Post-Stroke Cognitive Impairment and Dementia

Circulation Research, Год журнала: 2022, Номер 130(8), С. 1252 - 1271

Опубликована: Апрель 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.

Язык: Английский

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

Brain, Год журнала: 2022, Номер 145(4), С. 1338 - 1353

Опубликована: Янв. 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.

Язык: Английский

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Neuropsychological evidence of multi-domain network hubs in the human thalamus

eLife, Год журнала: 2021, Номер 10

Опубликована: Окт. 6, 2021

Hubs in the human brain support behaviors that arise from network interactions. Previous studies have identified hub regions thalamus are connected with multiple functional networks. However, behavioral significance of thalamic hubs has yet to be established. Our framework predicts subregions strong properties broadly involved functions across cognitive domains. To test this prediction, we studied patients focal lesions conjunction analyses thalamocortical connectome. In our stronger were associated widespread deficits executive, language, and memory functions, whereas weaker more limited deficits. These results highlight how a large-scale model can broaden understanding function for cognition.

Язык: Английский

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Thalamocortical contributions to cognitive task activity

eLife, Год журнала: 2022, Номер 11

Опубликована: Дек. 20, 2022

Thalamocortical interaction is a ubiquitous functional motif in the mammalian brain. Previously (Hwang et al., 2021), we reported that lesions to network hubs human thalamus are associated with multi-domain behavioral impairments language, memory, and executive functions. Here, show how task-evoked thalamic activity organized support these broad cognitive abilities. We analyzed magnetic resonance imaging (MRI) data from subjects performed 127 tasks encompassing range of representations. first investigated spatial organization found basis set patterns evoked processing needs each task. Specifically, anterior, medial, posterior-medial exhibit hub-like profiles suggestive participation. These task overlapped interlinking cortical systems. To further determine relevance thalamocortical connectivity, built data-driven model test whether can be used predict activity. The predicted task-specific patterns, outperformed comparison models on cortical, hippocampal, striatal regions. Simulated low-dimensional, multi-task hub regions impaired prediction. This simulation result was supported by neuropsychological patients focal lesions. In summary, our results suggest general organizational principle system supports

Язык: Английский

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Mapping correlated neurological deficits after stroke to distributed brain networks

Brain Structure and Function, Год журнала: 2022, Номер 227(9), С. 3173 - 3187

Опубликована: Июль 26, 2022

Язык: Английский

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Discovering the gene-brain-behavior link in autism via generative machine learning

Science Advances, Год журнала: 2024, Номер 10(24)

Опубликована: Июнь 12, 2024

Autism is traditionally diagnosed behaviorally but has a strong genetic basis. A genetics-first approach could transform understanding and treatment of autism. However, isolating the gene-brain-behavior relationship from confounding sources variability challenge. We demonstrate novel technique, 3D transport-based morphometry (TBM), to extract structural brain changes linked copy number variation (CNV) at 16p11.2 region. identified two distinct endophenotypes. In data Simons Variation in Individuals Project, detection these endophenotypes enabled 89 95% test accuracy predicting CNV images alone. Then, TBM direct visualization driving accurate prediction, revealing dose-dependent among deletion duplication carriers. These are sensitive articulation disorders explain portion intelligence quotient variability. Genetic stratification combined with reveal new many neurodevelopmental disorders, accelerating precision medicine, human neurodiversity.

Язык: Английский

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Edge-centric analysis of stroke patients: An alternative approach for biomarkers of lesion recovery

NeuroImage Clinical, Год журнала: 2022, Номер 35, С. 103055 - 103055

Опубликована: Янв. 1, 2022

Most neuroimaging studies of post-stroke recovery rely on analyses derived from standard node-centric functional connectivity to map the distributed effects in stroke patients. Here, given importance nonlocal and diffuse damage, we use an edge-centric approach order provide alternative description this disorder. These techniques allow for rendering metrics such as normalized entropy, which describes diversity edge communities at each node. Moreover, enables identification high amplitude co-fluctuations fMRI time series. We found that entropy is associated with lesion severity continually increases across patients' recovery. Furthermore, not only relate but are also level The current study first application a clinical population longitudinal dataset demonstrates how different perspective data analysis can further characterize topographic modulations brain dynamics.

