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Ismail UN, Yahya N, Manan HA. Investigating functional connectivity related to stroke recovery: A systematic review. Brain Res 2024; 1840:149023. [PMID: 38815644 DOI: 10.1016/j.brainres.2024.149023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 06/01/2024]
Abstract
INTRODUCTION Stroke recovery is a complex process influenced by various factors, including specific neural reorganization. The objective of this systematic review was to identify important functional connectivity (FC) changes in resting-state fMRI data that were often correlated with motor, emotional, and cognitive outcome improvement. METHOD A systematic search using PubMed and SCOPUS databases was conducted to identify relevant studies published between 2010 and 2023. RESULTS A total of 766 studies were identified, of which 20 studies (602 S individuals) met the inclusion criteria. Fourteen studies focussed on motor recovery while six on cognitive recovery. All studies reported interhemispheric FC to be strongly associated with motor and cognitive recovery. The preservation and changes of M1-M1 (eight incidences) and M1-SMA (nine incidences) FC were found to be strongly correlated with motor function improvement. For cognitive recovery, restoration and preservation of FC with and between default mode network (DMN)-related regions were important for the process. CONCLUSIONS This review identified specific patterns of FC that were consistently reported with recovery of motor and cognitive function. The findings may serve in refining future management strategies to enhance patient outcomes.
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Affiliation(s)
- Umi Nabilah Ismail
- Makmal Pemprosesan Imej Kefungsian (Functional Image Processing Laboratory), Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56 000 Cheras, Kuala Lumpur, Malaysia
| | - Noorazrul Yahya
- Diagnostic Imaging & Radiotherapy Program, Centre of Diagnostic, Therapeutic and Investigative Sciences (CODTIS), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Hanani Abdul Manan
- Makmal Pemprosesan Imej Kefungsian (Functional Image Processing Laboratory), Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56 000 Cheras, Kuala Lumpur, Malaysia; Department of Radiology and Intervention, Hospital Pakar Kanak-Kanak (Children Specialist Hospital), Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Kuala Lumpur, Malaysia.
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Boerwinkle VL, Manjón I, Sussman BL, McGary A, Mirea L, Gillette K, Broman-Fulks J, Cediel EG, Arhin M, Hunter SE, Wyckoff SN, Allred K, Tom D. Resting-State Functional Magnetic Resonance Imaging Network Association With Mortality, Epilepsy, Cognition, and Motor Two-Year Outcomes in Suspected Severe Neonatal Acute Brain Injury. Pediatr Neurol 2024; 152:41-55. [PMID: 38198979 DOI: 10.1016/j.pediatrneurol.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 11/14/2023] [Accepted: 12/06/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND AND OBJECTIVES In acute brain injury of neonates, resting-state functional magnetic resonance imaging (MRI) (RS) showed incremental association with consciousness, mortality, cognitive and motor development, and epilepsy, with correction for multiple comparisons, at six months postgestation in neonates with suspected acute brain injury (ABI). However, there are relatively few developmental milestones at six months to benchmark against, thus, we extended this cohort study to evaluate two-year outcomes. METHODS In 40 consecutive neonates with ABI and RS, ordinal scores of resting-state networks; MRI, magnetic resonance spectroscopy, and electroencephalography; and up to 42-month outcomes of mortality, general and motor development, Pediatric Cerebral Performance Category Scale (PCPC), and epilepsy informed associations between tests and outcomes. RESULTS Mean gestational age was 37.8 weeks, 68% were male, and 60% had hypoxic-ischemic encephalopathy. Three died in-hospital, four at six to 42 months, and five were lost to follow-up. Associations included basal ganglia network with PCPC (P = 0.0003), all-mortality (P = 0.005), and motor (P = 0.0004); language/frontoparietal network with developmental delay (P = 0.009), PCPC (P = 0.006), and all-mortality (P = 0.01); default mode network with developmental delay (P = 0.003), PCPC (P = 0.004), neonatal intensive care unit mortality (P = 0.01), and motor (P = 0.009); RS seizure onset zone with epilepsy (P = 0.01); and anatomic MRI with epilepsy (P = 0.01). CONCLUSION For the first time, at any age, resting state functional MRI in ABI is associated with long-term epilepsy and RSNs predicted mortality in neonates. Severity of RSN abnormality was associated with incrementally worsened neurodevelopment including cognition, language, and motor function over two years.
