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Connection Disruption Underlying Attention Deficit in Subcortical Stroke.

Jingchun Liu1, Caihong Wang1, Qingqing Diao1

  • 1From the Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, No. 154, Anshan Rd, Heping District, Tianjin 300052, China (J.L., Q.D., W.Q., C.Y.); and Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (C.W., J.C.).

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Subcortical stroke in the right hemisphere impairs thalamic-prefrontal and caudate-prefrontal pathways, leading to attention deficits. This study used voxel-based lesion-symptom mapping and diffusion-tensor tractography to identify these neural connections.

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Area of Science:

  • Neuroscience
  • Neurology
  • Radiology

Background:

  • Attention deficits are common after stroke.
  • Subcortical stroke, particularly in the basal ganglia, can affect cognitive functions.
  • Understanding the neural basis of attention deficits is crucial for rehabilitation.

Purpose of the Study:

  • To investigate the neural substrates of attention deficit in chronic subcortical stroke patients.
  • To combine voxel-based lesion-symptom mapping (VLSM) and diffusion-tensor (DT) tractography for this investigation.

Main Methods:

  • Acquired diffusion magnetic resonance imaging data from 49 chronic subcortical stroke patients and 52 controls.
  • Assessed visual attention function using a modified attention network test.
  • Employed VLSM to identify lesion locations related to attention deficit and DT tractography to determine impaired connections.

Main Results:

  • Patients with chronic stroke showed prolonged reaction times (RT) compared to controls.
  • VLSM identified acute stroke lesions in the right caudate nucleus correlating with prolonged RT.
  • Diffusion tensor tractography revealed impaired right thalamic-prefrontal and caudate-prefrontal pathways in stroke patients, correlated with prolonged RT.

Conclusions:

  • Impairment of thalamic-prefrontal and caudate-prefrontal pathways by stroke lesions underlies attention deficits in right-hemisphere subcortical stroke.
  • VLSM and DT tractography are effective tools for elucidating the neural correlates of cognitive deficits after stroke.