Structural covariance in subcortical stroke patients measured by automated MRI-based volumetry

A network-level investigation of the volumetric changes of subcortical stroke patients is still lacking. Here, we explored the alterations of structural covariance caused by subcortical stroke with automated brain volumetry. T1-weighed brain MRI scans were obtained from 63 normal controls (NC), 46 stroke patients with infarct in left internal capsule (CI_L), 33 stroke patients with infarct in right internal capsule (CI_R). We performed automatic anatomical segmentation of the T1-weighted brain images with AccuBrain. Volumetric structural covariance analyses were first performed within the basal ganglia structures that were both identified by voxel-based morphometry with AAL atlas and AccuBrain. Subsequently, we additionally included the infratentorial regions that were particularly quantified by AccuBrain for the structural covariance analyses and investigated the alterations of anatomical connections within these subcortical regions in CI_L and CI_R compared with NC. The association between the regional brain volumetry and motor function was also evaluated in stroke groups. There were significant and extensive volumetric differences in stroke patients. These significant regions were generally symmetric for CI_L and CI_R group depending on the side of stroke, involving both regions close to lesions and remote regions. The structural covariance analyses revealed the synergy volume alteration in subcortical regions both in CI_L and CI_R group. In addition, the alterations of volumetric structural covariance were more extensive in CI_L group than CI_R group. Moreover, we found that the subcortical regions with atrophy contributed to the deficits of motor function in CI_R group but not CI_L group, indicating a lesion-side effect of brain volumetric changes after stroke. These findings indicated that the chronic subcortical stroke patients have extensive disordered anatomical connections involving the whole-brain level network, and the connections patterns depend on the lesion-side.