Latent disconnectome prediction of long-term cognitive-behavioural symptoms in stroke

Brain, Journal Year: 2023, Volume and Issue: 146(5), P. 1963 - 1978

Published: March 16, 2023

Abstract Stroke significantly impacts the quality of life. However, long-term cognitive evolution in stroke is poorly predictable at individual level. There an urgent need to better predict symptoms based on acute clinical neuroimaging data. Previous works have demonstrated a strong relationship between location white matter disconnections and symptoms. rendering entire space possible disconnection-deficit associations optimally surveyable will allow for systematic association brain cognitive-behavioural measures Here we present most comprehensive framework, composite morphospace (disconnectome) neuropsychological scores 1 year after stroke. Linking latent disconnectome outcomes yields biological insights that are available as first atlas disconnectome-deficit relations across 86 scores—a Neuropsychological White Matter Atlas. Our novel predictive Disconnectome Symptoms Discoverer, achieved predictivity performances than six other models, including functional disconnection, lesion topology volume modelling. Out-of-sample prediction derived from this presented mean absolute error below 20% allowed personalize predictions. Prediction external cohort R2 = 0.201 semantic fluency. In addition, training testing were replicated two cohorts achieving 0.18 visuospatial performance. This framework interactive web application (http://disconnectomestudio.bcblab.com) provide foundations new practical approach modelling cognition We hope our help reduce burden deficits patients, their families wider society while also helping tailor future personalized treatment programmes discover targets treatments. expect framework’s range assessments power increase even further through crowdsourcing.

Language: Английский

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Dissecting white matter pathways: A neuroanatomical approach

Elsevier eBooks, Journal Year: 2025, Volume and Issue: unknown, P. 397 - 421

Published: Jan. 1, 2025

Language: Английский

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Predicting functional impairments with lesion‐derived disconnectome mapping: Validation in stroke patients with motor deficits

European Journal of Neuroscience, Journal Year: 2024, Volume and Issue: 59(11), P. 3074 - 3092

Published: April 5, 2024

Focal structural damage to white matter tracts can result in functional deficits stroke patients. Traditional voxel-based lesion-symptom mapping is commonly used localize brain structures linked neurological deficits. Emerging evidence suggests that the impact of focal may extend beyond immediate lesion sites. In this study, we present a disconnectome approach based on support vector regression (SVR) identify and pathways associated with For clinical validation, utilized imaging data from 340 patients exhibiting motor A map was initially derived lesions for each patient. Bootstrap sampling then employed balance sample size between minority group right or left those without Subsequently, SVR analysis voxels (p < .005). Our disconnectome-based significantly outperformed alternative approaches identifying major within corticospinal upper-lower limb Bootstrapping increased sensitivity (80%-87%) deficits, minimum 32 235 mm

Language: Английский

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Using mechanistic knowledge to appraise contemporary approaches to the rehabilitation of upper limb function following stroke

The Journal of Physiology, Journal Year: 2024, Volume and Issue: 603(3), P. 635 - 650

Published: Aug. 11, 2024

It is a paradox of neurological rehabilitation that, in an era which preclinical models have produced significant advances our mechanistic understanding neural plasticity, there inadequate support for many therapies recommended use clinical practice. When the goal to estimate probability that specific form therapy will positive effect, integration knowledge (concerning 'the structure or way working parts natural system') may improve quality inference. This illustrated by analysis three contemporary approaches lateralized dysfunction affecting people living with stroke: constraint-induced movement therapy; mental practice; and mirror therapy. Damage 'cross-road' regions structural (white matter) brain connectome generates deficits span multiple domains (motor, language, attention verbal/spatial memory). The integrity these determines not only initial functional status, but also response As disconnection constrains recovery capability, 'disconnectome' modelling provides basis personalized prognosis precision rehabilitation. now feasible refer lesion delineated using standard scan (dis)connectivity atlas derived from brains other stroke survivors. individual pattern thus obtained suggests most likely be compromised, therapeutic regimen can tailored accordingly. Stroke complex disorder burdens individuals distinct constellations damage. Mechanistic indispensable when seeking ameliorate behavioural impairments such damage gives rise.

Language: Английский

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Electroencephalogram Features Reflect Effort Corresponding to Graded Finger Extension: Implications for Hemiparetic Stroke

Biomedical Physics & Engineering Express, Journal Year: 2025, Volume and Issue: 11(2), P. 025022 - 025022

Published: Jan. 20, 2025

Brain-computer interfaces (BCIs) offer disabled individuals the means to interact with devices by decoding electroencephalogram (EEG). However, intent in fine motor tasks can be challenging, especially stroke survivors cortical lesions. Here, we attempt decode graded finger extension from EEG patients left-hand paresis and healthy controls. Participants extended their fingers one of four levels: low, medium, high, or 'no-go' (none), while hand, muscle (electromyography: EMG), brain (EEG) activity were monitored. Event-related desynchronization (ERD) was measured as change 8-30 Hz power during movement. Classifiers trained on features, EMG power, both (EEG+EMG) extension, accuracy assessed via four-fold cross-validation for each hand participant. Mean exceeded chance (25%) controls (n = 11) at 62% EMG, 60% EEG, 71% EEG+EMG left hand; 67%, 60%, 74%, respectively, right hand. Accuracies similar unimpaired group 3): 61%, 68%, 78%, respectively. But paretic only discriminated no-go movement above (41%); contrast, gave 65% (68% EEG+EMG), comparable non-paretic The median ERD significant (p < 0.01) over area groups increased level extension. favored hemisphere contralateral active expected, it ipsilateral due lesion hemisphere, which may explain its discriminative ability. Hence, captures effort regardless success failure task; harnessing residual improves correlation. This marker could leveraged rehabilitative protocols that focus control.