Язык: Английский

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Therapeutic Potential and Limitation of Serotonin Type 7 Receptor Modulation

International Journal of Molecular Sciences, Год журнала: 2023, Номер 24(3), С. 2070 - 2070

Опубликована: Янв. 20, 2023

Although a number of mood-stabilising atypical antipsychotics and antidepressants modulate serotonin type 7 receptor (5-HT7), the detailed contributions 5-HT7 function to clinical efficacy pathophysiology have not been fully understood. The antipsychotic agent, lurasidone, partial agonist reuptake inhibitor, vortioxetine, exhibit higher binding affinity than other conventional antidepressants. To date, initially expected rapid onset antidepressant effects-in comparison with or antipsychotics-due inhibition has observed lurasidone vortioxetine; however, several studies suggest that likely contributes quality life patients schizophrenia mood disorders via improvement cognition. Furthermore, recent preclinical reported might mitigate antipsychotic-induced weight gain metabolic complication by blocking monoamine receptors. Further for development modulation against neurodevelopmental neurodegenerative diseases ongoing. various findings from indicate possibility modifications can provide two independent strategies. first is ameliorates dysfunction inter-neuronal transmission in mature networks. activation improve due microstructure abnormality neurotransmission network-which could be unaffected therapeutic agents-via modulating intracellular signalling during stage loss neural networks aging. This review attempts describe current novel applications based on findings.

Язык: Английский

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The Value of Patient Registries to Advance Basic and Translational Research in the Area of Traumatic Brain Injury

Frontiers in Behavioral Neuroscience, Год журнала: 2022, Номер 16

Опубликована: Апрель 25, 2022

The number of individuals affected by traumatic brain injury (TBI) is growing globally. TBIs may cause a range physical, cognitive, and psychiatric deficits that can negatively impact employment, academic attainment, community independence, interpersonal relationships. Although there has been significant decrease in the related deaths over past several decades, no corresponding reduction disability same time period. We propose patient registries with large, representative samples rich multidimensional longitudinal data have tremendous value advancing basic translational research capturing, characterizing, predicting individual differences deficit profile outcomes. Patient registries, together recent theoretical methodological advances analytic approaches neuroscience, provide powerful tools for leveraging heterogeneity traditionally cited as barrier inhibiting progress treatment clinical practice. report on our experiences, challenges, developing maintaining own registry. conclude pointing to some future opportunities discovery are afforded registry model.

Язык: Английский

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CarveMix: A simple data augmentation method for brain lesion segmentation

NeuroImage, Год журнала: 2023, Номер 271, С. 120041 - 120041

Опубликована: Март 17, 2023

Brain lesion segmentation provides a valuable tool for clinical diagnosis and research, convolutional neural networks (CNNs) have achieved unprecedented success in the task. Data augmentation is widely used strategy to improve training of CNNs. In particular, data approaches that mix pairs annotated images been developed. These methods are easy implement promising results various image processing tasks. However, existing based on mixing not designed brain lesions may perform well segmentation. Thus, design this type simple method still an open problem. work, we propose yet effective approach, dubbed as CarveMix, CNN-based Like other mixing-based methods, CarveMix stochastically combines two (annotated only) obtain new labeled samples. To make our more suitable segmentation, lesion-aware, where combination performed with focus preserves information. Specifically, from one carve region interest (ROI) according location geometry variable ROI size. The carved then replaces corresponding voxels second synthesize network training, additional harmonization steps applied heterogeneous can originate different sources. Besides, further model mass effect unique whole tumor during mixing. evaluate proposed method, experiments were multiple publicly available or private datasets, show improves accuracy code at https://github.com/ZhangxinruBIT/CarveMix.git.

Язык: Английский

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