Greater loss in structural integrity of the ipsilesional corticospinal tract (CST) is associated with poorer motor outcome in hemiparetic stroke patients. Animal models of stroke have demonstrated that structural remodeling of white matter in the ipsilesional and contralesional hemispheres is associated with improved motor recovery. Accordingly, motor recovery in stroke patients may relate to the relative strength of CST degeneration and remodeling. This study examined the relationship between microstructural status of brain white matter tracts, indexed by the fractional anisotropy (FA) metric derived from diffusion tensor imaging (DTI) data, and motor skill of the stroke-affected hand in chronic stroke patients. Voxelwise analysis revealed that motor skill significantly and positively correlated with FA of the ipsilesional and contralesional CST in the patients. Additional voxelwise analyses showed that patients with poorer motor skill had reduced FA of bilateral CST compared to normal control subjects whereas patients with better motor skill had elevated FA of bilateral CST compared to controls. These findings were confirmed using a DTI-tractography method applied to the CST in both hemispheres. The results of this study suggest that the level of motor skill recovery achieved in hemiparetic stroke patients relates to microstructural status of the CST in both the ipsilesional and contralesional hemispheres, which may reflect the net effect of degeneration and remodeling of bilateral CST.
Near-Infrared Spectroscopy (NIRS) allows the recovery of cortical oxy-and deoxyhemoglobin changes associated with evoked brain activity. NIRS is a back-reflection measurement making it very sensitive to the superficial layers of the head, i.e. the skin and the skull, where systemic interference occurs. As a result, the NIRS signal is strongly contaminated with systemic interference of superficial origin. A recent approach to overcome this problem has been the use of additional short source-detector separation optodes as regressors. Since these additional measurements are mainly sensitive to superficial layers in adult humans, they can be used to remove the systemic interference present in longer separation measurements, improving the recovery of the cortical hemodynamic response function (HRF). One question that remains to answer is whether or not a short separation measurement is required in close proximity to each long separation NIRS channel. Here, we show that the systemic interference occurring in the superficial layers of the human head is inhomogeneous across the surface of the scalp. As a result, the improvement obtained by using a short separation optode decreases as the relative distance between the short and the long measurement is increased. NIRS data was acquired on 6 human subjects both at rest and during a motor task consisting of finger tapping. The effect of distance between the short and the long channel was first quantified by recovering a synthetic hemodynamic response added over the resting-state data. The effect was also observed in the functional data collected during the finger tapping task. Together, these results suggest that the short separation measurement must be located as close as 1.5 cm from the standard NIRS channel in order to provide an improvement which is of practical use. In this case, the improvement in Contrast-to-Noise Ratio (CNR) compared to a standard General Linear Model (GLM) procedure without using any small separation optode reached 50 % for HbO and 100 % for HbR. Using small separations located farther than 2 cm away resulted in mild or negligible improvements only.
Diffuse Optical Imaging (DOI) allows the recovery of the hemodynamic response associated with evoked brain activity. The signal is contaminated with systemic physiological interference which occurs in the superficial layers of the head as well as in the brain tissue. The back-reflection geometry of the measurement makes the DOI signal strongly contaminated by systemic interference occurring in the superficial layers. A recent development has been the use of signals from small source-detector separation (1 cm) optodes as regressors. Since those additional measurements are mainly sensitive to superficial layers in adult humans, they help in removing the systemic interference present in longer separation measurements (3 cm). Encouraged by those findings, we developed a dynamic estimation procedure to remove global interference using small optode separations and to estimate simultaneously the hemodynamic response. The algorithm was tested by recovering a simulated synthetic hemodynamic response added over baseline DOI data acquired from 6 human subjects at rest. The performance of the algorithm was quantified by the Pearson R2 coefficient and the mean square error (MSE) between the recovered and the simulated hemodynamic responses. Our dynamic estimator was also compared with a static estimator and the traditional adaptive filtering method. We observed a significant improvement (two-tailed paired t-test, p < 0.05) in both HbO and HbR recovery using our Kalman filter dynamic estimator compared to the traditional adaptive filter, the static estimator and the standard GLM technique.
Near-Infrared Spectroscopy (NIRS) measures the functional hemodynamic response occuring at the surface of the cortex. Large pial veins are located above the surface of the cerebral cortex. Following activation, these veins exhibit oxygenation changes but their volume likely stays constant. The back-reflection geometry of the NIRS measurement renders the signal very sensitive to these superficial pial veins. As such, the measured NIRS signal contains contributions from both the cortical region as well as the pial vasculature. In this work, the cortical contribution to the NIRS signal was investigated using (1) Monte Carlo simulations over a realistic geometry constructed from anatomical and vascular MRI and (2) multimodal NIRS-BOLD recordings during motor stimulation. A good agreement was found between the simulations and the modeling analysis of in vivo measurements. Our results suggest that the cortical contribution to the deoxyhemoglobin signal change (ΔHbR) is equal to 16–22% of the cortical contribution to the total hemoglobin signal change (ΔHbT). Similarly, the cortical contribution of the oxyhemoglobin signal change (ΔHbO) is equal to 73–79% of the cortical contribution to the ΔHbT signal. These results suggest that ΔHbT is far less sensitive to pial vein contamination and therefore, it is likely that the ΔHbT signal provides better spatial specificity and should be used instead of ΔHbO or ΔHbR to map cerebral activity with NIRS. While different stimuli will result in different pial vein contributions, our finger tapping results do reveal the importance of considering the pial contribution.
