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Determining the Functional Status of the Corticospinal Tract Within One Week of Stroke
Published on: February 22, 2020
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Post-stroke deficit prediction from lesion and indirect structural and functional disconnection
Alessandro Salvalaggio1, Michele De Filippo De Grazia2, Marco Zorzi2,3
1Clinica Neurologica, Department of Neuroscience, and Padova Neuroscience Center (PNC), University of Padova, Italy.
Brain : a Journal of Neurology
|June 24, 2020
Summary
Estimating structural disconnection from brain lesions accurately predicts stroke-related behavioral deficits. However, indirect functional disconnection measures are less effective and not a substitute for direct functional MRI, especially for cognitive impairments.
Area of Science:
- Neuroscience
- Neurology
- Medical Imaging
Background:
- Stroke-induced behavioral deficits stem from structural damage and widespread network dysfunction.
- Clinical structural imaging offers methods to estimate structural and functional disconnection indirectly.
- These indirect methods are more accessible than direct functional and diffusion MRI measures.
Purpose of the Study:
- To validate the clinical relevance of indirect estimation methods for predicting behavioral deficits post-stroke.
- To compare the predictive power of indirect structural and functional disconnection with direct functional connectivity measures.
- To assess the utility of these methods across various functional domains.
Main Methods:
- A prospective cohort of 132 first-time stroke patients was studied.
- Multivariate ridge regression related lesion and indirect disconnection maps to behavioral deficits.
- Direct functional connectivity was measured using resting-state functional MRI in a subgroup.
Main Results:
- Both lesion and indirect structural disconnection maps predicted behavioral impairments in most domains (R2 range: 0.16–0.58), except verbal memory.
- Indirect functional disconnection showed limited predictive power (R2 range: 0.01–0.18), except for right visual field deficits (R2 = 0.38).
- Direct functional MRI measures significantly outperformed indirect functional disconnection in prediction.
Conclusions:
- Indirect estimation of structural connectivity damage effectively predicts post-stroke behavioral deficits.
- Indirect functional disconnection estimation is not a reliable predictor of behavioral deficits.
- Direct functional connectivity measurements are superior to indirect methods for assessing network dysfunction, particularly for cognitive deficits.
