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Prosopagnosia01:24

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Prosopagnosia, also known as face blindness, is the inability to recognize faces. In severe cases, individuals with prosopagnosia may not recognize close family members, including parents and spouses, by their faces. For instance, someone with prosopagnosia might walk past their child in a crowd, only realizing their mistake upon noticing their child's distinctive backpack or favorite jacket. Prosopagnosia specifically impairs facial recognition, while the recognition of other objects or...
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Structural Disconnections Caused by White Matter Hyperintensities in Post-Stroke Spatial Neglect.

Lisa Röhrig1, Hans-Otto Karnath1

  • 1Center of Neurology, Division of Neuropsychology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.

Human Brain Mapping
|November 25, 2024
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Summary

Pre-stroke white matter hyperintensities (WMH) worsen spatial neglect after stroke by disrupting brain networks. WMH combined with stroke lesions impact right frontal and subcortical areas, affecting attention.

Keywords:
attentionconnectomedisconnection‐symptom mappingleukoaraiosisnetworkpredictive modeling

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Area of Science:

  • Neuroscience
  • Neurology
  • Neuroimaging

Background:

  • White matter hyperintensities (WMH) are common in cerebral small vessel disease and linked to cognitive deficits, including spatial neglect.
  • Spatial neglect, a disorder of spatial attention, often follows right hemisphere brain damage.

Purpose of the Study:

  • To investigate how WMH impact structural disconnections related to spatial neglect.
  • To compare different measures of structural disconnection for predicting neglect severity.

Main Methods:

  • Indirect quantification of the structural disconnectome induced by stroke lesions, WMH, or their combination.
  • Comparison of voxel-wise, pairwise, tract-wise, and parcel-wise disconnection measures.
  • Predictive modeling to assess the relationship between disconnections and acute neglect severity.

Main Results:

  • WMH-derived disconnections alone did not correlate with neglect.
  • Combined WMH and stroke lesion disconnections significantly contributed to neglect severity, affecting right frontal and subcortical regions (e.g., middle frontal gyrus, basal ganglia, thalamus, fronto-pontine tract).
  • Voxel-wise disconnection data, particularly from stroke-based disconnections, best predicted neglect severity, explaining 42% of the variance.

Conclusions:

  • Pre-stroke WMH alter white matter microstructure, contributing to post-stroke spatial attention deficits.
  • These microstructural changes likely impair the integrity of brain attention networks, exacerbating neglect.
  • Voxel-wise analysis of structural disconnections is a valuable tool for understanding and predicting post-stroke neglect.