Connection Disruption Underlying Attention Deficit in Subcortical Stroke

Abstract

Purpose To investigate neural substrates underlying attention deficit in patients with chronic subcortical stroke by combining voxel-based lesion-symptom mapping (VLSM) and diffusion-tensor (DT) tractography. Materials and Methods Institutional review board approval and written informed consent were obtained. Diffusion magnetic resonance imaging data were prospectively acquired from August 1, 2014, to March 30, 2015, in 49 patients (32 men, 17 women; mean age, 55.7 years ± 8.0; age range, 40-71 years) with subcortical infarctions in the basal ganglia and neighboring regions and 52 control subjects (30 men, 22 women; mean age, 54.4 years ± 7.5; age range, 40-68 years). A modified version of the attention network test was used to assess visual attention function. On the basis of the lesion map at the acute stage, VLSM was used to identify lesion locations related to attention deficit in patients with stroke. DT tractography then was used to determine the responsible impaired connections by using diffusion data at the chronic stage (>6 months after stroke). Results When compared with control subjects, patients with chronic stroke exhibited prolonged reaction time (RT) of correct responses (P = .009). VLSM revealed that acute stroke lesion in the right caudate nucleus and nearby white matter (found in seven patients) was correlated with the prolonged RT (P < .05). DTT showed that the responsible lesion was located in the right thalamic- and caudate-prefrontal pathways in control subjects. The subgroup with right-sided brain damage had significantly decreased fractional anisotropy in these pathways (P < .001), which were correlated with the prolonged RT (P = .009 for the thalamic-prefrontal pathway, P < .001 for the caudate-prefrontal pathway). Conclusion Thalamic-prefrontal and caudate-prefrontal pathways impaired by stroke lesions appear to underlie attention deficit in patients with subcortical stroke in the right hemisphere.

Brain anomaly networks uncover heterogeneous functional reorganization patterns after stroke

“…We further perform a two-sample t -test for lesion volume (ml) between the patients with FMA >10 and those with FMA ≤10, not showing significant difference between these two subgroups (Mean ± Std: 7.85 ± 5.86 ml for FMA ≤10); 9.32 ± 5.38 ml for FMA >10; p = 0.44). We also performed a voxel-based lesion-symptom mapping (VLSM) analysis ( Bates et al, 2003 ; Liu et al, 2018 ). The VLSM results suggested that stroke patients do not show significant correlations (at a voxel-wise threshold of p < 0.001, uncorrected) between lesion location at chronic stage and both FMA scores and entropy values.…”

The Associations Between White Matter Disruptions and Cognitive Decline at the Early Stage of Subcortical Vascular Cognitive Impairment: A Case–Control Study

“…Previous studies ( Biesbroek et al, 2017 ; Tu et al, 2017 ; Liu et al, 2019b ) have revealed that SVCI patients exhibit nearly global changes with decreased FA and increased MD in WM tracts especially those located in thalamic-prefrontal and caudate-prefrontal pathways. It has been proven that these two pathways are markedly related to neuropsychological assessments of executive function, attention, and processing speed in many task-related functional studies ( Block et al, 2007 ; Müller-Oehring et al, 2015 ; Liu et al, 2018 ). Our study showed that the TMT-B assessment was significantly different between the patients and healthy controls.…”

Study protocol: retrospectively mining multisite clinical data to presymptomatically predict seizure onset for individual patients with Sturge-Weber

“…LSM successfully identified neural substrates of survival and language outcomes after adult brain tumor78; LSM identified neural substrates of language,79–81 motor,82 word comprehension,83 voice recognition,84 attention,85 computational ability82 and somatosensory outcomes86 after adult stroke lesions, etc. These studies used one LSM model, not three, and mostly V-LSM, the basic LSM model.…”