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Ivanova MV, Pappas I, Inglis B, Pracar AL, Herron TJ, Baldo JV, Kayser AS, D’Esposito M, Dronkers NF. Cerebral perfusion in post-stroke aphasia and its relationship to residual language abilities. Brain Commun 2023; 6:fcad252. [PMID: 38162898 PMCID: PMC10757451 DOI: 10.1093/braincomms/fcad252] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 05/26/2023] [Accepted: 09/28/2023] [Indexed: 01/03/2024] Open
Abstract
Stroke alters blood flow to the brain resulting in damaged tissue and cell death. Moreover, the disruption of cerebral blood flow (perfusion) can be observed in areas surrounding and distal to the lesion. These structurally preserved but suboptimally perfused regions may also affect recovery. Thus, to better understand aphasia recovery, the relationship between cerebral perfusion and language needs to be systematically examined. In the current study, we aimed to evaluate (i) how stroke affects perfusion outside of lesioned areas in chronic aphasia and (ii) how perfusion in specific cortical areas and perilesional tissue relates to language outcomes in aphasia. We analysed perfusion data from a large sample of participants with chronic aphasia due to left hemisphere stroke (n = 43) and age-matched healthy controls (n = 25). We used anatomically defined regions of interest that covered the frontal, parietal, and temporal areas of the perisylvian cortex in both hemispheres, areas typically known to support language, along with several control regions not implicated in language processing. For the aphasia group, we also looked at three regions of interest in the perilesional tissue. We compared perfusion levels between the two groups and investigated the relationship between perfusion levels and language subtest scores while controlling for demographic and lesion variables. First, we observed that perfusion levels outside the lesioned areas were significantly reduced in frontal and parietal regions in the left hemisphere in people with aphasia compared to the control group, while no differences were observed for the right hemisphere regions. Second, we found that perfusion in the left temporal lobe (and most strongly in the posterior part of both superior and middle temporal gyri) and inferior parietal areas (supramarginal gyrus) was significantly related to residual expressive and receptive language abilities. In contrast, perfusion in the frontal regions did not show such a relationship; no relationship with language was also observed for perfusion levels in control areas and all right hemisphere regions. Third, perilesional perfusion was only marginally related to language production abilities. Cumulatively, the current findings demonstrate that blood flow is reduced beyond the lesion site in chronic aphasia and that hypoperfused neural tissue in critical temporoparietal language areas has a negative impact on behavioural outcomes. These results, using perfusion imaging, underscore the critical and general role that left hemisphere posterior temporal regions play in various expressive and receptive language abilities. Overall, the study highlights the importance of exploring perfusion measures in stroke.
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Affiliation(s)
- Maria V Ivanova
- Department of Psychology, University of California, Berkeley, CA 94720, USA
- Research Service, VA Northern California Health Care System, Martinez, CA 94553, USA
| | - Ioannis Pappas
- Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA 90033, USA
| | - Ben Inglis
- Henry H. Wheeler, Jr. Brain Imaging Center, University of California, Berkeley, CA 94720, USA
| | - Alexis L Pracar
- Department of Psychology, University of California, Berkeley, CA 94720, USA
| | - Timothy J Herron
- Research Service, VA Northern California Health Care System, Martinez, CA 94553, USA
| | - Juliana V Baldo
- Research Service, VA Northern California Health Care System, Martinez, CA 94553, USA
| | - Andrew S Kayser
- Division of Neurology, San Francisco VA Health Care System, San Francisco, CA 94121, USA
- Department of Neurology, University of California San Francisco, San Francisco, CA 94158, USA
| | - Mark D’Esposito
- Department of Psychology, University of California, Berkeley, CA 94720, USA
- Neurology Service, VA Northern California Health Care System, Martinez, CA 94553, USA
| | - Nina F Dronkers
- Department of Psychology, University of California, Berkeley, CA 94720, USA
- Depertment of Neurology, University of California, Davis, CA 95817, USA
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Ivanova MV, Pappas I. Understanding recovery of language after stroke: insights from neurovascular MRI studies. FRONTIERS IN LANGUAGE SCIENCES 2023; 2:1163547. [PMID: 38162928 PMCID: PMC10757818 DOI: 10.3389/flang.2023.1163547] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
Stroke causes a disruption in blood flow to the brain that can lead to profound language impairments. Understanding the mechanisms of language recovery after stroke is crucial for the prognosis and effective rehabilitation of people with aphasia. While the role of injured brain structures and disruptions in functional connectivity have been extensively explored, the relationship between neurovascular measures and language recovery in both early and later stages has not received sufficient attention in the field. Fully functioning healthy brain tissue requires oxygen and nutrients to be delivered promptly via its blood supply. Persistent decreases in blood flow after a stroke to the remaining non-lesioned tissue have been shown to contribute to poor language recovery. The goal of the current paper is to critically examine stroke studies looking at the relationship between different neurovascular measures and language deficits and mechanisms of language recovery via changes in neurovascular metrics. Measures of perfusion or cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) provide complementary approaches to understanding neurovascular mechanisms post stroke by capturing both cerebral metabolic demands and mechanical vascular properties. While CBF measures indicate the amount of blood delivered to a certain region and serve as a proxy for metabolic demands of that area, CVR indices reflect the ability of the vasculature to recruit blood flow in response to a shortage of oxygen, such as when one is holding their breath. Increases in CBF during recovery beyond the site of the lesion have been shown to promote language gains. Similarly, CVR changes, when collateral vessels are recruited to help reorganize the flow of blood in hypoperfused regions, have been related to functional recovery post stroke. In the current review, we highlight the main findings in the literature investigating neurovascular changes in stroke recovery with a particular emphasis on how language abilities can be affected by changes in CBF and CVR. We conclude by summarizing existing methodological challenges and knowledge gaps that need to be addressed in future work in this area, outlining a promising avenue of research.
