Motor dexterity and strength depend upon integrity of the attention-control system

Rinne, Paul; Hassan, Mursyida; Fernandes, Cristina; Han, Erika; Hennessy, Emma; Waldman, Adam D.; Sharma, Pankaj; Soto, David; Leech, Robert; Malhotra, Paresh; Bentley, Paul

doi:10.1073/pnas.1715617115

Cited by 66 publications

(55 citation statements)

References 62 publications

(109 reference statements)

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“…Damage to domain-general brain networks may explain why cognitive impairments seen in stroke patients are distributed across many different cognitive processes (Sachdev et al, 2004;Vasquez & Zakzanis, 2015). We have previously shown that intact domaingeneral brain regions are critical in recovery of language function following aphasic stroke (Brownsett et al, 2014;Geranmayeh et al, 2014Geranmayeh et al, , 2016Geranmayeh et al, , 2017 in keeping with studies confirming their role in recovery of motor deficits (Rinne et al, 2018) and the learning of pseudo language (Sliwinska et al, 2017). This builds a convincing case for their potential as a prognostic biomarker.…”

Section: Introductionsupporting

confidence: 66%

A Bayesian optimisation approach for rapidly mapping residual network function in stroke

Lorenz

Johal

Dick

et al. 2020

Preprint

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AbstractPost-stroke cognitive and linguistic impairments are debilitating conditions, with current therapies only showing small improvements. Domain-general brain networks seem to play a critical role in stroke recovery and characterising their residual function with functional neuroimaging (fMRI) has the potential to yield biomarkers capable of guiding patient-specific rehabilitation. However, this is currently challenging in patients as such detailed characterisation requires too many different cognitive tasks. Here, we use neuroadaptive Bayesian optimisation to overcome this problem, an approach combining real-time fMRI with machine-learning. By intelligently searching across many tasks, this approach rapidly maps out patient-specific profiles of residual domain-general network function. Whereas controls have highly similar profiles, patients show idiosyncratic profiles of network abnormalities that are associated with behavioural performance. This approach can be extended to diverse brain networks and combined with brain stimulation or other therapeutics, thereby opening new avenues for precision medicine targeting diverse neurological and psychiatric conditions.

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Section: Introductionsupporting

confidence: 66%

A Bayesian optimisation approach for rapidly mapping residual network function in stroke

Lorenz

Johal

Dick

et al. 2020

Preprint

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“…It is now well-known that unilateral stroke not only results in weakness of the opposite half of the body, i.e., contralateral to the lesion or contralesional limb, but also significant motor deficits in the same half of the body, i.e., ipsilateral to the lesion or ipsilesional limb (1)(2)(3)(4). Previous work suggests that deficits in the ipsilesional arm and hand varies with the severity of contralesional deficits, especially in the sub-acute and chronic phase after stroke (5)(6)(7)(8). More interestingly, the unilateral motor deficits observed for contralesional and ipsilesional limbs seem to be hemisphere-specific and thus depend on side of stroke lesion (9)(10)(11)(12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Relationship Between Motor Capacity of the Contralesional and Ipsilesional Hand Depends on the Side of Stroke in Chronic Stroke Survivors With Mild-to-Moderate Impairment

Varghese

Winstein

2020

Front. Neurol.

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There is growing evidence that after a stroke, sensorimotor deficits in the ipsilesional hand are related to the degree of impairment in the contralesional upper extremity. Here, we asked if the relationship between the motor capacities of the two hands differs based on the side of stroke. Forty-two pre-morbidly right-handed chronic stroke survivors (left hemisphere damage, LHD = 21) with mild-to-moderate paresis performed distal items of the Wolf Motor Function Test (dWMFT). We found that compared to RHD, the relationship between contralesional arm impairment (Upper Extremity Fugl-Meyer, UEFM) and ipsilesional hand motor capacity was stronger (R 2 LHD = 0.42; R 2 RHD < 0.01; z = 2.12; p = 0.03) and the slope was steeper (t = −2.03; p = 0.04) in LHD. Similarly, the relationship between contralesional dWMFT and ipsilesional hand motor capacity was stronger (R 2 LHD = 0.65; R 2 RHD = 0.09; z = 2.45; p = 0.01) and the slope was steeper (t = 2.03; p = 0.04) in LHD compared to RHD. Multiple regression analysis confirmed the presence of an interaction between contralesional UEFM and side of stroke (β 3 = 0.66 ± 0.30; p = 0.024) and between contralesional dWMFT and side of stroke (β 3 = −0.51 ± 0.34; p = 0.05). Our findings suggest that the relationship between contraand ipsi-lesional motor capacity depends on the side of stroke in chronic stroke survivors with mild-to-moderate impairment. When contralesional impairment is more severe, the ipsilesional hand is proportionally slower in those with LHD compared to those with RHD.

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“…36 Deficits in non-lateralized attention, though potentially more common after right hemisphere stroke e.g., 37 are observed in strokes affecting either hemisphere. e.g., 38 Recently, Rinne et al 39 demonstrated in both neurotypical aged and hemiparetic stroke participants a relationship between motor performance (dexterity and strength) and attention control, as measured by distractor resistance, even controlling for lesion size and baseline performance.…”

Section: Attention/arousal As a Predictor Of Non-usementioning

confidence: 99%

Predictors of arm non-use in chronic stroke: a preliminary investigation

Buxbaum

Varghese

Stoll

et al. 2019

Preprint

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Background:The phenomenon of non-use after stroke is characterized by failure to use the contralesional arm despite adequate capacity. It has been suggested that nonuse is a consequence of the greater effort and/or attention required to use the affected limb, but such accounts have not been tested, and we have poor understanding of the characteristics of individuals who exhibit non-use.Objective: We aimed to provide preliminary evidence regarding the demographic, neuropsychological, and psychological factors that may influence non-use in chronic stroke.Methods: Twenty chronic stroke survivors (10 left and 10 right hemisphere stroke) with mild-to-moderate sensory-motor impairment on the upper extremity Fugl-Meyer (UEFM)were assessed with the Actual Amount of Use Test (AAUT), which measures the disparity between amount of use and quality of movement in "spontaneous" versus "forced" conditions. Participants were als assessed with measures of limb apraxia, spatial neglect, attention/arousal, and self-efficacy (confidence in arm movement).Using stepwise multiple regression, we determined whether demographic information and/or performance on these measures predicted AAUT non-use scores.Results: Scores on the UEFM as well as attention/arousal and self-efficacy predicted the degree of non-use. Attention/arousal predicted non-use above and beyond UEFM. Conclusions:Given the complexity of the non-use phenomenon, it follows that a combination of impairment, attention/arousal, and perceived confidence predicted nonuse behavior. That a measure of attention/arousal predicted non-use behavior above and beyond sensory-motor functioning highlights the importance of motivated Predictors of non-use in stroke 3 engagement to drive use of the paretic limb. Larger-scale studies incorporating additional measures (e.g., mental health, lesion volume and white matter connectivity, pain, motivation) will be important for future investigations.

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Motor dexterity and strength depend upon integrity of the attention-control system

Cited by 66 publications

References 62 publications

A Bayesian optimisation approach for rapidly mapping residual network function in stroke

A Bayesian optimisation approach for rapidly mapping residual network function in stroke

Relationship Between Motor Capacity of the Contralesional and Ipsilesional Hand Depends on the Side of Stroke in Chronic Stroke Survivors With Mild-to-Moderate Impairment

Predictors of arm non-use in chronic stroke: a preliminary investigation

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