Manchester, UK
| | - Matthew A Lambon Ralph
- Neuroscience and Aphasia Research Unit, Division of Neuroscience and Experimental Psychology, School of Biological Sciences, University of Manchester, UK; MRC Cognition and Brain Sciences Unit, University of Cambridge, UK.
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21
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Tarawneh G, Nityananda V, Rosner R, Errington S, Herbert W, Arranz-Paraíso S, Busby N, Tampin J, Read J, Serrano-Pedraza I. Contrast thresholds reveal different visual masking functions in humans and praying mantises. Biol Open 2018; 7:7/4/bio029439. [PMID: 29700198 PMCID: PMC5936055 DOI: 10.1242/bio.029439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Recently, we showed a novel property of the Hassenstein–Reichardt detector, namely that insect motion detection can be masked by ‘undetectable’ noise, i.e. visual noise presented at spatial frequencies at which coherently moving gratings do not elicit a response (Tarawneh et al., 2017). That study compared the responses of human and insect motion detectors using different ways of quantifying masking (contrast threshold in humans and masking tuning function in insects). In addition, some adjustments in experimental procedure, such as presenting the stimulus at a short viewing distance, were necessary to elicit a response in insects. These differences offer alternative explanations for the observed difference between human and insect responses to visual motion noise. Here, we report the results of new masking experiments in which we test whether differences in experimental paradigm and stimulus presentation between humans and insects can account for the undetectable noise effect reported earlier. We obtained contrast thresholds at two signal and two noise frequencies in both humans and praying mantises (Sphodromantis lineola), and compared contrast threshold differences when noise has the same versus different spatial frequency as the signal. Furthermore, we investigated whether differences in viewing geometry had any qualitative impact on the results. Consistent with our earlier finding, differences in contrast threshold show that visual noise masks much more effectively when presented at signal spatial frequency in humans (compared to a lower or higher spatial frequency), while in insects, noise is roughly equivalently effective when presented at either the signal spatial frequency or lower (compared to a higher spatial frequency). The characteristic difference between human and insect responses was unaffected by correcting for the stimulus distortion caused by short viewing distances in insects. These findings constitute stronger evidence that the undetectable noise effect reported earlier is a genuine difference between human and insect motion processing, and not an artefact caused by differences in experimental paradigms. Summary: We investigate alternative explanations for a reported difference between human and insect responses to masked moving gratings, and demonstrate that it is a genuine feature of their visual systems.
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Affiliation(s)
- Ghaith Tarawneh
- Institute of Neuroscience, Henry Wellcome Building for Neuroecology, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4HH, UK
| | - Vivek Nityananda
- Institute of Neuroscience, Henry Wellcome Building for Neuroecology, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4HH, UK
| | - Ronny Rosner
- Institute of Neuroscience, Henry Wellcome Building for Neuroecology, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4HH, UK
| | - Steven Errington
- Institute of Neuroscience, Henry Wellcome Building for Neuroecology, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4HH, UK
| | - William Herbert
- Institute of Neuroscience, Henry Wellcome Building for Neuroecology, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4HH, UK
| | | | - Natalie Busby
- Institute of Neuroscience, Henry Wellcome Building for Neuroecology, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4HH, UK
| | - Jimmy Tampin
- Institute of Neuroscience, Henry Wellcome Building for Neuroecology, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4HH, UK
| | - Jenny Read
- Institute of Neuroscience, Henry Wellcome Building for Neuroecology, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4HH, UK
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Read J, Busby N, Herbert W, Arranz-Paraíso S, Jones L, Nityananda V, Tarawneh G, Serrano-Pedraza I. Motion encoding in human being and praying mantis investigated with a masking paradigm. J Vis 2015. [DOI: 10.1167/15.12.483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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23
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Naidoo J, Sima CS, Rodriguez K, Busby N, Nafa K, Ladanyi M, Riely GJ, Kris MG, Arcila ME, Yu HA. Epidermal growth factor receptor exon 20 insertions in advanced lung adenocarcinomas: Clinical outcomes and response to erlotinib. Cancer 2015; 121:3212-3220. [PMID: 26096453 DOI: 10.1002/cncr.29493] [Citation(s) in RCA: 147] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 04/28/2015] [Accepted: 04/30/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Epidermal growth factor receptor (EGFR) exon 20 insertions (exon20ins) represent approximately 10% of EGFR-mutant lung adenocarcinomas, and are associated with resistance to EGFR tyrosine kinase inhibitors (TKIs). Clinical outcomes in comparison with patients with sensitizing EGFR mutations are not well established. METHODS Patients with stage IV lung adenocarcinomas with EGFR exon20ins were identified through routine molecular testing. Clinicopathologic data were collected. Overall survival (OS) was measured from the diagnosis of stage IV disease, and in patients treated with EGFR TKIs, the time to progression (TTP) on erlotinib was measured. RESULTS One thousand eight hundred and eighty-two patients with stage IV lung adenocarcinomas were identified: 46 patients had EGFR exon20ins (2%), and 258 patients had an EGFR exon 19 deletion (exon19del)/L858R point mutation (14%). Among 11 patients with lung adenocarcinomas with EGFR exon20ins who received erlotinib, 3 patients (27%) had a partial response (FQEA, 1; ASV, 1; and unknown variant, 1). TTP for patients with EGFR exon20ins and patients with EGFR exon19del/L858R on erlotinib were 3 and 12 months, respectively (P < .01). Responses to chemotherapy were similar for patients with lung adenocarcinomas with EGFR exon20ins and patients with lung adenocarcinomas with EGFR exon19del/L858R. Median OS from the diagnosis of stage IV disease for patients with EGFR exon20ins and patients with EGFR exon19del/L858R was 26 months (95% confidence interval, 19 months-not reached n = 46) and 31 months (95% confidence interval, 28-33 months; n = 258), respectively (P = .53). CONCLUSIONS The majority of patients with advanced lung adenocarcinomas harboring EGFR exon20ins do not respond to EGFR TKI therapy. Standard chemotherapy should be used as first-line therapy. These patients have an OS similar to that of patients with sensitizing EGFR mutations. Individuals with certain variants such as FQEA and ASV may respond to erlotinib.
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Nityananda V, Tarawneh G, Jones L, Busby N, Herbert W, Davies R, Read JCA. The contrast sensitivity function of the praying mantis Sphodromantis lineola. J Comp Physiol A Neuroethol Sens Neural Behav Physiol 2015; 201:741-50. [PMID: 25894490 PMCID: PMC4510923 DOI: 10.1007/s00359-015-1008-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 03/25/2015] [Accepted: 03/30/2015] [Indexed: 12/02/2022]
Abstract
The detection of visual motion and its direction is a fundamental task faced by several visual systems. The motion detection system of insects has been widely studied with the majority of studies focussing on flies and bees. Here we characterize the contrast sensitivity of motion detection in the praying mantis Sphodromantis lineola, an ambush predator that stays stationary for long periods of time while preying on fast-moving prey. In this, its visual behaviour differs from previously studied insects and we might therefore expect its motion detection system to differ from theirs. To investigate the sensitivity of the mantis we analyzed its optomotor response in response to drifting gratings with different contrasts and spatio-temporal frequencies. We find that the contrast sensitivity of the mantis depends on the spatial and temporal frequencies present in the stimulus and is separably tuned to spatial and temporal frequency rather than specifically to object velocity. Our results also suggest that mantises are sensitive to a broad range of velocities, in which they differ from bees and are more similar to hoverflies. We discuss our results in relation to the contrast sensitivities of other insects and the visual ecology of the mantis.
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Affiliation(s)
- Vivek Nityananda
- Institute of Neuroscience, Henry Wellcome Building for Neuroecology, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK,
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Yu HA, Sima CS, Hellmann MD, Naidoo J, Busby N, Rodriguez K, Riely GJ, Kris MG. Differences in the survival of patients with recurrent versus de novo metastatic KRAS-mutant and EGFR-mutant lung adenocarcinomas. Cancer 2015; 121:2078-82. [PMID: 25781862 DOI: 10.1002/cncr.29313] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 02/04/2015] [Accepted: 02/04/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND Prognostic variables are independently associated with survival and are fundamental to clinical trial design. In the current study, the authors evaluated the impact of stage of disease at the time of the initial diagnosis on overall survival (OS) in 2 independent, oncogene-defined cohorts. METHODS All patients with epidermal growth factor receptor (EGFR)-mutant and KRAS-mutant metastatic lung adenocarcinomas were identified through routine molecular testing from January 2005 through January 2011. Clinical characteristics were obtained. OS from the date of diagnosis of recurrent or de novo metastatic disease was estimated using the Kaplan-Meier method. RESULTS A total of 635 patients with KRAS-mutant and 496 patients with EGFR-mutant metastatic lung adenocarcinomas were identified. Among patients with KRAS-mutant lung adenocarcinomas, those with de novo metastatic disease were found to have a shorter median OS compared with those with recurrent metastatic disease (13 months vs 18 months; P = .003). In a multivariable analysis of patients with KRAS-mutant lung adenocarcinomas, de novo metastatic disease at the time of diagnosis (TNM stage IV vs stage I-III: hazard ratio, 1.5 [95% confidence interval, 1.2-1.8]; P<.001) was independently associated with shorter OS. In patients with EGFR-mutant lung adenocarcinomas, after controlling for age and Karnofsky performance status, de novo metastatic disease at the time of diagnosis (stage IV vs stage I-III: hazard ratio, 1.3 [95% confidence interval, 1.0-1.7]; P = .03) was found to be independently associated with shorter OS. CONCLUSIONS Among patients with KRAS-mutant lung adenocarcinomas, stage of disease at diagnosis was associated with OS from the time of diagnosis of recurrent/metastatic disease. In multivariable analyses, in both patients with EGFR-mutant and KRAS-mutant lung adenocarcinomas, advanced stage at the time of diagnosis was found to be independently associated with shorter survival. Stage at diagnosis is a prognostic variable that should be accounted for in prospective studies in patients with metastatic lung adenocarcinomas.