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Affiliation(s)
- Maria V. Ivanova
- Department of Psychology, University of California, Berkeley, Berkeley, CA, United States
| | - Ioannis Pappas
- USC Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, United States
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Li KP, Wu JJ, Zhou ZL, Xu DS, Zheng MX, Hua XY, Xu JG. Noninvasive Brain Stimulation for Neurorehabilitation in Post-Stroke Patients. Brain Sci 2023; 13:brainsci13030451. [PMID: 36979261 PMCID: PMC10046557 DOI: 10.3390/brainsci13030451] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/26/2023] [Accepted: 02/27/2023] [Indexed: 03/09/2023] Open
Abstract
Characterized by high morbidity, mortality, and disability, stroke usually causes symptoms of cerebral hypoxia due to a sudden blockage or rupture of brain vessels, and it seriously threatens human life and health. Rehabilitation is the essential treatment for post-stroke patients suffering from functional impairments, through which hemiparesis, aphasia, dysphagia, unilateral neglect, depression, and cognitive dysfunction can be restored to various degrees. Noninvasive brain stimulation (NIBS) is a popular neuromodulatory technology of rehabilitation focusing on the local cerebral cortex, which can improve clinical functions by regulating the excitability of corresponding neurons. Increasing evidence has been obtained from the clinical application of NIBS, especially repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS). However, without a standardized protocol, existing studies on NIBS show a wide variation in terms of stimulation site, frequency, intensity, dosage, and other parameters. Its application for neurorehabilitation in post-stroke patients is still limited. With advances in neuronavigation technologies, functional near-infrared spectroscopy, and functional MRI, specific brain regions can be precisely located for stimulation. On the basis of our further understanding on neural circuits, neuromodulation in post-stroke rehabilitation has also evolved from single-target stimulation to co-stimulation of two or more targets, even circuits and the network. The present study aims to review the findings of current research, discuss future directions of NIBS application, and finally promote the use of NIBS in post-stroke rehabilitation.
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Affiliation(s)
- Kun-Peng Li
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Jia-Jia Wu
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Zong-Lei Zhou
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China
| | - Dong-Sheng Xu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Mou-Xiong Zheng
- Department of Traumatology and Orthopedics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
- Correspondence: (M.-X.Z.); (X.-Y.H.); (J.-G.X.)
| | - Xu-Yun Hua
- Department of Traumatology and Orthopedics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
- Correspondence: (M.-X.Z.); (X.-Y.H.); (J.-G.X.)
| | - Jian-Guang Xu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai 201203, China
- Correspondence: (M.-X.Z.); (X.-Y.H.); (J.-G.X.)
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Li Y, Yu Z, Zhou X, Wu P, Chen J. Aberrant interhemispheric functional reciprocities of the default mode network and motor network in subcortical ischemic stroke patients with motor impairment: A longitudinal study. Front Neurol 2022; 13:996621. [PMID: 36267883 PMCID: PMC9577250 DOI: 10.3389/fneur.2022.996621] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/15/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose The purpose of the present study was to explore the longitudinal changes in functional homotopy in the default mode network (DMN) and motor network and its relationships with clinical characteristics in patients with stroke. Methods Resting-state functional magnetic resonance imaging was performed in stroke patients with subcortical ischemic lesions and healthy controls. The voxel-mirrored homotopic connectivity (VMHC) method was used to examine the differences in functional homotopy in patients with stroke between the two time points. Support vector machine (SVM) and correlation analyses were also applied to investigate whether the detected significant changes in VMHC were the specific feature in patients with stroke. Results The patients with stroke had significantly lower VMHC in the DMN and motor-related regions than the controls, including in the precuneus, parahippocampus, precentral gyrus, supplementary motor area, and middle frontal gyrus. Longitudinal analysis revealed that the impaired VMHC of the superior precuneus showed a significant increase at the second time point, which was no longer significantly different from the controls. Between the two time points, the changes in VMHC in the superior precuneus were significantly correlated with the changes in clinical scores. SVM analysis revealed that the VMHC of the superior precuneus could be used to correctly identify the patients with stroke from the controls with a statistically significant accuracy of 81.25% (P ≤ 0.003). Conclusions Our findings indicated that the increased VMHC in the superior precuneus could be regarded as the neuroimaging manifestation of functional recovery. The significant correlation and the discriminative power in classification results might provide novel evidence to understand the neural mechanisms responsible for brain reorganization after stroke.
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Affiliation(s)
- Yongxin Li
- School of Traditional Chinese Medicine, Formula-Pattern Research Center, Jinan University, Guangzhou, China
- *Correspondence: Yongxin Li
| | - Zeyun Yu
- Acupuncture and Tuina School/Tird Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xuan Zhou
- School of Traditional Chinese Medicine, Formula-Pattern Research Center, Jinan University, Guangzhou, China
| | - Ping Wu
- Acupuncture and Tuina School/Tird Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Ping Wu
| | - Jiaxu Chen
- School of Traditional Chinese Medicine, Formula-Pattern Research Center, Jinan University, Guangzhou, China
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Firwana YMS, Zolkefley MKI, Mohamed Hatta HZ, Rowbin C, Che Mohd Nassir CMN, Hanafi MH, Abdullah MS, Keserci B, Lannin NA, Mustapha M. Regional cerebral blood perfusion changes in chronic stroke survivors as potential brain correlates of the functional outcome following gamified home-based rehabilitation (IntelliRehab)-a pilot study. J Neuroeng Rehabil 2022; 19:94. [PMID: 36002827 PMCID: PMC9404656 DOI: 10.1186/s12984-022-01072-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 08/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hospital-based stroke rehabilitation for stroke survivors in developing countries may be limited by staffing ratios and length of stay that could hamper recovery potential. Thus, a home-based, gamified rehabilitation system (i.e., IntelliRehab) was tested for its ability to increase cerebral blood flow (CBF), and the secondary impact of changes on the upper limb motor function and functional outcomes. OBJECTIVE To explore the effect of IntelliRehab on CBF in chronic stroke patients and its correlation with the upper limb motor function. METHODS Two-dimensional pulsed Arterial Spin Labelling (2D-pASL) was used to obtain CBF images of stable, chronic stroke subjects (n = 8) over 3-months intervention period. CBF alterations were mapped, and the detected differences were marked as regions of interest. Motor functions represented by Fugl-Meyer Upper Extremity Assessment (FMA) and Stroke Impact Scale (SIS) were used to assess the primary and secondary outcomes, respectively. RESULTS Regional CBF were significantly increased in right inferior temporal gyrus and left superior temporal white matter after 1-month (p = 0.044) and 3-months (p = 0.01) of rehabilitation, respectively. However, regional CBF in left middle fronto-orbital gyrus significantly declined after 1-month of rehabilitation (p = 0.012). Moreover, SIS-Q7 and FMA scores significantly increased after 1-month and 3-months of rehabilitation. There were no significant correlations, however, between CBF changes and upper limb motor function. CONCLUSIONS Participants demonstrated improved motor functions, supporting the benefit of using IntelliRehab as a tool for home-based rehabilitation. However, within-participant improvements may have limited potential that suggests the need for a timely administration of IntelliRehab to get the maximum capacity of improvement.
