Early effect of thrombolysis on structural brain network organisation after anterior‐circulation stroke in the randomized <scp>WAKE‐UP</scp> trial

Schlemm, Eckhard; Jensen, Märit; Kuceyeski, Amy; Jamison, Keith; Ingwersen, Thies; Mayer, Christine M.; Königsberg, Alina; Boutitie, Florent; Ebinger, Martin; Endres, Matthias; Fiebach, Jochen B.; Fiehler, Jens; Galinović, Ivana; Lemmens, Robin; Muir, Keith W.; Nighoghossian, Norbert; Pedraza, Salvador; Puig, Josep; Simonsen, Claus Z; Thijs, Vincent; Wouters, Anke; Gerloff, Christian; Thomalla, Götz; Cheng, Bastian

doi:10.1002/hbm.26073

Cited by 4 publications

(2 citation statements)

References 90 publications

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“…Here, profiles of single regions disconnected from larger brain networks, and profiles of disturbed interconnecting pathways at a pairwise region-to-region level have been found to carry relevant information 12 . Treatment-related insights have been provided by assessing effects of thrombolysis onto network disconnections 19 and topology 20 , or the influence of tract-specific disconnections before thrombectomy for outcome inference 21 . As one important limitation however, at least some of these disconnectome analyses have primarily focused on patients with rather mild to moderate deficits with initial National Institutes of Health Stroke Scale (NIHSS) scores ranging between 1 and 3 7,11,13,18 or up to 7 12,20 .…”

Section: Introductionmentioning

confidence: 99%

“…Treatment-related insights have been provided by assessing effects of thrombolysis onto network disconnections 19 and topology 20 , or the influence of tract-specific disconnections before thrombectomy for outcome inference 21 . As one important limitation however, at least some of these disconnectome analyses have primarily focused on patients with rather mild to moderate deficits with initial National Institutes of Health Stroke Scale (NIHSS) scores ranging between 1 and 3 7,11,13,18 or up to 7 12,20 . Data regarding severely impaired patients are limited.…”

Section: Introductionmentioning

confidence: 99%

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Frontoparietal structural network disconnections correlate with outcome after a severe stroke

Frontzkowski,

Fehring,

Frey

et al. 2024

Preprint

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Structural disconnectome analyses have provided valuable insights into how a stroke lesion results in widespread network disturbances and how these relate to deficits, recovery patterns, and outcome. Previous analyses have primarily focused on patients with relatively mild to moderate deficits. However, outcomes vary among survivors of severe strokes, and the mechanisms of recovery remain poorly understood. This study assesses the association between lesion-induced network disconnection and outcome after severe stroke. Thirty-eight ischaemic stroke patients underwent MRI brain imaging early after stroke and longitudinal clinical follow-up. Lesion information was integrated with normative connectome data to infer individual disconnectome profiles on a localized regional and region-to-region pathway level. Ordinal logistic regressions were computed to link disconnectome information to the modified Rankin Scale after 3-6 months. Disconnections of ipsilesional frontal, parietal and temporal cortical brain areas were significantly associated with a worse motor outcome after a severe stroke, adjusted for the initial deficit, lesion volume, and age. The analysis of the underlying pathways mediating this association revealed location specific results: For frontal, prefrontal and temporal brain areas, the association was primarily driven by relatively sparse intrahemispheric disconnections. In contrast, the ipsilesional primary motor cortex, the dorsal premotor cortex, and various parietal brain regions showed a remarkable involvement of either frontoparietal intrahemispheric or additionally interhemispheric disconnections. These results indicate that localized disconnection of multiple regions embedded in the structural frontoparietal network correlates with worse outcome after severe stroke. Specifically, primary motor and parietal cortices might gain a particular importance as they structurally link frontoparietal networks of both hemispheres. These data shed novel light on the significance of distinct brain networks for recovery after severe stroke.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Frontoparietal structural network disconnections correlate with outcome after a severe stroke

Frontzkowski,

Fehring,

Frey

et al. 2024

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

Early effect of thrombolysis on structural brain network organisation after anterior‐circulation stroke in the randomized WAKE‐UP trial

Schlemm

Jensen

Kuceyeski

et al. 2022

Human Brain Mapping

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The symptoms of acute ischemic stroke can be attributed to disruption of the brain network architecture. Systemic thrombolysis is an effective treatment that preserves structural connectivity in the first days after the event. Its effect on the evolution of global network organisation is, however, not well understood. We present a secondary analysis of 269 patients from the randomized WAKE-UP trial, comparing 127 imaging-selected patients treated with alteplase with 142 controls who received placebo. We used indirect network mapping to quantify the impact of ischemic lesions on structural brain network organisation in terms of both global parameters of segregation and integration, and local disruption of individual connections. Network damage was estimated before randomization and again 22 to

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Frontoparietal Structural Network Disconnections Correlate With Outcome After a Severe Stroke

Frontzkowski,

Fehring,

Frey

et al. 2024

Human Brain Mapping

View full text Add to dashboard Cite

Structural disconnectome analyses have provided valuable insights into how a stroke lesion results in widespread network disturbances and how these relate to deficits, recovery patterns, and outcomes. Previous analyses have primarily focused on patients with relatively mild to moderate deficits. However, outcomes vary among survivors of severe strokes, and the mechanisms of recovery remain poorly understood. This study assesses the association between lesion‐induced network disconnection and outcome after severe stroke. Thirty‐eight ischaemic stroke patients underwent MRI brain imaging early after stroke and longitudinal clinical follow‐up. Lesion information was integrated with normative connectome data to infer individual disconnectome profiles on a localized regional and region‐to‐region pathway level. Ordinal logistic regressions were computed to link disconnectome information to the modified Rankin Scale after 3–6 months. Disconnections of ipsilesional frontal, parietal, and temporal cortical brain areas were significantly associated with a worse motor outcome after a severe stroke, adjusted for the initial deficit, lesion volume, and age. The analysis of the underlying pathways mediating this association revealed location‐specific results: For frontal, prefrontal, and temporal brain areas, the association was primarily driven by relatively sparse intrahemispheric disconnections. In contrast, the ipsilesional primary motor cortex, the dorsal premotor cortex, and various parietal brain regions showed a remarkable involvement of either frontoparietal intrahemispheric or additionally interhemispheric disconnections. These results indicate that localized disconnection of multiple regions embedded in the structural frontoparietal network correlates with worse outcomes after severe stroke. Specifically, primary motor and parietal cortices might gain particular importance as they structurally link frontoparietal networks of both hemispheres. These data shed novel light on the significance of distinct brain networks for recovery after a severe stroke.

show abstract

Early effect of thrombolysis on structural brain network organisation after anterior‐circulation stroke in the randomized WAKE‐UP trial

Cited by 4 publications

References 90 publications

Frontoparietal structural network disconnections correlate with outcome after a severe stroke

Frontoparietal structural network disconnections correlate with outcome after a severe stroke

Early effect of thrombolysis on structural brain network organisation after anterior‐circulation stroke in the randomized WAKE‐UP trial

Frontoparietal Structural Network Disconnections Correlate With Outcome After a Severe Stroke

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