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Affiliation(s)
- Helena A Yu
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Camelia S Sima
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Matthew D Hellmann
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Jarushka Naidoo
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Natalie Busby
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Katherine Rodriguez
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Gregory J Riely
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Mark G Kris
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Medicine, Weill Cornell Medical College, New York, New York
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Yu H, Gutierrez M, Riely G, Graham D, Busby N, Hinson J, Orlemons E. A Phase Ib Dose-Escalation Study of the Hsp90 Inhibitor Snx-5422 and Erlotinib in Patients with Egfr-Mutant Lung Cancer and Acquired Resistance to Egfr Tyrosine Kinase Inhibitors. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu349.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Yu HA, Hellmann MD, Sima CS, Busby N, Rodriguez K, Riely GJ, Kris MG. Stage at diagnosis as a prognostic marker for patients with KRAS-mutant metastatic lung adenocarcinomas. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.8111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | - Natalie Busby
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | - Mark G. Kris
- Memorial Sloan Kettering Cancer Center, New York, NY
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Francke U, Busby N, Shaw D, Hansen S, Brown MG. Assignment of the nucleoside phosphorylase (NP) gene locus to region 14pter leads to 14q21. Cytogenet Cell Genet 1976; 16:135-7. [PMID: 824099 DOI: 10.1159/000130574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Busby N, Courval J, Francke U. Regional assignments of the genes for fumarate hydratase and guanylate kinase on chromosome 1 and for lysosomal acid phosphatase and esterase A4 on chromosome 11. Cytogenet Genome Res 1976; 16:105-7. [PMID: 185008 DOI: 10.1159/000130565] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Francke U, Busby N, Shaw D, Hansen S, Brown MG. Intrachromosomal gene mapping in man: assignment of nucleoside phosphorylase to region 14cen leads to 14q21 by interspecific hybridization of cells with a t(X;14) (p22;q21) translocation. Somatic Cell Genet 1976; 2:27-40. [PMID: 829289 DOI: 10.1007/bf01539240] [Citation(s) in RCA: 68] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The structural gene for purine-nucleoside phosphorylase (NP) has been assigned to a subregion of chromosome 14 by somatic cell hybridization of male and female cells containing the balanced translocation t(X;14) (p22;q21). Peripheral lymphocytes were fused to a pseudodiploid HPRT-deficient established Chinese hamster cell line. 23 primary hybrid clones (10 derived from male and 13 from female cells) were isolated and maintained in HAT selective medium. Parallel subcultures from generations 16, 24, and 40 after clonal isolation were fully karyotyped and analyzed electrophorectically for expression of the human types of NP, HPRT, G6PD, and PGK. The human NP phenotype segregated discordantly with each human chromosome except chromosome 14 and the der(14),t(X;14) translocation chromosome. In all, 8 hybrids which had retained the der(X), t(X;14) translocation chromosome under HAT selective pressure and expressed human HPRT had lost the human NP phenotype. These results indicate localization of the NP gene in region 14pter leads to 14q21.
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Francke U, Busby N. Assignments of the human genes for lactate dehydrogenase-A and thymidine kinase to specific chromosomal regions. Cytogenet Cell Genet 1975; 14:313-9. [PMID: 1192784 DOI: 10.1159/000130371] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Busby N. Segregation following interchange induced by irradiating mature oocytes of Drosophila melanogaster. Mutat Res 1971; 11:391-6. [PMID: 5000017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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