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Affiliation(s)
- Younis M S Firwana
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Mohd Khairul Izamil Zolkefley
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.,Faculty of Industrial Sciences and Technology, Universiti Malaysia Pahang, Kuantan, Malaysia
| | - Hasnetty Zuria Mohamed Hatta
- Rehabilitation Unit, Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Christina Rowbin
- Rehabilitation Unit, Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Che Mohd Nasril Che Mohd Nassir
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.,Kulliyyah of Islamic Revealed Knowledge and Human Sciences, International Islamic University Malaysia, Kuala Lumpur, Malaysia
| | - Muhammad Hafiz Hanafi
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.,Rehabilitation Unit, Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Mohd Shafie Abdullah
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Bilgin Keserci
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Natasha A Lannin
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia
| | - Muzaimi Mustapha
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
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Jin Y, Bai X, Jiang B, Guo Z, Mu Q. Repetitive Transcranial Magnetic Stimulation Induces Quantified Functional and Structural Changes in Subcortical Stroke: A Combined Arterial Spin Labeling Perfusion and Diffusion Tensor Imaging Study. Front Hum Neurosci 2022; 16:829688. [PMID: 35463928 PMCID: PMC9019060 DOI: 10.3389/fnhum.2022.829688] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/28/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose To explore the changes of cerebral blood flow (CBF) and fractional anisotropy (FA) in stroke patients with motor dysfunction after repetitive transcranial magnetic stimulation (rTMS) treatment, and to better understand the role of rTMS on motor rehabilitation of subcortical stroke patients from the perfusion and structural level. Materials and Methods In total, 23 first-episode acute ischemic stroke patients and sixteen healthy controls (HCs) were included. The patients were divided into the rTMS and sham group. The rehabilitation assessments and examination of perfusion and structural MRI were performed before and after rTMS therapy for each patient. Voxel-based analysis was used to detect the difference in CBF and FA among all three groups. The Pearson correlation analysis was conducted to evaluate the relationship between the CBF/FA value and the motor scales. Results After rTMS, significantly increased CBF was found in the ipsilesional supplementary motor area, postcentral gyrus, precentral gyrus, pons, medulla oblongata, contralesional midbrain, superior cerebellar peduncle, and middle cerebellar peduncle compared to that during the prestimulation and in the sham group, these fasciculi comprise the cortex-pontine-cerebellum-cortex (CPC) loop. Besides, altered CBF in the ipsilesional precentral gyrus, postcentral gyrus, and pons was positively associated with the improved Fugl-Meyer assessment (FMA) scores. Significantly decreased FA was found in the contralesional precentral gyrus, increased FA was found in the ipsilesional postcentral gyrus, precentral gyrus, contralesional supplementary motor area, and bilateral cerebellum, these fasciculi comprise the corticospinal tract (CST). The change of FMA score was positively correlated with altered FA value in the ipsilesional postcentral gyrus and negatively correlated with altered FA value in the contralesional precentral gyrus. Conclusion Our results suggested that rTMS could facilitate the motor recovery of stroke patients. High frequency could promote the improvement of functional activity of ipsilesional CPC loop and the recovery of the microstructure of CST.
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Affiliation(s)
- Yu Jin
- Department of Radiology, Chengdu Second People’s Hospital, Chengdu, China
| | - Xi Bai
- Department of Radiology, Langzhong People’s Hospital, Langzhong, China
| | - Binghu Jiang
- Department of Radiology, Nanchong Central Hospital, Institute of Rehabilitation and Imaging of Brain Function, The Second Clinical Medical College of North Sichuan Medical College, Nanchong, China
| | - Zhiwei Guo
- Department of Radiology, Nanchong Central Hospital, Institute of Rehabilitation and Imaging of Brain Function, The Second Clinical Medical College of North Sichuan Medical College, Nanchong, China
- *Correspondence: Zhiwei Guo,
| | - Qiwen Mu
- Department of Radiology, Nanchong Central Hospital, Institute of Rehabilitation and Imaging of Brain Function, The Second Clinical Medical College of North Sichuan Medical College, Nanchong, China
- Qiwen Mu,
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7
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Cerebral blood flow and cognitive outcome after pediatric stroke in the middle cerebral artery. Sci Rep 2021; 11:19421. [PMID: 34593847 PMCID: PMC8484584 DOI: 10.1038/s41598-021-98309-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 09/07/2021] [Indexed: 01/06/2023] Open
Abstract
Adaptive recovery of cerebral perfusion after pediatric arterial ischemic stroke (AIS) is sought to be crucial for sustainable rehabilitation of cognitive functions. We therefore examined cerebral blood flow (CBF) in the chronic stage after stroke and its association with cognitive outcome in patients after pediatric AIS. This cross-sectional study investigated CBF and cognitive functions in 14 patients (age 13.5 ± 4.4 years) after pediatric AIS in the middle cerebral artery (time since AIS was at least 2 years prior to assessment) when compared with 36 healthy controls (aged 13.8 ± 4.3 years). Cognitive functions were assessed with neuropsychological tests, CBF was measured with arterial spin labeled imaging in the anterior, middle, and posterior cerebral artery (ACA, MCA, PCA). Patients had significantly lower IQ scores and poorer cognitive functions compared to healthy controls (p < 0.026) but mean performance was within the normal range in all cognitive domains. Arterial spin labeled imaging revealed significantly lower CBF in the ipsilesional MCA and PCA in patients compared to healthy controls. Further, we found significantly higher interhemispheric perfusion imbalance in the MCA in patients compared to controls. Higher interhemispheric perfusion imbalance in the MCA was significantly associated with lower working memory performance. Our findings revealed that even years after a pediatric stroke in the MCA, reduced ipsilesional cerebral blood flow occurs in the MCA and PCA and that interhemispheric imbalance is associated with cognitive performance. Thus, our data suggest that cerebral hypoperfusion might underlie some of the variability observed in long-term outcome after pediatric stroke.
