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Thielen H, Tuts N, Welkenhuyzen L, Lemmens R, Wibail A, Huenges Wajer IMC, Lafosse C, Mantini D, Gillebert CR. Post-stroke sensory hypersensitivity: insights from lesion-symptom and disconnection mapping. Brain Commun 2025; 7:fcaf176. [PMID: 40385377 PMCID: PMC12081950 DOI: 10.1093/braincomms/fcaf176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2024] [Revised: 04/07/2025] [Accepted: 05/05/2025] [Indexed: 05/27/2025] Open
Abstract
A post-injury increase in sensory sensitivity is frequently reported by acquired brain injury patients, including stroke patients. These symptoms are related to poor functional outcomes, but their underlying neural mechanisms remain unclear. Since stroke results in focal lesions that can easily be visualized on imaging, the lesions of stroke survivors can be used to study the neuroanatomy of post-injury sensory hypersensitivity. We used multivariate support vector regression lesion-symptom mapping and indirect structural disconnection mapping to uncover the lesion location and white matter tracts related to post-stroke sensory hypersensitivity. A total of 103 patients were included in the study, of which 47% reported post-stroke sensory hypersensitivity across different sensory modalities. The lesion-symptom and structural connectivity mapping identified the putamen, thalamus, amygdala and insula in the grey matter as well as fronto-insular tracts, and the fronto-striatal tract in the white matter as neural structures potentially involved in post-stroke sensory hypersensitivity. By examining the neuroanatomy of post-stroke sensory hypersensitivity in a large stroke sample, this study offers a significant advancement in our understanding of the neural basis of post-stroke sensory hypersensitivity.
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Affiliation(s)
- Hella Thielen
- Department Brain and Cognition, Leuven Brain Institute, KU Leuven, Leuven 3000, Belgium
| | - Nora Tuts
- Department Brain and Cognition, Leuven Brain Institute, KU Leuven, Leuven 3000, Belgium
| | - Lies Welkenhuyzen
- Department Brain and Cognition, Leuven Brain Institute, KU Leuven, Leuven 3000, Belgium
- Department Psychology, Hospital East-Limbourgh, Genk 3600, Belgium
- TRACE, Centre for Translational Psychological Research (TRACE), KU Leuven—Hospital East-Limbourgh, Genk 3600, Belgium
| | - Robin Lemmens
- Department of Neurosciences, Experimental Neurology, KU Leuven, Leuven 3000, Belgium
- Department of Neurology, University Hospitals Leuven, Leuven 3000, Belgium
| | - Alain Wibail
- Neurology, Hospital East-Limbourgh, Genk 3600, Belgium
| | - Irene M C Huenges Wajer
- Department of Medical Psychology, Amsterdam University Medical Centre, Amsterdam 1105AZ, The Netherlands
| | - Christophe Lafosse
- Paramedical and Scientific Director, RevArte Rehabilitation Hospital, Edegem 2650, Belgium
| | - Dante Mantini
- Department of Movement Sciences, Movement Control and Neuroplasticity Research Group, KU Leuven, Leuven 3000, Belgium
| | - Céline R Gillebert
- Department Brain and Cognition, Leuven Brain Institute, KU Leuven, Leuven 3000, Belgium
- TRACE, Centre for Translational Psychological Research (TRACE), KU Leuven—Hospital East-Limbourgh, Genk 3600, Belgium
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Tran EB, Vonk JM, Casaletto K, Zhang D, Christin R, Marathe S, Gorno-Tempini ML, Chang EF, Kleen JK. Development and validation of a nonverbal consensus-based semantic memory paradigm in patients with epilepsy. J Int Neuropsychol Soc 2024; 30:671-679. [PMID: 38616725 PMCID: PMC11473708 DOI: 10.1017/s1355617724000158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
OBJECTIVE Brain areas implicated in semantic memory can be damaged in patients with epilepsy (PWE). However, it is challenging to delineate semantic processing deficits from acoustic, linguistic, and other verbal aspects in current neuropsychological assessments. We developed a new Visual-based Semantic Association Task (ViSAT) to evaluate nonverbal semantic processing in PWE. METHOD The ViSAT was adapted from similar predecessors (Pyramids & Palm Trees test, PPT; Camels & Cactus Test, CCT) comprised of 100 unique trials using real-life color pictures that avoid demographic, cultural, and other potential confounds. We obtained performance data from 23 PWE participants and 24 control participants (Control), along with crowdsourced normative data from 54 Amazon Mechanical Turk (Mturk) workers. RESULTS ViSAT reached a consensus >90% in 91.3% of trials compared to 83.6% in PPT and 82.9% in CCT. A deep learning model demonstrated that visual features of the stimulus images (color, shape; i.e., non-semantic) did not influence top answer choices (p = 0.577). The PWE group had lower accuracy than the Control group (p = 0.019). PWE had longer response times than the Control group in general and this was augmented for the semantic processing (trial answer) stage (both p < 0.001). CONCLUSIONS This study demonstrated performance impairments in PWE that may reflect dysfunction of nonverbal semantic memory circuits, such as seizure onset zones overlapping with key semantic regions (e.g., anterior temporal lobe). The ViSAT paradigm avoids confounds, is repeatable/longitudinal, captures behavioral data, and is open-source, thus we propose it as a strong alternative for clinical and research assessment of nonverbal semantic memory.
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Affiliation(s)
- Edwina B. Tran
- Department of Neurology, University of California, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Jet M.J. Vonk
- Department of Neurology, University of California, San Francisco, CA, USA
- Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Kaitlin Casaletto
- Department of Neurology, University of California, San Francisco, CA, USA
- Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Da Zhang
- Department of Neurology, University of California, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Raphael Christin
- Department of Neurology, University of California, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Siddharth Marathe
- Department of Neurology, University of California, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Maria Luisa Gorno-Tempini
- Department of Neurology, University of California, San Francisco, CA, USA
- Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Edward F. Chang
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | - Jonathan K. Kleen
- Department of Neurology, University of California, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
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