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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Causal mapping of human brain function

Nature reviews. Neuroscience, Journal Year: 2022, Volume and Issue: 23(6), P. 361 - 375

Published: April 20, 2022

Language: Английский

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Brain lesions disrupting addiction map to a common human brain circuit

Nature Medicine, Journal Year: 2022, Volume and Issue: 28(6), P. 1249 - 1255

Published: June 1, 2022

Abstract Drug addiction is a public health crisis for which new treatments are urgently needed. In rare cases, regional brain damage can lead to remission. These cases may be used identify therapeutic targets neuromodulation. We analyzed two cohorts of patients addicted smoking at the time focal (cohort 1 n = 67; cohort 2 62). Lesion locations were mapped atlas and network functionally connected each lesion location was computed using human connectome data ( 1,000). Associations with remission identified. Generalizability assessed an independent alcohol risk scores 186). Specificity through comparison 37 other neuropsychological variables. Lesions disrupting occurred in many different but characterized by specific pattern connectivity. This involved positive connectivity dorsal cingulate, lateral prefrontal cortex, insula negative medial temporal cortex. circuit reproducible across cohorts, associated reduced risk, metrics. Hubs that best matched profile paracingulate gyrus, left frontal operculum, fronto-polar conclude lesions map hubs this provide testable

Language: Английский

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Lead-DBS v3.0: Mapping deep brain stimulation effects to local anatomy and global networks

NeuroImage, Journal Year: 2023, Volume and Issue: 268, P. 119862 - 119862

Published: Jan. 5, 2023

Following its introduction in 2014 and with support of a broad international community, the open-source toolbox Lead-DBS has evolved into comprehensive neuroimaging platform dedicated to localizing, reconstructing, visualizing electrodes implanted human brain, context deep brain stimulation (DBS) epilepsy monitoring. Expanding clinical indications for DBS, increasing availability related research tools, growing community clinician-scientist researchers, however, have led an ongoing need maintain, update, standardize codebase Lead-DBS. Major development efforts recent years now yielded end-to-end solution DBS-based analysis allowing image preprocessing, lead localization, volume modeling, statistical within single tool. The aim present manuscript is introduce fundamental additions pipeline including deformation warpfield editor novel algorithms electrode localization. Furthermore, we total three tools map DBS effects local, tract- network-levels. These updates are demonstrated using patient example (for subject-level analysis), as well retrospective cohort 51 Parkinson's disease patients who underwent subthalamic nucleus group-level analysis). Their applicability further by comparing various methodological choices amount explained variance outcomes across streams. Finally, based on folder file naming specifications groups neuroscience, imaging data structure (BIDS) derivative standard Thus, this multi-institutional collaborative effort represents important stage evolution comprehensive, connectomics.

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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Icariside II preconditioning evokes robust neuroprotection against ischaemic stroke, by targeting Nrf2 and the OXPHOS/NF‐κB/ferroptosis pathway

British Journal of Pharmacology, Journal Year: 2022, Volume and Issue: 180(3), P. 308 - 329

Published: Sept. 27, 2022

Background and Purpose Astrocytic nuclear factor erythroid‐derived 2‐related 2 (Nrf2) is a potential therapeutic target of ischaemic preconditioning (IPC). Icariside II (ICS II) naturally occurring flavonoid derived from Herba Epimedii with Nrf2 induction potency. This study was designed to clarify if exposure ICS mimicks IPC neuroprotection astrocytes contributes against stroke. Experimental Approach Mice transient middle cerebral artery occlusion (MCAO)‐induced focal ischaemia primary challenged oxygen–glucose deprivation (OGD) were used explore the neuroprotective effect preconditioning. Additionally, Nrf2‐deficient mice pretreated determine whether exerts its by activating Nrf2. Key Results pretreatment mitigated injury in mouse model stroke along improving long‐term recovery. Furthermore, proteomics screening identified as crucial gene evoked treatment required for anti‐oxidative anti‐inflammatory II. Also, directly bound reinforced transcriptional activity after MCAO. Moreover, exerted cytoprotective effects on astrocyte cultures following lethal OGD exposure, promoting translocation OXPHOS/NF‐κB/ferroptosis axis, while decreased siRNA blocked Conclusion Implications provides robust via astrocytic Nrf2‐mediated axis. Thus, could be promising activator treat

