Neurophysiologic Correlates of Post-stroke Mood and Emotional Control

Abstract

Objective: Emotional disturbance is a common complication of stroke significantly affecting functional recovery and quality of life. Identifying relevant neurophysiologic markers associated with post-stroke emotional disturbance may lead to a better understanding of this disabling condition, guiding the diagnosis, development of new interventions and the assessments of treatment response.Methods: Thirty-five subjects with chronic stroke were enrolled in this study. The emotion sub-domain of Stroke Impact Scale (SIS-Emotion) was used to assess post-stroke mood and emotional control. The relation between SIS-Emotion and neurophysiologic measures was assessed by using covariance mapping and univariate linear regression. Multivariate analyses were conducted to identify and adjust for potential confounders. Neurophysiologic measures included power asymmetry and coherence assessed by electroencephalography (EEG); and motor threshold, intracortical inhibition (ICI) and intracortical facilitation (ICF) measured by transcranial magnetic stimulation (TMS).Results: Lower scores on SIS-Emotion was associated with (1) frontal EEG power asymmetry in alpha and beta bands, (2) central EEG power asymmetry in alpha and theta bands, and (3) lower inter-hemispheric coherence over frontal and central areas in alpha band. SIS-Emotion also correlated with higher ICF and MT in the unlesioned hemisphere as measured by TMS.Conclusions: To our knowledge, this is the first study using EEG and TMS to index neurophysiologic changes associated with post-stroke mood and emotional control. Our results suggest that inter-hemispheric imbalance measured by EEG power and coherence, as well as an increased ICF in the unlesioned hemisphere measured by TMS might be relevant markers associated with post-stroke mood and emotional control which can guide future studies investigating new diagnostic and treatment modalities in stroke rehabilitation.

Neural temporal dynamics of negative emotional symptoms after iTBS in patients with stroke: a TMS-EEG study

“…Abnormalities of the Alpha oscillation in the cerebral cortex, including the anterior cingulate cortex and the prefrontal cortex, might be modulated after rTMS over the prefrontal lobe by providing topdown control of thalamic and thalamocortical cortical Alpha oscillations and restoring functional links with the anterior thalamus. Additionally, the reduction in functional connectivity between the frontal and parietal lobes in patients with PSD resulted in an imbalance of the Alpha band power and the cerebral hemisphere, which might be associated with emotional control in post-stroke patients [22]. These ndings suggested that a decrease in negative emotional symptoms correlates with increased functional connectivity in the Alpha band, aligning with our observations.…”

“…Doruk et al found that the Delta, Theta, Alpha, and Beta interhemispheric coherence decreased in patients with depression, possibly because pathological conditions that affected the integrity of neural tissue could cause changes in the structure and function of the damaged area. Doruk et al posited that observed the reduction in cerebral interhemispheric connectivity is indicative of post-stroke anatomical, adaptive and maladaptive changes in neural connections between damaged and undamaged cerebral hemispheres [22]. Studies have investigated the functional connectivity of amygdala subregions in patients with major depression, showing that the functional connectivity between the right central medial, lateral basal, and right middle frontal gyrus may be responsible for the neurobiological mechanism of anxiety-induced depression [23].…”

Deficit of Inhibition as a Marker of Neuroplasticity (DEFINE Study) in Rehabilitation: A Longitudinal Cohort Study Protocol

“…These changes have been thus identified through the use of biomarkers such as EEG and fNIRS, for instance, strong correlations between theta and delta band activities in the hippocampus and successful inhibitory mechanisms in rodent models (70). The use of EEG as a biomarker "tracker" thus becomes important because sensory inhibition reflects an automatic cortical inhibition function, which can be used as a measure of the brain's inhibitory status (71)(72)(73)(74). These findings support one of the study's main hypotheses that motor function deficits are associated with lower cerebral inhibitory activity when compared with a healthy control group.…”

An Emotion Assessment of Stroke Patients by Using Bispectrum Features of EEG Signals

“…With this concept, most recent studies of emotion assessment for stroke patients have utilized brain signals. Adamaszek et al studied the emotional impairment using the event-related potentials (ERP) of a stroke patient [ 15 ], Doruk et al studied the emotional impairment in stroke patients by comparing the emotional score in the Stroke Impact Scale (SIS) with the EEG features, the EEG power asymmetry and coherence [ 16 ]. Bong et al assessed the emotions of stroke patients by using EEG signals in the time-frequency domain [ 12 ].…”