1
|
Ramirez-Garcia G, Escutia-Macedo X, Cook DJ, Moreno-Andrade T, Villarreal-Garza E, Campos-Coy M, Elizondo-Riojas G, Gongora-Rivera F, Garza-Villarreal EA, Fernandez-Ruiz J. Consistent spatial lesion-symptom patterns: A comprehensive analysis using triangulation in lesion-symptom mapping in a cohort of stroke patients. Magn Reson Imaging 2024; 109:286-293. [PMID: 38531463 DOI: 10.1016/j.mri.2024.03.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 02/29/2024] [Accepted: 03/19/2024] [Indexed: 03/28/2024]
Abstract
INTRODUCTION The relationship between brain lesions and stroke outcomes is crucial for advancing patient prognosis and developing effective therapies. Stroke is a leading cause of disability worldwide, and it is important to understand the neurological basis of its varied symptomatology. Lesion-symptom mapping (LSM) methods provide a means to identify brain areas that are strongly associated with specific symptoms. However, inner variations in LSM methods can yield different results. To address this, our study aimed to characterize the lesion-symptom mapping variability using three different LSM methods. Specifically, we sought to determine a lesion symptom core across LSM approaches enhancing the robustness of the analysis and removing potential spatial bias. MATERIAL & METHODS A cohort consisting of 35 patients with either right- or left-sided middle cerebral artery strokes were enrolled and evaluated using the NIHSS at 24 h post-stroke. Anatomical T1w MRI scans were also obtained 24 h post-stroke. Lesion masks were segmented manually and three distinctive LSM methods were implemented: ROI correlation-based, univariate, and multivariate approaches. RESULTS The results of the LSM analyses showed substantial spatial differences in the extension of each of the three lesion maps. However, upon overlaying all three lesion-symptom maps, a consistent lesion core emerged, corresponding to the territory associated with elevated NIHSS scores. This finding not only enhances the spatial accuracy of the lesion map but also underscores its clinical relevance. CONCLUSION This study underscores the significance of exploring complementary LSM approaches to investigate the association between brain lesions and stroke outcomes. By utilizing multiple methods, we can increase the robustness of our results, effectively addressing and neutralizing potential spatial bias introduced by each individual method. Such an approach holds promise for enhancing our understanding of stroke pathophysiology and optimizing patient care strategies.
Collapse
Affiliation(s)
- Gabriel Ramirez-Garcia
- Laboratorio de Neuropsicologia, Departamento de Fisiologia, Facultad de Medicina, Universidad Nacional Autonoma de Mexico, Ciudad de Mexico, Mexico; Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Ximena Escutia-Macedo
- Laboratorio de Neuropsicologia, Departamento de Fisiologia, Facultad de Medicina, Universidad Nacional Autonoma de Mexico, Ciudad de Mexico, Mexico
| | - Douglas J Cook
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada; Translational Stroke Research Lab, Department of Surgery, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Talia Moreno-Andrade
- Departamento de Neurologia, Hospital Universitario Dr. Jose Eleuterio Gonzalez Universidad Autonoma de Nuevo León, Monterrey, Nuevo Leon, Mexico; Unidad de Neuromodulacion y Plasticidad Cerebral, Centro de Investigacion y Desarrollo en Ciencias de la Salud, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | - Estefania Villarreal-Garza
- Departamento de Neurologia, Hospital Universitario Dr. Jose Eleuterio Gonzalez Universidad Autonoma de Nuevo León, Monterrey, Nuevo Leon, Mexico
| | - Mario Campos-Coy
- Unidad de Neuromodulacion y Plasticidad Cerebral, Centro de Investigacion y Desarrollo en Ciencias de la Salud, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico; Departamento de Imagen Diagnostica, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | - Guillermo Elizondo-Riojas
- Unidad de Neuromodulacion y Plasticidad Cerebral, Centro de Investigacion y Desarrollo en Ciencias de la Salud, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico; Departamento de Imagen Diagnostica, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | - Fernando Gongora-Rivera
- Departamento de Neurologia, Hospital Universitario Dr. Jose Eleuterio Gonzalez Universidad Autonoma de Nuevo León, Monterrey, Nuevo Leon, Mexico; Unidad de Neuromodulacion y Plasticidad Cerebral, Centro de Investigacion y Desarrollo en Ciencias de la Salud, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | - Eduardo A Garza-Villarreal
- Instituto de Neurobiologia, Universidad Nacional Autonoma de Mexico, Juriquilla, Queretaro, Mexico; Departamento de Neurologia, Hospital Universitario Dr. Jose Eleuterio Gonzalez Universidad Autonoma de Nuevo León, Monterrey, Nuevo Leon, Mexico
| | - Juan Fernandez-Ruiz
- Laboratorio de Neuropsicologia, Departamento de Fisiologia, Facultad de Medicina, Universidad Nacional Autonoma de Mexico, Ciudad de Mexico, Mexico; Facultad de Psicologia, Universidad Veracruzana, Xalapa, Veracruz, Mexico.