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Wang C, Miao P, Liu J, Li Z, Wei Y, Wang Y, Zhang Y, Wang K, Cheng J. Validation of cerebral blood flow connectivity as imaging prognostic biomarker on subcortical stroke. J Neurochem 2021; 159:172-184. [PMID: 33774813 PMCID: PMC9291780 DOI: 10.1111/jnc.15359] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/16/2021] [Accepted: 03/23/2021] [Indexed: 11/26/2022]
Abstract
Stroke is a major cause of vascular cognitive dysfunction, such as memory impairment. We aimed to explore the neural substrates underlying verbal memory impairment in subcortical stroke patients by the methods of voxel‐wise cerebral blood flow (CBF) and the functional covariance network (FCN). Sixty patients with chronic subcortical stroke and 60 normal controls (NCs) were recruited into this study. We used a three‐dimensional pseudo‐continuous arterial spin‐labeling imaging to measure alterations in CBF and FCNs. We mapped the overall CBF alterations in a voxel‐wise manner and compared CBF measurements using a two‐sample t test. Correlations between CBF and verbal memory were also investigated. Subsequently, we constructed FCNs by calculating the correlation between specific regions and all other voxels of a whole brain, separately within the two groups. Thereafter, by comparing differences of the FCN patterns between the patient and NC groups, we investigated the connection alterations within the FCN maps. The stroke patients showed verbal short‐term memory (VSTM) deficits compared to NCs. The patients exhibited decreased CBF in the ipsilesional insula and ventral sensorimotor network, and increased CBF in contralesional frontal cortical and subcortical regions (putamen and thalamus). Meanwhile, the CBF in the ipsilesional insula was positively correlated, and the contralesional frontal cortical was negativity correlated, with VSTM scores. Moreover we found that stroke patients exhibited disordered connection within FCNs compared to NCs. The study suggests that the underlying imaging biomarker of VSTM impairment in patients with subcortical stroke was associated with disconnection of the frontal lobe network.
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Affiliation(s)
- Caihong Wang
- Department of MRI, Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Peifang Miao
- Department of MRI, Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingchun Liu
- Department of Radiology, Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhen Li
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ying Wei
- Department of MRI, Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yingying Wang
- Department of MRI, Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yong Zhang
- MR Research, GE Healthcare, Shanghai, China
| | - Kaiyu Wang
- MR Research, GE Healthcare, Beijing, China
| | - Jingliang Cheng
- Department of MRI, Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Wei Y, Wu L, Wang Y, Liu J, Miao P, Wang K, Wang C, Cheng J. Disrupted Regional Cerebral Blood Flow and Functional Connectivity in Pontine Infarction: A Longitudinal MRI Study. Front Aging Neurosci 2020; 12:577899. [PMID: 33328960 PMCID: PMC7710811 DOI: 10.3389/fnagi.2020.577899] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/12/2020] [Indexed: 11/28/2022] Open
Abstract
Abnormal cerebral blood flow (CBF) and resting-state functional connectivity (rs-FC) are sensitive biomarkers of disease progression and prognosis. This study investigated neural underpinnings of motor and cognitive recovery by longitudinally studying the changes of CBF and FC in pontine infarction (PI). Twenty patients underwent three-dimensional pseudo-continuous arterial spin labeling (3D-pcASL), resting-state functional magnetic resonance imaging (rs-fMRI) scans, and behavioral assessments at 1 week, 1, 3, and 6 months after stroke. Twenty normal control (NC) subjects underwent the same examination once. First, we investigated CBF changes in the acute stage, and longitudinal changes from 1 week to 6 months after PI. Brain regions with longitudinal CBF changes were then used as seeds to investigate longitudinal FC alterations during the follow-up period. Compared with NC, patients in the left PI (LPI) and right PI (RPI) groups showed significant CBF alterations in the bilateral cerebellum and some supratentorial brain regions at the baseline stage. Longitudinal analysis revealed that altered CBF values in the right supramarginal (SMG_R) for the LPI group, while the RPI group showed significantly dynamic changes of CBF in the left calcarine sulcus (CAL_L), middle occipital gyrus (MOG_L), and right supplementary motor area (SMA_R). Using the SMG_R as the seed in the LPI group, FC changes were found in the MOG_L, middle temporal gyrus (MTG_L), and prefrontal lobe (IFG_L). Correlation analysis showed that longitudinal CBF changes in the SMG_R and FC values between the SMG_R and MOG_L were associated with motor and memory scores in the LPI group, and longitudinal CBF changes in the CAL_L and SMA_R were related to memory and motor recovery in the RPI group. These longitudinal CBF and accompany FC alterations may provide insights into the neural mechanism underlying functional recovery after PI, including that of motor and cognitive functions.
