Generative lesion pattern decomposition of cognitive impairment after stroke

Area of Science:

• Neuroscience
• Neurology
• Cognitive Science

Background:

• Cognitive impairment is a common and debilitating consequence of stroke.
• The precise mechanisms by which left and right cerebral hemisphere lesions interact to produce specific cognitive deficits remain incompletely understood.

Purpose of the Study:

• To investigate the distinct roles of left and right hemisphere lesion topographies in predicting cognitive impairments following acute ischemic stroke.
• To elucidate the relationship between specific brain regions, hemispheric lateralization, and patterns of cognitive dysfunction post-stroke.

Main Methods:

• Integrated machine learning and Bayesian hierarchical modeling for a hemisphere-aware analysis.
• Analyzed data from 1080 acute ischemic stroke patients with comprehensive cognitive assessments at approximately 3 months post-stroke.

Main Results:

• The left hemisphere was significantly relevant for predicting language and memory deficits.
• The right hemisphere was predominantly associated with visuospatial functioning impairments.
• Global cognitive impairments were predictable by lesion topographies from both hemispheres.
• Specific regions like the left hippocampus and occipital cortex related to naming/memory, while the right hippocampus/occipital cortex linked to visuospatial deficits.

Conclusions:

• Hemispheric lateralization of lesion patterns uniquely characterizes cognitive capacity loss after ischemic brain damage.
• Understanding these hemispheric contributions is crucial for predicting and potentially mitigating stroke-related cognitive sequelae.