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Affiliation(s)
- Varina L Boerwinkle
- Division of Child Neurology, University of North Carolina Medical School, Chapel Hill, North Carolina.
| | - Iliana Manjón
- University of Arizona College of Medicine - Tucson, Tucson, Arizona
| | - Bethany L Sussman
- Division of Neuroscience Research, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, Arizona
| | - Alyssa McGary
- Department of Clinical Research, Phoenix Children's Hospital, Phoenix, Arizona
| | - Lucia Mirea
- Department of Clinical Research, Phoenix Children's Hospital, Phoenix, Arizona
| | - Kirsten Gillette
- Division of Child Neurology, University of North Carolina Medical School, Chapel Hill, North Carolina
| | - Jordan Broman-Fulks
- Division of Child Neurology, University of North Carolina Medical School, Chapel Hill, North Carolina
| | - Emilio G Cediel
- Division of Child Neurology, University of North Carolina Medical School, Chapel Hill, North Carolina
| | - Martin Arhin
- Division of Child Neurology, University of North Carolina Medical School, Chapel Hill, North Carolina
| | - Senyene E Hunter
- Division of Child Neurology, University of North Carolina Medical School, Chapel Hill, North Carolina
| | - Sarah N Wyckoff
- Division of Neuroscience Research, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, Arizona
| | - Kimberlee Allred
- Division of Neonatology, Phoenix Children's Hospital, Phoenix, Arizona
| | - Deborah Tom
- Division of Neonatology, Phoenix Children's Hospital, Phoenix, Arizona
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Wang Y, Ji Q, Zhou C, Wang Y. Brain mechanisms linking language processing and open motor skill training. Front Hum Neurosci 2022; 16:911894. [PMID: 35992938 PMCID: PMC9386041 DOI: 10.3389/fnhum.2022.911894] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 07/19/2022] [Indexed: 11/13/2022] Open
Abstract
Given the discovery of a distributed language and motor functional network, surprisingly few studies have explored whether language processing is related to motor skill training. To address this issue, the present study used functional magnetic resonance imaging to compare whole-brain activation between nonexperts and experts in table tennis, an open skill sport in which players make rapid decisions in response to an ever-changing environment. Whole-brain activation was assessed in 30 expert table tennis players with more than 7 years’ experience and 35 age-matched nonexpert college students while they performed both a size and a semantic judgment task of words presented on a monitor. Compared with nonexperts, expert table tennis players showed greater activation in the left middle occipital gyrus and right precuneus while judging the size of the words versus during baseline fixation. They also showed greater activation in the left lingual gyrus during the semantic judgment task versus during baseline fixation. Our findings indicate that the visual regions engaged in language processing are associated with open motor skill training.
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Affiliation(s)
- Yixuan Wang
- School of Psychology, Shanghai University of Sport, Shanghai, China
| | - Qingchun Ji
- Department of Physical Education, Shanghai University of Engineering Science, Shanghai, China
| | - Chenglin Zhou
- School of Psychology, Shanghai University of Sport, Shanghai, China
| | - Yingying Wang
- School of Psychology, Shanghai University of Sport, Shanghai, China
- *Correspondence: Yingying Wang,
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Sussman BL, Wyckoff SN, Heim J, Wilfong AA, Adelson PD, Kruer MC, Gonzalez MJ, Boerwinkle VL. Is Resting State Functional MRI Effective Connectivity in Movement Disorders Helpful? A Focused Review Across Lifespan and Disease. Front Neurol 2022; 13:847834. [PMID: 35493815 PMCID: PMC9046695 DOI: 10.3389/fneur.2022.847834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 03/23/2022] [Indexed: 11/20/2022] Open
Abstract
In the evolving modern era of neuromodulation for movement disorders in adults and children, much progress has been made recently characterizing the human motor network (MN) with potentially important treatment implications. Herein is a focused review of relevant resting state fMRI functional and effective connectivity of the human motor network across the lifespan in health and disease. The goal is to examine how the transition from functional connectivity to dynamic effective connectivity may be especially informative of network-targeted movement disorder therapies, with hopeful implications for children.