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Affiliation(s)
- Ying Wei
- First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Luobing Wu
- First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yingying Wang
- First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingchun Liu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Peifang Miao
- First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Kaiyu Wang
- GE Healthcare MR Research, Beijing, China
| | - Caihong Wang
- First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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10
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Leistner R, Everts R, Federspiel A, Kornfeld S, Slavova N, Steiner L, Wiest R, Steinlin M, Grunt S. Cerebral blood flow imbalance is associated with motor outcome after pediatric arterial ischemic stroke. PLoS One 2019; 14:e0223584. [PMID: 31603919 PMCID: PMC6788710 DOI: 10.1371/journal.pone.0223584] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 09/24/2019] [Indexed: 12/30/2022] Open
Abstract
Cerebral hemodynamics after arterial ischemic stroke (AIS) in children are largely unknown. This study aims to explore long-term cerebral perfusion balance of vital tissue and its relation to motor outcome after childhood AIS. Patients diagnosed with childhood AIS (≤16 years at diagnosis, time since stroke ≥2 years) and typically developing peers were examined. Hemiparesis was classified according to the Pediatric Stroke Outcome Measure. Manual ability was assessed using the ABILHAND-Kids questionnaire. Cerebral blood flow was measured by arterial spin labeling and analyzed in the following brain regions: the hemispheres, the territory of the anterior cerebral artery (ACA), the middle cerebral artery (MCA), and in subregions of the MCA territory (MCA anterior, middle, posterior). To assess cerebral perfusion balance, laterality indices were calculated using cerebral blood flow in the ipsi- and contralesional hemisphere. Laterality indices were compared between stroke patients with and without hemiparesis, and peers. Twenty participants diagnosed with AIS were included (12 boys, 8 girls; mean age 14.46±4.96 years; time since stroke 8.08±3.62 years); 9 (45%) were diagnosed with hemiparesis. Additionally, 47 typically developing peers (21 boys, 26 girls; mean age 14.24±5.42 years) were studied. Laterality indices were higher in stroke patients and oriented to the contralesional hemisphere in all brain regions except the ACA territory and MCA posterior subregion. This was significantly different from peers, who showed balanced laterality indices. There was a significant correlation between laterality indices and manual ability, except in the ACA territory. AIS is associated with long-term alterations of cerebral blood flow in vital tissue, even in patients without hemiparesis. The degree of imbalance of cerebral perfusion in children after AIS is associated with manual ability.
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Affiliation(s)
- Rebekka Leistner
- Division of Neuropediatrics, Development and Rehabilitation, University Children’s Hospital, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Regula Everts
- Division of Neuropediatrics, Development and Rehabilitation, University Children’s Hospital, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of Diabetes, Endocrinology, Clinical Nutrition and Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- * E-mail:
| | - Andrea Federspiel
- Psychiatric Neuroimaging Unit, Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Salome Kornfeld
- Division of Neuropediatrics, Development and Rehabilitation, University Children’s Hospital, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nedelina Slavova
- Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Leonie Steiner
- Division of Neuropediatrics, Development and Rehabilitation, University Children’s Hospital, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Roland Wiest
- Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Maja Steinlin
- Division of Neuropediatrics, Development and Rehabilitation, University Children’s Hospital, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sebastian Grunt
- Division of Neuropediatrics, Development and Rehabilitation, University Children’s Hospital, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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11
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Delorme M, Vergotte G, Perrey S, Froger J, Laffont I. Time course of sensorimotor cortex reorganization during upper extremity task accompanying motor recovery early after stroke: An fNIRS study. Restor Neurol Neurosci 2019; 37:207-218. [PMID: 31227675 DOI: 10.3233/rnn-180877] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND The acute phase of stroke is accompanied by functional changes and interplay of both hemispheres. However, our understanding of how the time course of upper limb functional motor recovery is related to the progression of brain reorganization in the sensorimotor areas remains limited. This study aimed to assess the time course of hemodynamic patterns of cortical sensorimotor areas using functional near infrared spectroscopy (fNIRS) and motor recovery within three months after a stroke. METHOD Eight right-handed first ischemic/hemorrhagic stroke patients (60±8 years, 3 women) with mild to severe hemiparesis were examined with repetitive fNIRS measurements and motor recovery tests (Fugl-Meyer score) during two months. Hemodynamic changes over the ipsilesional and contralesional sensorimotor areas were collected from a multi-channel fNIRS system during intermittent isometric muscle contractions at self-selected submaximal force levels for each arm. Lateralization index was computed to evaluate the changes in the interhemispheric balance between the cortical sensorimotor areas. RESULTS Lateralization index values during non-paretic arm movements showed no significant changes over time in patients and were comparable to those observed in eight healthy controls. Paretic-arm movements were associated early with a bilateral cortical activity before shifting to ipsilesional patterns (p < 0.01). Progressive lateralization observed over the two months (p < 0.05) evolved concomitantly with an increase in the Fugl-Meyer score (p < 0.001). CONCLUSIONS Cortical reorganization monitoring using fNIRS during the first weeks after stroke may be applied for assessing progressive brain plasticity in addition to clinical measures of performance.
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Affiliation(s)
- Marion Delorme
- EuroMov, Univ. Montpellier, Montpellier, France.,Nîmes University Hospital, Department of Physical Medicine and Rehabilitation, Nîmes, France
| | | | | | - Jérôme Froger
- EuroMov, Univ. Montpellier, Montpellier, France.,Nîmes University Hospital, Department of Physical Medicine and Rehabilitation, Nîmes, France
| | - Isabelle Laffont
- EuroMov, Univ. Montpellier, Montpellier, France.,Montpellier University Hospital, Department of Physical Medicine and Rehabilitation, Montpellier, France
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12
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Wang C, Miao P, Liu J, Wei S, Guo Y, Li Z, Zheng D, Cheng J. Cerebral blood flow features in chronic subcortical stroke: Lesion location-dependent study. Brain Res 2019; 1706:177-183. [DOI: 10.1016/j.brainres.2018.11.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 11/07/2018] [Accepted: 11/08/2018] [Indexed: 02/07/2023]
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13
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Hong X, Lu ZK, Teh I, Nasrallah FA, Teo WP, Ang KK, Phua KS, Guan C, Chew E, Chuang KH. Brain plasticity following MI-BCI training combined with tDCS in a randomized trial in chronic subcortical stroke subjects: a preliminary study. Sci Rep 2017; 7:9222. [PMID: 28835651 PMCID: PMC5569072 DOI: 10.1038/s41598-017-08928-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 05/24/2017] [Indexed: 12/17/2022] Open
Abstract
Brain-computer interface-assisted motor imagery (MI-BCI) or transcranial direct current stimulation (tDCS) has been used in stroke rehabilitation, though their combinatory effect is unknown. We investigated brain plasticity following a combined MI-BCI and tDCS intervention in chronic subcortical stroke patients with unilateral upper limb disability. Nineteen patients were randomized into tDCS and sham-tDCS groups. Diffusion and perfusion MRI, and transcranial magnetic stimulation were used to study structural connectivity, cerebral blood flow (CBF), and corticospinal excitability, respectively, before and 4 weeks after the 2-week intervention. After quality control, thirteen subjects were included in the CBF analysis. Eleven healthy controls underwent 2 sessions of MRI for reproducibility study. Whereas motor performance showed comparable improvement, long-lasting neuroplasticity can only be detected in the tDCS group, where white matter integrity in the ipsilesional corticospinal tract and bilateral corpus callosum was increased but sensorimotor CBF was decreased, particularly in the ipsilesional side. CBF change in the bilateral parietal cortices also correlated with motor function improvement, consistent with the increased white matter integrity in the corpus callosum connecting these regions, suggesting an involvement of interhemispheric interaction. The preliminary results indicate that tDCS may facilitate neuroplasticity and suggest the potential for refining rehabilitation strategies for stroke patients.
