Post-Stroke Cognitive Impairment and Dementia

Circulation Research, Journal Year: 2022, Volume and Issue: 130(8), P. 1252 - 1271

Published: April 14, 2022

Poststroke cognitive impairment and dementia (PSCID) is a major source of morbidity mortality after stroke worldwide. PSCID occurs as consequence ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage. Cognitive manifesting clinical categorized vascular even in people with comorbid neurodegenerative pathology, which common elderly individuals can contribute to the expression PSCID. Manifestations cerebral small vessel disease, such covert brain infarcts, white matter lesions, microbleeds, cortical microinfarcts, are also patients likewise outcomes. Although studies historically varied approach timing methods diagnosis, most them demonstrate that older age, lower educational status, socioeconomic disparities, premorbid functional decline, life-course exposure risk factors, history prior increase Stroke characteristics, particular severity, lesion volume, location, multiplicity recurrence, influence risk. Understanding complex interaction between an acute event preexisting pathology remains priority will be critical for developing strategies personalized prediction, prevention, targeted interventions, rehabilitation. Current challenges field relate lack harmonization definition classification PSCID, approaches neurocognitive assessment, duration follow-up stroke. However, evolving knowledge on pathophysiology, neuroimaging, biomarkers offers potential applications may inform trials. Preventing cornerstone any strategy achieve optimal health. We summarize recent developments discuss future directions closing call action systematically include outcome assessment into poststroke outcome.

Language: Английский

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Brain disconnections link structural connectivity with function and behaviour

Nature Communications, Journal Year: 2020, Volume and Issue: 11(1)

Published: Oct. 9, 2020

Abstract Brain lesions do not just disable but also disconnect brain areas, which once deprived of their input or output, can no longer subserve behaviour and cognition. The role white matter connections has remained an open question for the past 250 years. Based on 1333 stroke lesions, here we reveal human Disconnectome demonstrate its relationship to functional segregation brain. Results indicate that territories are only defined by connections, highly stereotyped spatial distribution disconnections. While former granted us possibility map 590 functions whole brain, latter compels a revision taxonomy functions. Overall, our freely available Atlas White Matter Function will enable improved clinical-neuroanatomical predictions lesion studies provide platform explorations in domain

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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Post-stroke outcomes predicted from multivariate lesion-behaviour and lesion network mapping

Brain, Journal Year: 2022, Volume and Issue: 145(4), P. 1338 - 1353

Published: Jan. 10, 2022

Abstract Clinicians and scientists alike have long sought to predict the course severity of chronic post-stroke cognitive motor outcomes, as ability do so would inform treatment rehabilitation strategies. However, it remains difficult make accurate predictions about outcomes due, in large part, high inter-individual variability recovery a reliance on clinical heuristics rather than empirical methods. The neuroanatomical location stroke is key variable associated with long-term because lesion can be derived from routinely collected neuroimaging data there an opportunity use this information empirically based deficits. For example, compared statistically weighted multivariate lesion-behaviour maps regions that, when damaged, are specific deficits aggregated outcome cohorts. Here, our goal was evaluate whether we leverage two cohorts individuals focal brain lesions 12-month independent sample patients. Further, evaluated could augment these by estimating structural functional networks disrupted association each map through network mapping, which normative connectivity neurologically healthy elucidate lesion-associated networks. We using anatomical strongest impairment for results. These peak regional findings became ‘seeds’ generate networks, approach that offers potentially greater precision previously used single-lesion approaches. Next, sample, quantified overlap mapping how much variance explain behavioural latent growth curve statistical model. found lesion-deficit modality able significant amount outcomes. Both were beyond mapping. Functional performed best prediction language deficits, Altogether, results support notion combined improve at 12-months.

Language: Английский

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Population-based tract-to-region connectome of the human brain and its hierarchical topology

Nature Communications, Journal Year: 2022, Volume and Issue: 13(1)

Published: Aug. 22, 2022

Abstract Connectome maps region-to-region connectivities but does not inform which white matter pathways form the connections. Here we constructed a population-based tract-to-region connectome to fill this information gap. The quantifies population probability of tract innervating cortical region. results show that ~85% entries are consistent across individuals, whereas remaining (~15%) have substantial individual differences requiring individualized mapping. Further hierarchical clustering on regions revealed dorsal, ventral, and limbic networks based connective patterns. bundles categorization fiber bundle systems in association pathways. This provides insights into topology between bundles. derived relation further offers gray structures.