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Affiliation(s)
- Bethany L. Sussman
- Division of Neuroscience, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, United States
- *Correspondence: Bethany L. Sussman
| | - Sarah N. Wyckoff
- Division of Neuroscience, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, United States
- Department of Research, Phoenix Children's Hospital, Phoenix, AZ, United States
| | - Jennifer Heim
- Division of Pediatric Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, United States
| | - Angus A. Wilfong
- Division of Pediatric Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, United States
| | - P. David Adelson
- Division of Pediatric Neurosurgery, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, United States
| | - Michael C. Kruer
- Division of Pediatric Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, United States
- Departments of Child Health, Neurology, Genetics and Cellular & Molecular Medicine, University of Arizona College of Medicine – Phoenix, Phoenix, AZ, United States
| | | | - Varina L. Boerwinkle
- Division of Pediatric Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, United States
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Association of network connectivity via resting state functional MRI with consciousness, mortality, and outcomes in neonatal acute brain injury. Neuroimage Clin 2022; 34:102962. [PMID: 35152054 PMCID: PMC8851268 DOI: 10.1016/j.nicl.2022.102962] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 02/05/2022] [Accepted: 02/07/2022] [Indexed: 01/07/2023]
Abstract
Basal ganglia and seizure onset zone networks were associated with motor outcomes. Broad language/cognitive region networks were associated with developmental delay. Discharge with mortality was linked to default mode and language/cognitive networks. Exams were not linked to networks after multiple testing corrections. Lack of detection of all studied networks only occurred in those who did not survive.
Background An accurate and comprehensive test of integrated brain network function is needed for neonates during the acute brain injury period to inform on morbidity. This retrospective cohort study assessed whether integrated brain network function acquired by resting state functional MRI during the acute period in neonates with brain injury, is associated with acute exam, neonatal mortality, and 6-month outcomes. Methods Study subjects included 40 consecutive neonates with resting state functional MRI acquired within 31 days after suspected brain insult from March 2018 to July 2019 at Phoenix Children’s Hospital. Acute-period exam and test results were assigned ordinal scores based on severity as documented by respective treating specialists. Analyses (Fisher exact, Wilcoxon-rank sum test, ordinal/multinomial logistic regression) examined association of resting state networks with demographics, presentation, neurological exam, electroencephalogram, anatomical MRI, magnetic resonance spectroscopy, passive task functional MRI, and outcomes of discharge condition, outpatient development, motor tone, seizure, and mortality. Results Subjects had a mean (standard deviation) gestational age of 37.8 (2.6) weeks, a majority were male (63%), with a diagnosis of hypoxic ischemic encephalopathy (68%). Findings at birth included mild distress (48%), moderately abnormal neurological exam (33%), and consciousness characterized as awake but irritable (40%). Significant associations after multiple testing corrections were detected for resting state networks: basal ganglia with outpatient developmental delay (odds ratio [OR], 14.5; 99.4% confidence interval [CI], 2.00–105; P < .001) and motor tone/weakness (OR, 9.98; 99.4% CI, 1.72–57.9; P < .001); language/frontoparietal network with discharge condition (OR, 5.13; 99.4% CI, 1.22–21.5; P = .002) and outpatient developmental delay (OR, 4.77; 99.4% CI, 1.21–18.7; P=.002); default mode network with discharge condition (OR, 3.72; 99.4% CI, 1.01–13.78; P=.006) and neurological exam (P = .002 (FE); OR, 11.8; 99.4% CI, 0.73–191; P = .01 (OLR)); and seizure onset zone with motor tone/weakness (OR, 3.31; 99.4% CI, 1.08–10.1; P=.003). Resting state networks were not detected in three neonates, who died prior to discharge. Conclusions This study provides level 3 evidence (OCEBM Levels of Evidence Working Group) demonstrating that in neonatal acute brain injury, the degree of abnormality of resting state networks is associated with acute exam and outcomes. Total lack of brain network detection was only found in patients who did not survive.