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Affiliation(s)
- Xin Hong
- Singapore Bioimaging Consortium, Agency for Science Technology and Research, 11 Biopolis Way, #02-02 Helios, Singapore, 138667, Singapore
| | - Zhong Kang Lu
- Institute for Infocomm Research, Agency for Science Technology and Research, 1 Fusionopolis Way, #21-01 Connexis (South Tower), Singapore, 138632, Singapore
| | - Irvin Teh
- Clinical Imaging Research Center, Agency for Science Technology and Research, Centre for Translational Medicine (MD6), 14 Medical Drive, #B1-01, Singapore, 117599, Singapore
- Wellcome Trust Centre for Human Genetics, Roosevelt Drive, Oxford, OX3 7BN, UK
| | - Fatima Ali Nasrallah
- Singapore Bioimaging Consortium, Agency for Science Technology and Research, 11 Biopolis Way, #02-02 Helios, Singapore, 138667, Singapore
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, 4072, Australia
| | - Wei Peng Teo
- Division of Neurology, National University Hospital System, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia
| | - Kai Keng Ang
- Institute for Infocomm Research, Agency for Science Technology and Research, 1 Fusionopolis Way, #21-01 Connexis (South Tower), Singapore, 138632, Singapore
| | - Kok Soon Phua
- Institute for Infocomm Research, Agency for Science Technology and Research, 1 Fusionopolis Way, #21-01 Connexis (South Tower), Singapore, 138632, Singapore
| | - Cuntai Guan
- Institute for Infocomm Research, Agency for Science Technology and Research, 1 Fusionopolis Way, #21-01 Connexis (South Tower), Singapore, 138632, Singapore
- School of Computer Science and Engineering, Nanynag Technological University, 50 Nanyang Avenue, Singapore, 639798, Singapore
| | - Effie Chew
- Division of Neurology, National University Hospital System, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore.
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, 1E Kent Ridge Road, Singapore, 119228, Singapore.
| | - Kai-Hsiang Chuang
- Singapore Bioimaging Consortium, Agency for Science Technology and Research, 11 Biopolis Way, #02-02 Helios, Singapore, 138667, Singapore.
- Clinical Imaging Research Center, Agency for Science Technology and Research, Centre for Translational Medicine (MD6), 14 Medical Drive, #B1-01, Singapore, 117599, Singapore.
- Queensland Brain Institute and Centre for Advanced Imaging, The University of Queensland, Brisbane, Queensland, 4072, Australia.
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14
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Hannanu FF, Zeffiro TA, Lamalle L, Heck O, Renard F, Thuriot A, Krainik A, Hommel M, Detante O, Jaillard A. Parietal operculum and motor cortex activities predict motor recovery in moderate to severe stroke. NEUROIMAGE-CLINICAL 2017; 14:518-529. [PMID: 28317947 PMCID: PMC5342999 DOI: 10.1016/j.nicl.2017.01.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 01/09/2017] [Accepted: 01/22/2017] [Indexed: 12/18/2022]
Abstract
While motor recovery following mild stroke has been extensively studied with neuroimaging, mechanisms of recovery after moderate to severe strokes of the types that are often the focus for novel restorative therapies remain obscure. We used fMRI to: 1) characterize reorganization occurring after moderate to severe subacute stroke, 2) identify brain regions associated with motor recovery and 3) to test whether brain activity associated with passive movement measured in the subacute period could predict motor outcome six months later. Because many patients with large strokes involving sensorimotor regions cannot engage in voluntary movement, we used passive flexion-extension of the paretic wrist to compare 21 patients with subacute ischemic stroke to 24 healthy controls one month after stroke. Clinical motor outcome was assessed with Fugl-Meyer motor scores (motor-FMS) six months later. Multiple regression, with predictors including baseline (one-month) motor-FMS and sensorimotor network regional activity (ROI) measures, was used to determine optimal variable selection for motor outcome prediction. Sensorimotor network ROIs were derived from a meta-analysis of arm voluntary movement tasks. Bootstrapping with 1000 replications was used for internal model validation. During passive movement, both control and patient groups exhibited activity increases in multiple bilateral sensorimotor network regions, including the primary motor (MI), premotor and supplementary motor areas (SMA), cerebellar cortex, putamen, thalamus, insula, Brodmann area (BA) 44 and parietal operculum (OP1-OP4). Compared to controls, patients showed: 1) lower task-related activity in ipsilesional MI, SMA and contralesional cerebellum (lobules V-VI) and 2) higher activity in contralesional MI, superior temporal gyrus and OP1-OP4. Using multiple regression, we found that the combination of baseline motor-FMS, activity in ipsilesional MI (BA4a), putamen and ipsilesional OP1 predicted motor outcome measured 6 months later (adjusted-R2 = 0.85; bootstrap p < 0.001). Baseline motor-FMS alone predicted only 54% of the variance. When baseline motor-FMS was removed, the combination of increased activity in ipsilesional MI-BA4a, ipsilesional thalamus, contralesional mid-cingulum, contralesional OP4 and decreased activity in ipsilesional OP1, predicted better motor outcome (djusted-R2 = 0.96; bootstrap p < 0.001). In subacute stroke, fMRI brain activity related to passive movement measured in a sensorimotor network defined by activity during voluntary movement predicted motor recovery better than baseline motor-FMS alone. Furthermore, fMRI sensorimotor network activity measures considered alone allowed excellent clinical recovery prediction and may provide reliable biomarkers for assessing new therapies in clinical trial contexts. Our findings suggest that neural reorganization related to motor recovery from moderate to severe stroke results from balanced changes in ipsilesional MI (BA4a) and a set of phylogenetically more archaic sensorimotor regions in the ventral sensorimotor trend, in which OP1 and OP4 processes may complement the ipsilesional dorsal motor cortex in achieving compensatory sensorimotor recovery. Motor recovery after stroke can be robustly predicted using a passive task fMRI paradigm. Sensorimotor network activity is decreased in moderate to severe stroke patients relative to healthy controls Compensatory mechanisms in severe stroke involve both the dorsal (MI BA4a), and the ventral (OP1 and OP4) sensorimotor stream