| |
Collapse
|
2
|
Moreno-Andrade T, Garza-Villarreal E, González-Aquines A, Villarreal-Garza E, López-Garza N, Campos-Coy M, Elizondo-Riojas G, Góngora-Rivera F. [Diffusion tensor imaging of the corticospinal pathway and its association with the prognosis of acute cerebral infarction: experience with a cohort in Mexico]. Rev Neurol 2021; 72:16-22. [PMID: 33378075 DOI: 10.33588/rn.7201.2020232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Magnetic resonance diffusion tensor imaging through the fraction of anisotropy allows evaluation of the integrity of the motor pathways after cerebral infarction. AIMS To correlate the fraction of anisotropy with the clinical scales and the prognosis of cerebral infarction. SUBJECTS AND METHODS Prospective study of patients with cerebral infarction to compare the fraction of anisotropy in different regions of interest with functional evaluations and with controls free of infarction. A subgroup of subjects with rehabilitation underwent an initial MRI scan and another at three months, with clinical follow-up for six months. RESULTS Thirty-eight consecutive patients with middle cerebral artery infarction were included. The fraction of anisotropy values were lower in the ipsilateral corticospinal pathway than the fraction of anisotropy of the corticospinal pathway of the controls. The values of the fraction of anisotropy in the ipsilateral corticospinal pathway were associated with the value of the functional scale on admission. Changes in the fraction of anisotropy values between the initial MRI and the scan performed at three months correlated with the score on the functional scale and the modified Rankin scale at three and six months. CONCLUSIONS The value of the fraction of anisotropy in the ipsilateral internal capsule is associated with the presence of a lesion and with its presenting symptoms. Changes in the fraction of anisotropy at three months suggest long-term clinical recovery.
Collapse
Affiliation(s)
- T Moreno-Andrade
- Hospital Universitario Doctor José E. González. Universidad Autónoma de Nuevo León, Monterrey, México.,Centro de Investigación y Desarrollo en Ciencias de la Salud (CIDICS). Universidad Autónoma de , Monterrey, México
| | - E Garza-Villarreal
- Hospital Universitario Doctor José E. González. Universidad Autónoma de Nuevo León, Monterrey, México.,Centro de Investigación y Desarrollo en Ciencias de la Salud (CIDICS). Universidad Autónoma de , Monterrey, México.,Laboratorio Nacional de Imagenología por Resonancia Magnética. Instituto de Neurobiología, México DF, México.,Centro de Neurociencias Integrativa y Funcional. Universidad de Aarhus, Aarhus, Dinamarca
| | - A González-Aquines
- Hospital Universitario Doctor José E. González. Universidad Autónoma de Nuevo León, Monterrey, México
| | - E Villarreal-Garza
- Hospital Universitario Doctor José E. González. Universidad Autónoma de Nuevo León, Monterrey, México
| | - N López-Garza
- Hospital Universitario Doctor José E. González. Universidad Autónoma de Nuevo León, Monterrey, México
| | - M Campos-Coy
- Departamento de Imagen Diagnóstica. Universidad Autónoma de Nuevo León, Monterrey, México
| | - G Elizondo-Riojas
- Departamento de Imagen Diagnóstica. Universidad Autónoma de Nuevo León, Monterrey, México
| | - F Góngora-Rivera
- Hospital Universitario Doctor José E. González. Universidad Autónoma de Nuevo León, Monterrey, México.,Centro de Investigación y Desarrollo en Ciencias de la Salud (CIDICS). Universidad Autónoma de , Monterrey, México
| |
Collapse
|