Language: Английский

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Preserved Corticospinal Tract Revealed by Acute Perfusion Imaging Relates to Better Outcome After Thrombectomy in Stroke

Stroke, Journal Year: 2023, Volume and Issue: 54(12), P. 3081 - 3089

Published: Nov. 27, 2023

The indication for mechanical thrombectomy (MT) in stroke patients with large vessel occlusion has been constantly expanded over the past years. Despite remarkable treatment effects at group level clinical trials, many remain severely disabled even after successful recanalization. A better understanding of this outcome variability will help to improve decision-making on MT acute stage. Here, we test whether current models can be refined by integrating information preservation corticospinal tract as a functionally crucial white matter derived from perfusion imaging. We retrospectively analyzed 162 and anterior circulation who were admitted University Medical Center Lübeck between 2014 2020 underwent MT. ischemic core was defined fully automatized based computed tomography cerebral blood volume data using outlier detection clustering algorithms. Normative whole-brain structural connectivity used infer affected or preserved. Ordinal logistic regression correlate modified Rankin Scale 90 days. associated reduced risk worse functional occlusion-stroke undergoing MT, an odds ratio 0.28 (95% CI, 0.15-0.53). This association still significant adjusting multiple confounding covariables, such age, lesion load, initial symptom severity, sex, side, recanalization status. preinterventional perfusion-based surrogate disconnectivity is strongly outcomes If validated independent samples concept could serve novel tool understand intersubject stroke.

Language: Английский

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Force/position-based velocity control strategy for the lower limb rehabilitation robot during active training: design and validation

Frontiers in Bioengineering and Biotechnology, Journal Year: 2024, Volume and Issue: 11

Published: Jan. 8, 2024

Aiming at the shortcomings of most existing control strategies for lower limb rehabilitation robots that are difficult to guarantee trajectory tracking effect and active participation patient, this paper proposes a force/position-based velocity (FPVC) strategy hybrid end-effector robot (HE-LRR) during training. The configuration HE-LRR is described inverse Jacobian analysis carried out. Then, FPVC design introduced in detail, including normal planning tangential planning. experimental platform system presented. A series experiments conducted validate strategy’s performance, measurement experiments, force experiments. Experimental studies show end effector possesses good following performance with reference desired velocity, subjects can be adjusted by parameters. have verified rationality strategy, which meet requirements participation, indicating its application prospects patient’s robot-assisted

Language: Английский

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White matter tract disconnection in Gerstmann's syndrome: Insights from a single case study

Cortex, Journal Year: 2023, Volume and Issue: 166, P. 322 - 337

Published: July 11, 2023

It has been suggested that Gerstmann's syndrome is the result of subcortical disconnection rather than emerging from damage a multifunctional brain region within parietal lobe. However, patterns white matter tract following have barely investigated. This single case study allows characterising in terms disconnected networks. We report left patient affected by tetrad: agraphia, acalculia, left/right orientation problems, and finger agnosia. Lesion mapping, atlas-based estimation probability disconnection, DTI-based tractography revealed lesion was mainly located superior lobule, it caused disruption both intraparietal tracts passing through inferior lobule (e.g., connecting angular, supramarginal, postcentral gyri, lobule) fronto-parietal long longitudinal fasciculus). The site appears to be more superiorly as compared cerebral regions shown active other studies during tasks impaired syndrome, reached area potentially critical emergence hypothesised previous studies. Importantly, reconstruction lobe indicates this crossed angular gyrus lobule. Taken together, these findings suggest might considered empirical evidence tetrad tracts.

Language: Английский

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Are we ready to cure post-stroke cognitive impairment? Many key prerequisites can be achieved quickly and easily

European Stroke Journal, Journal Year: 2024, Volume and Issue: unknown

Published: Aug. 11, 2024

Post-stroke (PS) cognitive impairment (CI) is frequent and its devastating functional vital consequences are well known. Despite recent guidelines, they still largely neglected. A large number of studies have re-examined the epidemiology, diagnosis, imaging determinants management PSCI. The aim this update to determine whether these new data answer questions that essential reducing PSCI, unmet needs, steps be taken.

Language: Английский

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Breaking the ice through an effective translationality in neurorehabilitation: are we heading to the right direction?

Expert Review of Medical Devices, Journal Year: 2024, Volume and Issue: unknown, P. 1 - 8

Published: Oct. 23, 2024

Introduction Translational medicine has been facing a persistent crisis for decades, and the field of neurorehabilitation is no exception. The challenges delays that prevent patients, caregivers, clinicians from promptly benefiting advancements in bioengineering new technological discoveries are well-documented.

Language: Английский

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