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Affiliation(s)
- Firdaus Fabrice Hannanu
- Unité IRM 3T-Recherche- UMS IRMaGe – Centre Hospitalier Universitaire (CHU) Grenoble Alpes, France
- Laboratoire MATICE - Pôle Recherche – CHU Grenoble-Alpes, France
| | - Thomas A. Zeffiro
- Laboratoire MATICE - Pôle Recherche – CHU Grenoble-Alpes, France
- Neurometrika, Potomac, MD, United States
| | - Laurent Lamalle
- Unité IRM 3T-Recherche- UMS IRMaGe – Centre Hospitalier Universitaire (CHU) Grenoble Alpes, France
- IRMaGe - Inserm US-017, France
- IRMaGe - CNRS UMS-3552, France
- IRMaGe - Université Grenoble-Alpes -, France
| | - Olivier Heck
- Neuroradiologie et IRM-Centre Hospitalier Universitaire Grenoble-Alpes, France
- Grenoble Institut des Neurosciences (GIN) Inserm U836-UJF-CEA-CHU, France
| | - Félix Renard
- AGEIS, EA-UGA 7407 Université Grenoble Alpes, France
| | - Antoine Thuriot
- AGEIS, EA-UGA 7407 Université Grenoble Alpes, France
- Unité neurovasculaire - CHU Grenoble-Alpes, France
| | - Alexandre Krainik
- Unité IRM 3T-Recherche- UMS IRMaGe – Centre Hospitalier Universitaire (CHU) Grenoble Alpes, France
- IRMaGe - Inserm US-017, France
- IRMaGe - CNRS UMS-3552, France
- IRMaGe - Université Grenoble-Alpes -, France
- Neuroradiologie et IRM-Centre Hospitalier Universitaire Grenoble-Alpes, France
- Grenoble Institut des Neurosciences (GIN) Inserm U836-UJF-CEA-CHU, France
| | - Marc Hommel
- Laboratoire MATICE - Pôle Recherche – CHU Grenoble-Alpes, France
- AGEIS, EA-UGA 7407 Université Grenoble Alpes, France
- Clinatec - CHU Grenoble-Alpes, France
| | - Olivier Detante
- Laboratoire MATICE - Pôle Recherche – CHU Grenoble-Alpes, France
- Grenoble Institut des Neurosciences (GIN) Inserm U836-UJF-CEA-CHU, France
- Unité neurovasculaire - CHU Grenoble-Alpes, France
| | - Assia Jaillard
- Unité IRM 3T-Recherche- UMS IRMaGe – Centre Hospitalier Universitaire (CHU) Grenoble Alpes, France
- Laboratoire MATICE - Pôle Recherche – CHU Grenoble-Alpes, France
- AGEIS, EA-UGA 7407 Université Grenoble Alpes, France
- Corresponding author at: Unité IRM 3T Recherche - CHU Grenoble-Alpes - CS 10217, 38043 Grenoble, France.Unité IRM 3T Recherche - CHU Grenoble-Alpes - CS 10217Grenoble38043France
| | - ISIS-HERMES Study GroupGaramboisK.1Barbieux-GuillotM.2Favre-WikiI.2GrandS.3Le BasJ.F.4MoisanA.5RichardM.J.6De FraipontF.6GereJ.7MarcelS.7VadotW.8RodierG.8PerennouD.9ChrispinA.9DavoineP.9NaegeleB.2AntoineP.2TropresI.10RenardF.11Stroke Unit Centre Hospitalier UniversitaireGrenoble Alpes [CHUGA], FranceStroke Unit CHUGA, FranceNeuroradiology CHUGA, FranceNeuroradiologie CHUGA, FranceUnité Mixte de Thérapie Cellulaire [UMTC] CHUGA, FranceUMTC, FranceStroke Unit, CH Chambéry, FranceStroke Unit, CH Annecy, FranceRehabilitation Unit CHUGA, FranceIRMaGe UGA, FranceAGEIS-UGA, France
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15
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Wagner F, Weder S, Caversaccio MD, Federspiel A, Wiest R, Senn P. Functional magnetic resonance imaging in seven borderline cochlear implant candidates: a preliminary research study. Clin Otolaryngol 2017; 42:1053-1057. [PMID: 27930861 DOI: 10.1111/coa.12806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2016] [Indexed: 12/01/2022]
Affiliation(s)
- F Wagner
- Department of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital Bern, Bern, Switzerland
| | - S Weder
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital Bern, Bern, Switzerland
| | - M D Caversaccio
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital Bern, Bern, Switzerland
| | - A Federspiel
- Translational Research Centre, University Hospital of Psychiatry, Inselspital, University Hospital Bern, Bern, Switzerland
| | - R Wiest
- Department of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital Bern, Bern, Switzerland
| | - P Senn
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital Bern, Bern, Switzerland
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16
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17
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Li Y, Chen Z, Su X, Zhang X, Wang P, Zhu Y, Xu Q, Xu J, Tong S. Functional lateralization in cingulate cortex predicts motor recovery after basal ganglia stroke. Neurosci Lett 2016; 613:6-12. [PMID: 26742641 DOI: 10.1016/j.neulet.2015.12.051] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 12/20/2015] [Accepted: 12/23/2015] [Indexed: 11/18/2022]
Abstract
The basal ganglia (BG) is involved in higher order motor control such as movement planning and execution of complex motor synergies. Neuroimaging study on stroke patients specifically with BG lesions would help to clarify the consequence of BG damage on motor control. In this paper, we performed a longitudinal study in the stroke patients with lesions in BG regions across three motor recovery stages, i.e., less than 2week (Session 1), 1-3m (Session 2) and more than 3m (Session 3). The patients showed an activation shift from bilateral hemispheres during early sessions (<3m) to the ipsilesional cortex in late session (>3m), suggesting a compensation effect from the contralesional hemisphere during motor recovery. We found that the lateralization of cerebellum(CB) for affected hand task correlated with patients' concurrent Fugl-Meyer index (FMI) in Session 2. Moreover, the cingulate cortex lateralization index in Session 2 was shown to significantly correlate with subsequent FMI change between Session 3 and Session 2, which serves as a prognostic marker for motor recovery. Our findings consolidated the close interactions between BG and CB during the motor recovery after stroke. The dominance of activation in contralateral cingulate cortex was associated with a better motor recovery, suggesting the important role of ipsilesional attention modulation in the early stage after BG stroke.