Language: Английский

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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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Combining brain perturbation and neuroimaging in non-human primates

NeuroImage, Journal Year: 2021, Volume and Issue: 235, P. 118017 - 118017

Published: March 29, 2021

Brain perturbation studies allow detailed causal inferences of behavioral and neural processes. Because the combination brain methods measurement techniques is inherently challenging, research in humans has predominantly focused on non-invasive, indirect perturbations, or neurological lesion studies. Non-human primates have been indispensable as a neurobiological system that highly similar to while simultaneously being more experimentally tractable, allowing visualization functional structural impact systematic perturbation. This review considers state art non-human primate with focus approaches can be combined neuroimaging. We consider both non-reversible (lesions) reversible temporary perturbations such electrical, pharmacological, optical, optogenetic, chemogenetic, pathway-selective, ultrasound based interference methods. Method-specific considerations from development community are offered facilitate this field support further innovations. conclude by identifying novel avenues for innovation highlighting clinical translational potential

Language: Английский

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Functional Contributions of the Arcuate Fasciculus to Language Processing

Frontiers in Human Neuroscience, Journal Year: 2021, Volume and Issue: 15

Published: June 25, 2021

Current evidence strongly suggests that the arcuate fasciculus (AF) is critical for language, from spontaneous speech and word retrieval to repetition comprehension abilities. However, further pinpoint its unique differential role in anatomy needs be explored greater detail contribution language processing beyond of known cortical areas must established. We address this a comprehensive evaluation specific functional AF well-characterized cohort individuals with chronic aphasia (n = 33) following left hemisphere stroke. To evaluate macro- microstructural integrity AF, tractography based on constrained spherical deconvolution model was performed. The right hemispheres were then manually reconstructed using modified 3-segment (Catani et al., 2005), 2-segment (Glasser Rilling, 2008). normalized volume measure long posterior segments significantly correlated indices while controlling gender lesion volume. Specific contributions accounting - inferior frontal, parietal, temporal tested multiple regression analyses. Involvement tract demonstrated: segment contributed naming abilities; anterior fluency naming; comprehension. results highlight important fiber pathways impairments areas. At same time, no clear tracts could ascertained. In sum, our findings lend support broader processing, particular emphasis naming, point as being most crucial supporting residual

Language: Английский

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Abnormal dynamic functional connectivity is linked to recovery after acute ischemic stroke

Human Brain Mapping, Journal Year: 2021, Volume and Issue: 42(7), P. 2278 - 2291

Published: March 2, 2021

The aim of the current study was to explore whole-brain dynamic functional connectivity patterns in acute ischemic stroke (AIS) patients and their relation short long-term severity. We investigated resting-state MRI-based 41 AIS two five days after symptom onset. Re-occurring configurations were obtained using a sliding window approach k-means clustering. evaluated differences between three NIHSS-stroke severity defined groups (mildly, moderately, severely affected patients). Furthermore, we built Bayesian hierarchical models evaluate predictive capacity examine interrelation with clinical measures, such as white matter hyperintensity lesions. Finally, established correlation analyses well 90-day neurological recovery (ΔNIHSS). identified distinct acutely post-stroke. More spent significantly more time configuration that characterized by particularly strong isolated processing brain domains (three-level ANOVA: p < .05, post hoc t tests: FDR-corrected). Configuration-specific estimates possessed addition one measures. Recovery, indexed realized change NIHSS over time, linked bilateral intraparietal lobule left angular gyrus (Pearson's r = -.68, .003, Our findings demonstrate transiently increased information multiple case severe AIS. Dynamic involving default mode network components correlated first 3 months poststroke.

Language: Английский

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Subcortical-cortical dynamical states of the human brain and their breakdown in stroke

Nature Communications, Journal Year: 2022, Volume and Issue: 13(1)

Published: Aug. 29, 2022

The mechanisms controlling dynamical patterns in spontaneous brain activity are poorly understood. Here, we provide evidence that cortical dynamics the ultra-slow frequency range (<0.01-0.1 Hz) requires intact cortical-subcortical communication. Using functional magnetic resonance imaging (fMRI) at rest, identify Dynamic Functional States (DFSs), transient but recurrent clusters of and subcortical regions synchronizing frequencies. We observe shifts temporally coincident with clusters, flexibly either limbic (hippocampus/amygdala), or nuclei (thalamus/basal ganglia). Focal lesions induced by stroke, especially those damaging white matter connections between basal ganglia/thalamus cortex, provoke anomalies fraction times, dwell transitions DFSs, causing a bias toward abnormal network integration. Dynamical observed 2 weeks after stroke recover time contribute to explaining neurological impairment long-term outcome.

Language: Английский

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