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Ní Bhroin M, Kelly L, Sweetman D, Aslam S, O'Dea MI, Hurley T, Slevin M, Murphy J, Byrne AT, Colleran G, Molloy EJ, Bokde ALW. Relationship Between MRI Scoring Systems and Neurodevelopmental Outcome at Two Years in Infants With Neonatal Encephalopathy. Pediatr Neurol 2022; 126:35-42. [PMID: 34736061 DOI: 10.1016/j.pediatrneurol.2021.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 10/04/2021] [Accepted: 10/05/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) scoring systems are used in the neonatal period to predict outcome in infants with neonatal encephalopathy. Our aim was to assess the relationship between three MRI scores and neurodevelopmental outcome assessed using Bayley Scales of Infant and Toddler Development, third edition (Bayley-III), at two years in infants with neonatal encephalopathy. METHODS Term-born neonates with evidence of perinatal asphyxia born between 2011 and 2015 were retrospectively reviewed. MRI scanning was performed within the first two weeks of life and scored using Barkovich, National Institute of Child Health and Human Development (NICHD) Neonatal Research Network (NRN), and Weeke systems by a single assessor blinded to the infants clinical course. Neurodevelopmental outcome was assessed using composite scores on the Bayley-III at two years. Multiple linear regression analyses were used to assess the association between MRI scores and Bayley-III composite scores, with postmenstrual age at scan and sex included as covariates. RESULTS Of the 135 recruited infants, 90 infants underwent MRI, and of these, 66 returned for follow-up. MRI abnormalities were detected with the highest frequency using the Weeke score (Barkovich 40%, NICHD NRN 50%, Weeke 77%). The inter-rater agreement was good for the Barkovich score and excellent for NICHD NRN and Weeke scores. There was a significant association between Barkovich, NICHD NRN, and Weeke scores and Bayley-III cognitive and motor scores. Only the Weeke score was associated with Bayley-III language scores. CONCLUSIONS Our findings confirm the predictive value of existing MRI scoring systems for cognitive and motor outcome and suggest that more detailed scoring systems have predictive value for language outcome.
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Affiliation(s)
- Megan Ní Bhroin
- Cognitive Systems Group, Discipline of Psychiatry, School of Medicine, Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience (TCIN), Trinity College Dublin, Dublin, Ireland.
| | - Lynne Kelly
- Department of Paediatric and Child Health, Trinity College Dublin, Tallaght University Hospital (TUH), Dublin, Ireland
| | - Deirdre Sweetman
- Department of Neonatology, The National Maternity Hospital, Dublin, Ireland
| | - Saima Aslam
- Department of Neonatology, Children's Hospital Ireland (CHI) at Crumlin, Dublin, Ireland
| | - Mary I O'Dea
- Department of Paediatric and Child Health, Trinity College Dublin, Tallaght University Hospital (TUH), Dublin, Ireland; Department of Neonatology, Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Tim Hurley
- Department of Paediatric and Child Health, Trinity College Dublin, Tallaght University Hospital (TUH), Dublin, Ireland
| | - Marie Slevin
- Department of Neonatology, The National Maternity Hospital, Dublin, Ireland
| | - John Murphy
- Department of Neonatology, The National Maternity Hospital, Dublin, Ireland
| | - Angela T Byrne
- Department of Radiology, Children's Hospital Ireland (CHI) at Crumlin, Dublin, Ireland
| | - Gabrielle Colleran
- Department of Radiology, The National Maternity Hospital, Dublin, Ireland and Children's Hospital Ireland (CHI) at Temple Street, Dublin, Ireland; Department of Paediatrics, Trinity College Dublin, Dublin, Ireland; Women's and Children's Health, University College Dublin (UCD), School of Medicine, University College Dublin, Dublin, Ireland
| | - Eleanor J Molloy
- Department of Paediatric and Child Health, Trinity College Dublin, Tallaght University Hospital (TUH), Dublin, Ireland; Department of Neonatology, Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Arun L W Bokde
- Cognitive Systems Group, Discipline of Psychiatry, School of Medicine, Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience (TCIN), Trinity College Dublin, Dublin, Ireland
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