Disrupted structural and functional connectivity networks in ischemic stroke patients

Zhang, Jingna; Zhang, Ye; Wang, Li; Sang, Linqiong; Yang, Jun; Yan, Rubing; Li, Pengyue; Wang, Jian; Qiu, Mingguo

doi:10.1016/j.neuroscience.2017.09.009

Cited by 67 publications

(64 citation statements)

References 74 publications

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“…We therefore suggest that the capacity for both segregated and integrated information processing is impaired in AVM patients. Additionally, we found a significant decrease in global efficiency in AVM patients, indicating a general decline of information transfer efficiency across the whole brain, which coincides with several previous studies of stroke patients [ 12 , 19 ]. Nevertheless, the preserved small-worldness reflects the correction and resilience of the structural networks against pathological damages.…”

Section: Discussionsupporting

confidence: 91%

Altered Brain Structural Networks in Patients with Brain Arteriovenous Malformations Located in Broca’s Area

Jiang

et al. 2020

Neural Plasticity

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Focal brain lesions, such as stroke and tumors, can lead to remote structural alterations across the whole-brain networks. Brain arteriovenous malformations (AVMs), usually presumed to be congenital, often result in tissue degeneration and functional displacement of the perifocal areas, but it remains unclear whether AVMs may produce long-range effects upon the whole-brain white matter organization. In this study, we used diffusion tensor imaging and graph theory methods to investigate the alterations of brain structural networks in 14 patients with AVMs in the presumed Broca’s area, compared to 27 normal controls. Weighted brain structural networks were constructed based on deterministic tractography. We compared the topological properties and network connectivity between patients and normal controls. Functional magnetic resonance imaging revealed contralateral reorganization of Broca’s area in five (35.7%) patients. Compared to normal controls, the patients exhibited preserved small-worldness of brain structural networks. However, AVM patients exhibited significantly decreased global efficiency ( p = 0.004 ) and clustering coefficient ( p = 0.014 ), along with decreased corresponding nodal properties in some remote brain regions ( p < 0.05 , family-wise error corrected). Furthermore, structural connectivity was reduced in the right perisylvian regions but enhanced in the perifocal areas ( p < 0.05 ). The vulnerability of the left supramarginal gyrus was significantly increased ( p = 0.039 , corrected), and the bilateral putamina were added as hubs in the AVM patients. These alterations provide evidence for the long-range effects of AVMs on brain white matter networks. Our preliminary findings contribute extra insights into the understanding of brain plasticity and pathological state in patients with AVMs.

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Section: Discussionsupporting

confidence: 91%

Altered Brain Structural Networks in Patients with Brain Arteriovenous Malformations Located in Broca’s Area

Jiang

et al. 2020

Neural Plasticity

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“…Structurally, reduced centrality measures in stroke hemispheres ( Lee et al , 2015 ), as well as reduced communicability ( Crofts et al , 2011 ) and a modified backbone structure in contralesional hemispheres have been described. In a different cohort, nodal centrality measures of the inferior parietal lobe and the posterior cingulate gyrus were associated with motor impairment on the FM scale and immediate recall, respectively ( Zhang et al , 2017 ). Taken together, these results indicate a common tendency and topological pattern of disintegration in structural brain networks after stroke characterized by an impaired potential of long-range integration of information transfer combined with increased segregation in a more modular network architecture.…”

Section: Discussionmentioning

confidence: 99%

Structural brain networks and functional motor outcome after stroke—a prospective cohort study

Schlemm

Schulz

Bönstrup

et al. 2020

Brain Communications

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The time course of topological reorganization that occurs in the structural connectome after an ischaemic stroke is currently not well understood. We aimed to determine the evolution of structural brain networks in stroke patients with motor deficits and relate changes in their global topology to residual symptom burden and functional impairment. In this prospective cohort study, ischaemic stroke patients with supratentorial infarcts and motor symptoms were assessed longitudinally by advanced diffusion MRI and detailed clinical testing of upper extremity motor function at four time points from the acute to the chronic stage. For each time point, structural connectomes were reconstructed, and whole-hemisphere global network topology was quantified in terms of integration and segregation parameters. Using non-linear joint mixed-effects regression modelling, network evolution was related to lesion volume and clinical outcome. Thirty patients were included for analysis. Graph-theoretical analysis demonstrated that, over time, brain networks became less integrated and more segregated with decreasing global efficiency and increasing modularity. Changes occurred in both stroke and intact hemispheres and, in the latter, were positively associated with lesion volume. Greater change in topology was associated with larger residual symptom burden and greater motor impairment 1, 3 and 12 months after stroke. After ischaemic stroke, brain networks underwent characteristic changes in both ipsi- and contralesional hemispheres. Topological network changes reflect the severity of damage to the structural network and are associated with functional outcome beyond the impact of lesion volume.

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“…The introduction of two special MRI techniques, including functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI), has opened up visible avenues for exploring how the human brain works in physiological or pathological conditions, improving the precision of clinical decision, as well as helping develop rehabilitation strategies [29,39,40]. Previous fMRI studies in stroke patients have shown that functional reorganization coupled with structural remodeling during the motor recovery, indicating the necessity of combined researches about brain function and structure [41,42].…”

Section: Discussionmentioning

confidence: 99%

Acupuncture for poststroke hemiplegia focusing on bilateral cerebral connections: study protocol for a randomized controlled trial

Jiang

Geng

et al. 2019

Preprint

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Background: Acupuncture is safe and effective for improving the motor function of poststroke hemiplegic patients, but there still exists a certain gap between clinical practice and its neural mechanisms. The cerebral functional reconstruction after unilateral motor pathway injury exhibits a bilateral tendency, however current studies seldom pay attention to it. Hence, based on bilateral cerebral connections, the underlying mechanism of acupuncture in stroke rehabilitation remains research space to date. Methods: This is a single-center, randomized controlled, paralleled neuroimaging trial, with patients, outcome assessors, and data statisticians blinded. Stroke patients with motor dysfunction meeting the inclusion criteria will be randomly assigned (2:1) to receive either true acupoints treatment or sham acupoints treatment (5 sessions per week for 2 weeks). All the patients will receive conventional treatment and rehabilitation. Participants will undergo the neuroimaging scanning before and after the entire acupuncture treatment. The clinical primary outcomes are Fugl-Meyer assessments (FMA) and the National Institutes of Health stroke scales (NIHSS). The secondary outcome is Needle Sensation Assessment Scale (NSAS). The neuroimaing outcomes are voxel-mirrored homotopic connectivity (VMHC), fractional anisotropy (FA) and gray matter volume (GMV). The correlation analysis will be explored between the neuroimage indicators and clinical motor assessments. Discussion: From the perspective of bilateral connection, this trial will investigate the cerebral influence of acupuncture treatment on poststroke patients with motor dysfunction, promoting application of acupuncture in stroke rehabilitation. Trial registration: Chinese Clinical Trials Registry, ChiCTR 1800016263. Registered on 22 May, 2018.

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Disrupted structural and functional connectivity networks in ischemic stroke patients

Cited by 67 publications

References 74 publications

Altered Brain Structural Networks in Patients with Brain Arteriovenous Malformations Located in Broca’s Area

Altered Brain Structural Networks in Patients with Brain Arteriovenous Malformations Located in Broca’s Area

Structural brain networks and functional motor outcome after stroke—a prospective cohort study

Acupuncture for poststroke hemiplegia focusing on bilateral cerebral connections: study protocol for a randomized controlled trial

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