Damage to the corticospinal tract (CST) in stroke patients has been associated with functional reorganization in the ipsilesional and contralesional sensorimotor cortices. However, it is unknown whether a quantitative relationship exists between the extent of structural damage to the CST and functional reorganization in stroke patients. The purpose of the current study was to examine the relationship between structural CST damage and motor task-related cortical activity in chronic hemiparetic stroke patients. In 10 chronic hemiparetic stroke patients with heterogeneous lesions, CST damage was quantified using conventional structural magnetic resonance imaging and tractography based on diffusion tensor imaging. Cortical activity was measured using functional magnetic resonance imaging during repetitive flexion/extension movements of the digits. We found that the two measures of CST damage were strongly correlated. Moreover, greater CST damage was significantly and linearly correlated with increased activation during affected hand movement in the hand area of the contralesional primary sensorimotor cortex (M1/S1) and in the ipsilesional M1/S1 ventral to the hand area. To our knowledge, this is the first demonstration of a quantitative relationship between the extent of structural damage to the CST and functional reorganization in stroke patients. This relationship was observed in stroke patients with heterogeneous lesions, suggesting that CST damage is a factor relevant to the variation in functional reorganization in the clinical population.
The brain processes involved in the restoration of motor skill after hemiparetic stroke are not fully understood. The current study compared cortical activity in chronic stroke patients who successfully recovered hand motor skill and normal control subjects during performance of kinematically matched unskilled and skilled hand movements using functional magnetic resonance imaging. We found that cortical activation during performance of the unskilled movement was increased in the patients relative to controls in the contralesional primary sensorimotor cortex. Performance of the skilled movement elicited increased activation in the patients relative to controls in the contralesional primary sensorimotor cortex, ventral premotor cortex, supplementary motor area/cingulate, and occipitoparietal cortex. Further, the activation change in the contralesional occipitoparietal cortex was greater in the patients relative to controls with the increase in motor skill challenge. Kinematic differences, mirror movements, and residual motor deficits did not account for the enhanced activation in the contralesional cortices in the patients. These results suggest that activation in the contralesional cortical network was enhanced as a function of motor skill challenge in stroke patients with good motor recovery. The findings of the current study suggest that successful recovery of motor skill after hemiparetic stroke involves participation of the contralesional cortical network.
Background Interpretation and analysis of electroencephalography (EEG) measurements relies on the correspondence of electrode scalp coordinates to structural and functional regions of the brain. New Method An algorithm is introduced for automatic calculation of the International 10–20, 10-10, and 10-5 scalp coordinates of EEG electrodes on a boundary element mesh of a human head. The EEG electrode positions are then used to generate parcellation regions of the cerebral cortex based on proximity to the EEG electrodes. Results The scalp electrode calculation method presented in this study effectively and efficiently identifies EEG locations without prior digitization of coordinates. The average of electrode proximity parcellations of the cortex were tabulated with respect to structural and functional regions of the brain in a population of 20 adult subjects. Comparison with Existing Methods Parcellations based on electrode proximity and EEG sensitivity were compared. The parcellation regions based on sensitivity and proximity were found to have 44.0 ± 11.3% agreement when demarcated by the International 10–20, 32.4 ± 12.6% by the 10-10, and 24.7 ± 16.3% by the 10-5 electrode positioning system. Conclusions The EEG positioning algorithm is a fast and easy method of locating EEG scalp coordinates without the need for digitized electrode positions. The parcellation method presented summarizes the EEG scalp locations with respect to brain regions without computation of a full EEG forward model solution. The reference table of electrode proximity versus cortical regions may be used by experimenters to select electrodes that correspond to anatomical and functional regions of interest.
Children living in low‐resource settings are at risk for failing to reach their developmental potential. While the behavioral outcomes of growing up in such settings are well‐known, the neural mechanisms underpinning poor outcomes have not been well elucidated, particularly in the context of low‐ and middle‐income countries. In this study, we measure brain metabolic responses to social and nonsocial stimuli in a cohort of 6‐ and 36‐month‐old Bangladeshi children. Study participants in both cohorts lived in an urban slum and were exposed to a broad range of adversity early in life including extreme poverty, malnutrition, recurrent infections, and low maternal education. We observed brain regions that responded selectively to social stimuli in both ages indicating that these specialized brain responses are online from an early age. We additionally show that the magnitude of the socially selective response is related to maternal education, maternal stress, and the caregiving environment. Ultimately our results suggest that a variety of psychosocial hazards have a measurable relationship with the developing social brain.
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