Recovery from stroke: current concepts and future perspectives

Neurological Research and Practice, Год журнала: 2020, Номер 2(1)

Опубликована: Июнь 16, 2020

Abstract Stroke is a leading cause of acquired, permanent disability worldwide. Although the treatment acute stroke has been improved considerably, majority patients to date are left disabled with considerable impact on functional independence and quality life. As absolute number survivors likely further increase due demographic changes in our aging societies, new strategies needed order improve neurorehabilitation. The most critical driver recovery post-stroke neural reorganization. For developing novel, neurobiologically informed promote function, an understanding mechanisms enabling plasticity mandatory. This review provides comprehensive survey recent developments field using neuroimaging non-invasive brain stimulation. We discuss current concepts how reorganizes its architecture overcome stroke-induced deficits, also present evidence for maladaptive effects interfering recovery. demonstrate that combination neurostimulation techniques allows better can be modulated reorganization networks. Finally, neurotechnology-based allowing patient-tailored interventions achieve enhanced responses discussed. highlights important limitations models, finally closes possible solutions future directions.

Язык: Английский

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

Brain, Год журнала: 2020, Номер 143(7), С. 2173 - 2188

Опубликована: Май 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

Язык: Английский

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A set of functionally-defined brain regions with improved representation of the subcortex and cerebellum

NeuroImage, Год журнала: 2019, Номер 206, С. 116290 - 116290

Опубликована: Окт. 18, 2019

An important aspect of network-based analysis is robust node definition. This issue critical for functional brain network analyses, as poor choice can lead to spurious findings and misleading inferences about organization. Two sets nodes from our group are well represented in the literature: (1) 264 volumetric regions interest (ROIs) reported Power et al., 2011, (2) 333 cortical surface parcels Gordon 2016. However, subcortical cerebellar structures either incompletely captured or missing these ROI sets. Therefore, properties organization involving subcortex cerebellum may be underappreciated thus far. Here, we apply a winner-take-all partitioning method resting-state fMRI data generate novel functionally-constrained ROIs thalamus, basal ganglia, amygdala, hippocampus, cerebellum. We validate three datasets using several criteria, including agreement with existing literature anatomical atlases. Further, demonstrate that combining established recapitulates extends previously described new set made publicly available general use, full list MNI coordinates labels.

Язык: Английский

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

Frontiers in Neurology, Год журнала: 2019, Номер 10

Опубликована: Апрель 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.

Язык: Английский

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Plasticity and Spontaneous Activity Pulses in Disused Human Brain Circuits

Neuron, Год журнала: 2020, Номер 107(3), С. 580 - 589.e6

Опубликована: Июнь 16, 2020

Язык: Английский

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Structural Disconnections Explain Brain Network Dysfunction after Stroke

Cell Reports, Год журнала: 2019, Номер 28(10), С. 2527 - 2540.e9

Опубликована: Сен. 1, 2019

Stroke causes focal brain lesions that disrupt functional connectivity (FC), a measure of activity synchronization, throughout distributed networks. It is often assumed FC disruptions reflect damage to specific cortical regions. However, an alternative explanation they the structural disconnection (SDC) white matter pathways. Here, we compare these explanations using data from 114 stroke patients. Across multiple analyses, find SDC measures outperform measures, including putative critical regions, for explaining associated with stroke. We also identify core mode structure-function covariation links severity interhemispheric SDCs widespread across patients and correlates deficits in behavioral domains. conclude lesion's impact on connectome what determines its may play particularly important role mediating after

Язык: Английский

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Brain Modularity: A Biomarker of Intervention-related Plasticity

Trends in Cognitive Sciences, Год журнала: 2019, Номер 23(4), С. 293 - 304

Опубликована: Фев. 28, 2019

Язык: Английский

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Recovery from aphasia in the first year after stroke

Brain, Год журнала: 2022, Номер 146(3), С. 1021 - 1039

Опубликована: Апрель 7, 2022

Most individuals who experience aphasia after a stroke recover to some extent, with the majority of gains taking place in first year. The nature and time course this recovery process is only partially understood, especially its dependence on lesion location which are most important determinants outcome. aim study was provide comprehensive description patterns from year stroke. We recruited 334 patients acute left hemisphere supratentorial ischaemic or haemorrhagic evaluated their speech language function within 5 days using Quick Aphasia Battery (QAB). At initial point, 218 presented aphasia. Individuals were followed longitudinally, follow-up evaluations at 1 month, 3 months, post-stroke, wherever possible. Lesions manually delineated based clinical MRI CT imaging. Patients without divided into 13 groups similar, commonly occurring brain damage. Trajectories then investigated as group (i.e. extent) speech/language domain (overall function, word comprehension, sentence finding, grammatical construction, phonological encoding, motor programming, execution, reading). found that dynamic, multidimensional, gradated, little explanatory role for subtypes binary concepts such fluency. circumscribed frontal lesions recovered well, consistent previous observations. More surprisingly, larger extending parietal temporal lobes also did relatively temporal, temporoparietal, lesions. Persistent moderate severe deficits common extensive damage throughout middle cerebral artery distribution temporoparietal There striking differences between domains rates relationships overall suggesting specific differ extent they redundantly represented network, opposed depending specialized cortical substrates. Our findings have an immediate application will enable clinicians estimate likely individual patients, well uncertainty these predictions, acutely observable neurological factors.

Язык: Английский

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Three Distinct Sets of Connector Hubs Integrate Human Brain Function

Cell Reports, Год журнала: 2018, Номер 24(7), С. 1687 - 1695.e4

Опубликована: Авг. 1, 2018

Control over behavior is enabled by the brain's control networks, which interact with lower-level sensory motor and default networks to regulate their functions. Such interactions are facilitated specialized "connector hub" regions that interconnect discrete networks. Previous work has treated hubs as a single category of brain regions, although unitary nature dubious when examined in individual brains. Here we investigated using fMRI characterize individual-specific hub two independent datasets. We identified three separable sets connector integrate information between specific These categories occupy different positions within network structure; they affect differently artificially lesioned, differentially engaged during cognitive task performance. This suggests model organization functions enable top-down separate processing streams.

Язык: Английский

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

Nature Reviews Neurology, Год журнала: 2019, Номер 16(1), С. 43 - 55

Опубликована: Ноя. 26, 2019

Язык: Английский

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