Post-stroke deficit prediction from lesion and indirect structural and functional disconnection

Brain, Journal Year: 2020, Volume and Issue: 143(7), P. 2173 - 2188

Published: May 21, 2020

Abstract Behavioural deficits in stroke reflect both structural damage at the site of injury, and widespread network dysfunction caused by structural, functional, metabolic disconnection. Two recent methods allow for estimation functional disconnection from clinical imaging. This is achieved embedding a patient’s lesion into an atlas connections healthy subjects, deriving ensemble that pass through lesion, thus indirectly estimating its impact on whole brain connectome. indirect assessment more readily available than direct measures connectivity obtained with diffusion MRI, respectively, it theory applicable to wide variety disorders. To validate relevance these methods, we quantified prediction behavioural prospective cohort 132 first-time patients studied 2 weeks post-injury (mean age 52.8 years, range 22–77; 63 females; 64 right hemispheres). Specifically, used multivariate ridge regression relate multiple domains (left visual, left motor, language, spatial attention, verbal memory) pattern or In subgroup patients, also measured alterations resting-state MRI. Both maps were predictive impairment all (0.16 < R2 0.58) except memory (0.05 0.06). Prediction was scarce negligible (0.01 0.18) visual field (R2 = 0.38), even though anatomically plausible domains. MRI subset clearly superior conclusion, successfully predicted post-stroke level comparable information. However, did not predict deficits, nor substitute measurements, especially cognitive

Language: Английский

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Improved accuracy of lesion to symptom mapping with multivariate sparse canonical correlations

Neuropsychologia, Journal Year: 2017, Volume and Issue: 115, P. 154 - 166

Published: Sept. 5, 2017

Language: Английский

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Neuroplasticity of Language Networks in Aphasia: Advances, Updates, and Future Challenges

Frontiers in Neurology, Journal Year: 2019, Volume and Issue: 10

Published: April 2, 2019

Researchers have sought to understand how language is processed in the brain, brain damage affects abilities, and what can be expected during recovery period since early 19th century. In this review, we first discuss mechanisms of plasticity post-stroke both acute chronic phase recovery. We then review factors that are associated with First, organism intrinsic variables such as age, lesion volume location structural integrity influence Next, extrinsic treatment Here, recent advances our understanding highlight work emphasizes a network perspective Finally, propose interpretation principles neuroplasticity, originally proposed by Kleim Jones (2008) context extant literature aphasia rehabilitation. Ultimately, encourage researchers sophisticated intervention studies bring us closer goal providing precision for patients better neural underlie successful neuroplasticity.

Language: Английский

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Lesion Quantification Toolkit: A MATLAB software tool for estimating grey matter damage and white matter disconnections in patients with focal brain lesions

NeuroImage Clinical, Journal Year: 2021, Volume and Issue: 30, P. 102639 - 102639

Published: Jan. 1, 2021

Lesion studies are an important tool for cognitive neuroscientists and neurologists. However, while brain lesion have traditionally aimed to localize neurological symptoms specific anatomical loci, a growing body of evidence indicates that diseases such as stroke best conceptualized network disorders. While researchers in the fields neuroscience neurology therefore increasingly interested quantifying effects focal lesions on white matter connections form brain's structural connectome, few dedicated tools exist facilitate this endeavor. Here, we present Quantification Toolkit, publicly available MATLAB software package impacts lesions. The Toolkit uses atlas-based approaches estimate parcel-level grey loads multiple measures disconnection severity include tract-level measures, voxel-wise maps, parcel-wise matrices. toolkit also estimates lesion-induced increases lengths shortest paths between parcel pairs, which provide information about changes higher-order topology. We describe detail each different produced by toolkit, discuss their applications considerations relevant use, perform example analyses using real behavioral data collected from sub-acute patients. show performed produce results highly consistent with been reported prior literature, demonstrate consistency obtained conducted toolkit. anticipate will empower address research questions would be difficult or impossible traditional alone, ultimately, lead advances our understanding how disconnections contribute cognitive, behavioral, physiological consequences

Language: Английский

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Electroacupuncture combined with cognitive rehabilitation outperforms cognitive rehabilitation alone in treating post-stroke cognitive impairment: a randomized controlled trial

Frontiers in Neurology, Journal Year: 2025, Volume and Issue: 16

Published: Jan. 29, 2025

This study aimed to evaluate the effects of a 12-week intervention combining electroacupuncture (EA) with conventional cognitive rehabilitation (CR) on recovery and brain network topological properties in stroke patients. Thirty-four post-stroke impairment (PSCI) patients were randomly assigned either an EA + CR group or CR-only group, both undergoing five weekly interventions for 12 weeks. Cognitive assessments Diffusion Tensor Imaging tests performed pre- post-intervention. Primary outcomes included Montreal Assessment (MoCA), Digit Span Test (DST), Auditory Verbal Learning (AVLT-H), Aphasia Screening Scale. Secondary measured global nodal properties. The showed significant improvements MoCA ( p < 0.001), AVLT-H = 0.004), areas like naming 0.022), attention delayed recall 0.001). Local metrics, such as clustering coefficients (Cp) local efficiency (Eloc), significantly higher 0.05) though (Eglob) was unchanged. Improvements Eloc positively correlated scores r 0.0716, 0.018). Specific regions, including medial paracentral cingulate gyrus, inferior temporal left supramarginal exhibited property differences, suggesting that may enhance by targeting cognitively relevant regions. These findings indicate EA, combined CR, is safe effective treatment following stroke, potentially via structural improvements. Clinical trial registration https://clinicaltrials.gov/ , ChiCTR2200066160.