Language: Английский

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Lesion network mapping for symptom localization: recent developments and future directions

Current Opinion in Neurology, Journal Year: 2022, Volume and Issue: 35(4), P. 453 - 459

Published: July 5, 2022

Focal lesions causing specific neurological or psychiatric symptoms can occur in multiple different brain locations, complicating symptom localization. Here, we review lesion network mapping, a technique used to aid localization by mapping lesion-induced circuits rather than individual regions. We highlight recent examples of how this is being investigate clinical entities and identify therapeutic targets.To date, has successfully been applied more 40 complexes. In each case, locations were combined with an atlas human connections (the connectome) map heterogeneous the same common circuit. This approach lent insight into that have difficult localize using other techniques, such as hallucinations, tics, blindsight, pathological laughter crying. Further, recently improve symptoms, tremor addiction, which may translate new targets.Lesion be single Recent findings provided long-standing mysteries identified testable treatment targets for circuit-based symptom-based neuromodulation.

Language: Английский

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Network Localization of Pediatric Lesion‐Induced Dystonia

Annals of Neurology, Journal Year: 2025, Volume and Issue: unknown

Published: March 10, 2025

Dystonia is a movement disorder defined by involuntary muscle contractions leading to abnormal postures or twisting and repetitive movements. Classically dystonia has been thought of as the basal ganglia, but newer results in idiopathic lesion-induced adults point broader motor network dysfunction spanning cerebellum, premotor cortex, sensorimotor, frontoparietal regions. It unclear whether similar shared between different etiologies pediatric dystonia. Three cohorts patients with were identified. The lesion included hypoxia, kernicterus, stroke versus comparison subjects acquired lesions not associated Multivariate lesion-symptom mapping used evaluate anatomy networks showed that putamen globus pallidus (r = 0.41, p < 0.001). Lesion using normative connectome data from healthy children demonstrated these regional findings occurred within common brain-wide involves anterior medial cortical regions overlap cingulo-opercular action-mode somato-cognitive-action networks. We interpret novel evidence for unified brain network, which implicated coordination movement. Elucidation this gives insight into functional origins provides targets investigate therapeutic intervention. ANN NEUROL 2025.

Language: Английский

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Central precuneus lesions are associated with impaired executive function

Brain Structure and Function, Journal Year: 2022, Volume and Issue: 227(9), P. 3099 - 3108

Published: Sept. 10, 2022

Language: Английский

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Large-scale lesion symptom mapping of depression identifies brain regions for risk and resilience

Brain, Journal Year: 2022, Volume and Issue: 146(4), P. 1672 - 1685

Published: Oct. 1, 2022

Understanding neural circuits that support mood is a central goal of affective neuroscience, and improved understanding the anatomy could inform more targeted interventions in disorders. Lesion studies provide method inferring anatomical sites causally related to specific functions, including mood. Here, we performed large-scale study evaluating location acquired, focal brain lesions relation symptoms depression. Five hundred twenty-six individuals participated across two (356 male, average age 52.4 ± 14.5 years). Each subject had lesion identified on structural imaging an assessment depression using Beck Depression Inventory-II, both obtained chronic period post-lesion (>3 months). Multivariate lesion-symptom mapping was identify associated with higher or lower symptom burden, which refer as 'risk' versus 'resilience' regions. The networks white matter tracts peak regional findings were functional network mapping, respectively. Lesion-symptom regions significantly severity (r = 0.11; P 0.01). Peak include bilateral anterior insula, dorsolateral prefrontal cortex left dorsomedial cortex. Functional demonstrated these localized nodes salience network. right orbitofrontal cortex, medial inferolateral temporal default mode Structural implicated dorsal ventral tracts, although did not survive correction for multiple comparisons. Taken together, results demonstrate are greater risk resiliency setting lesions.

Language: Английский

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