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Affiliation(s)
- Yao Li
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China; Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Zengai Chen
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
| | - Xin Su
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Xiaoliu Zhang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Ping Wang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Yajing Zhu
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Qun Xu
- Department of Neurology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Jianrong Xu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Shanbao Tong
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China; Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200030, China.
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18
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Functional versus Nonfunctional Rehabilitation in Chronic Ischemic Stroke: Evidences from a Randomized Functional MRI Study. Neural Plast 2015; 2016:6353218. [PMID: 26839716 PMCID: PMC4709724 DOI: 10.1155/2016/6353218] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 09/27/2015] [Accepted: 09/30/2015] [Indexed: 11/18/2022] Open
Abstract
Motor rehabilitation of stroke survivors may include functional and/or nonfunctional strategy. The present study aimed to compare the effect of these two rehabilitation strategies by means of clinical scales and functional Magnetic Resonance Imaging (fMRI). Twelve hemiparetic chronic stroke patients were selected. Patients were randomly assigned a nonfunctional (NFS) or functional (FS) rehabilitation scheme. Clinical scales (Fugl-Meyer, ARA test, and modified Barthel) and fMRI were applied at four moments: before rehabilitation (P1) and immediately after (P2), 1 month after (P3), and three months after (P4) the end of rehabilitation. The NFS group improved significantly and exclusively their Fugl-Meyer scores at P2, P3, and P4, when compared to P1. On the other hand, the FS group increased significantly in Fugl-Meyer at P2, when compared to P1, and also in their ARA and Barthel scores. fMRI inspection at the individual level revealed that both rehabilitation schemes most often led to decreased activation sparseness, decreased activity of contralesional M1, increased asymmetry of M1 activity to the ipsilesional side, decreased perilesional activity, and decreased SMA activity. Increased M1 asymmetry with rehabilitation was also confirmed by Lateralization Indexes. Our clinical analysis revealed subtle differences between FS and NFS.
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Abela E, Missimer JH, Federspiel A, Seiler A, Hess CW, Sturzenegger M, Wiest R, Weder BJ. A Thalamic-Fronto-Parietal Structural Covariance Network Emerging in the Course of Recovery from Hand Paresis after Ischemic Stroke. Front Neurol 2015; 6:211. [PMID: 26528235 PMCID: PMC4602136 DOI: 10.3389/fneur.2015.00211] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 09/17/2015] [Indexed: 01/20/2023] Open
Abstract
AIM To describe structural covariance networks of gray matter volume (GMV) change in 28 patients with first-ever stroke to the primary sensorimotor cortices, and to investigate their relationship to hand function recovery and local GMV change. METHODS Tensor-based morphometry maps derived from high-resolution structural images were subject to principal component analyses to identify the networks. We calculated correlations between network expression and local GMV change, sensorimotor hand function and lesion volume. To verify which of the structural covariance networks of GMV change have a significant relationship to hand function, we performed an additional multivariate regression approach. RESULTS Expression of the second network, explaining 9.1% of variance, correlated with GMV increase in the medio-dorsal (md) thalamus and hand motor skill. Patients with positive expression coefficients were distinguished by significantly higher GMV increase of this structure during stroke recovery. Significant nodes of this network were located in md thalamus, dorsolateral prefrontal cortex, and higher order sensorimotor cortices. Parameter of hand function had a unique relationship to the network and depended on an interaction between network expression and lesion volume. Inversely, network expression is limited in patients with large lesion volumes. CONCLUSION Chronic phase of sensorimotor cortical stroke has been characterized by a large scale co-varying structural network in the ipsilesional hemisphere associated specifically with sensorimotor hand skill. Its expression is related to GMV increase of md thalamus, one constituent of the network, and correlated with the cortico-striato-thalamic loop involved in control of motor execution and higher order sensorimotor cortices. A close relation between expression of this network with degree of recovery might indicate reduced compensatory resources in the impaired subgroup.
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Affiliation(s)
- Eugenio Abela
- Support Center for Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, University Hospital Inselspital, University of Bern , Bern , Switzerland
| | - John H Missimer
- Laboratory of Biomolecular Research, Paul Scherrer Institute , Villigen , Switzerland
| | - Andrea Federspiel
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, University of Bern , Bern , Switzerland
| | - Andrea Seiler
- Support Center for Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, University Hospital Inselspital, University of Bern , Bern , Switzerland ; Department of Neurology, University Hospital Inselspital, University of Bern , Bern , Switzerland
| | - Christian Walter Hess
- Department of Neurology, University Hospital Inselspital, University of Bern , Bern , Switzerland
| | - Matthias Sturzenegger
- Department of Neurology, University Hospital Inselspital, University of Bern , Bern , Switzerland
| | - Roland Wiest
- Support Center for Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, University Hospital Inselspital, University of Bern , Bern , Switzerland
| | - Bruno J Weder
- Support Center for Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, University Hospital Inselspital, University of Bern , Bern , Switzerland ; Department of Neurology, Kantonsspital St. Gallen , St. Gallen , Switzerland
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