Language: Английский

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The neural and neurocomputational bases of recovery from post-stroke aphasia

Nature Reviews Neurology, Journal Year: 2019, Volume and Issue: 16(1), P. 43 - 55

Published: Nov. 26, 2019

Language: Английский

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Damage to Broca’s area does not contribute to long-term speech production outcome after stroke

Brain, Journal Year: 2020, Volume and Issue: 144(3), P. 817 - 832

Published: Dec. 28, 2020

Abstract Broca’s area in the posterior half of left inferior frontal gyrus has long been thought to be critical for speech production. The current view is that long-term production outcome patients with damage best explained by combination and neighbouring regions including underlying white matter, which was also damaged Paul two historic cases. Here, we dissociate effect from surrounding areas studying 134 stroke survivors relatively circumscribed lobe lesions spared lateral parietal superior temporal association cortices. Collectively, these had varying degrees one or more nine atlas-based grey matter regions: Brodmann 44 45 (together known as area), ventral premotor cortex, primary motor insula, putamen, anterior segment arcuate fasciculus, uncinate fasciculus aslant tract. Spoken picture description scores Comprehensive Aphasia Test were used measure. Multiple regression analyses allowed us tease apart contribution other variables influencing abilities such total lesion volume time post-stroke. We found that, our sample damage, impairments (lasting beyond 3 months post-stroke) solely predicted degree directly above vicinity part no (as confirmed Bayesian statistics). cannot a disconnection area, because worse after relative sparing than fasciculus. Our findings provide evidence three novel conclusions: (i) does not contribute strokes; (ii) persistent area; (iii) prior between can co-occurring

Language: Английский

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Connectome-based lesion-symptom mapping (CLSM): A novel approach to map neurological function

NeuroImage Clinical, Journal Year: 2017, Volume and Issue: 16, P. 461 - 467

Published: Jan. 1, 2017

Lesion-symptom mapping is a key tool in understanding the relationship between structure and function neuroscience as it can provide objective evidence about which regions are crucial for given process. Initial limitations with this approach were largely overcome by voxel-based lesion-symptom (VLSM), method introduced early 2000s, allows whole-brain to study association damaged areas behavioral impairment applying an independent statistical test at every voxel. By doing so, technique eliminated need predefine of interest or classify patients into groups based on arbitrary cutoff scores. VLSM has nonetheless its own limitations; chiefly, bias towards recognizing cortical necrosis/gliosis but poor sensitivity detecting injury along long white matter tracts, thus ignoring disconnection, per se lead impairment. Here, we propose complementary that, instead, establishes strength connections all brain (as defined standard atlas) array performance seen injury: connectome-based (CLSM). Whole-brain CLSM therefore potential identify behavior independently priori assumptions applicability across broad spectrum neurological psychiatric diseases. We that further our brain-structure relationships worth exploring clinical theoretical contexts.

Language: Английский

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Damage to white matter bottlenecks contributes to language impairments after left hemispheric stroke

NeuroImage Clinical, Journal Year: 2017, Volume and Issue: 14, P. 552 - 565

Published: Jan. 1, 2017

Damage to the white matter underlying left posterior temporal lobe leads deficits in multiple language functions. The may correspond a bottleneck where both dorsal and ventral pathways are vulnerable simultaneous damage. second putative deep prefrontal involving projections associated with thalamo-cortical has recently been proposed as source of semantic after stroke. Here, we first used atlases identify previously described bottlenecks matter. We then assessed effects damage each region on measures verbal fluency, picture naming, auditory decision-making 43 chronic hemispheric stroke patients. predicted all tasks, while anterior only significantly fluency. Importantly, regions were not attributable lesion volume, loads tracts traversing bottlenecks, or nearby cortical areas. Multivariate lesion-symptom mapping revealed additional predictors deficits. Post-hoc fiber tracking peak using publicly available tractography atlas evidence consistent results analyses. Together, our provide support for proposal that spatially specific affecting regions, particularly lobe, contributes This reflect disruption signaling processing streams.

Language: Английский

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Cortical and structural‐connectivity damage correlated with impaired syntactic processing in aphasia

Human Brain Mapping, Journal Year: 2019, Volume and Issue: 40(7), P. 2153 - 2173

Published: Jan. 22, 2019

Agrammatism in aphasia is not a homogeneous syndrome, but characterization of nonuniform set language behaviors which grammatical markers and complex syntactic structures are omitted, simplified, or misinterpreted. In sample 71 left-hemisphere stroke survivors, processing was quantified with the Northwestern Assessment Verbs Sentences (NAVS). Classification analyses were used to assess relation between NAVS performance morphosyntactically reduced speech picture descriptions. Voxel-based connectivity-based lesion-symptom mapping applied investigate neural correlates impaired processing. Despite nonrandom correspondence morphosyntactic production deficits, there variation individual patterns Morphosyntactically predicted by lesions inferior frontal cortex. Impaired verb argument structure damage posterior superior temporal angular gyrus, as well ventral pathway Damage this also predictive sentence comprehension production, particularly noncanonical sentences. Although agrammatic primarily cortex, other aspects rely rather on regional integrity temporoparietal cortex stream.

Language: Английский

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