Structural connectivity analyses in motor recovery research after stroke

Koch, Philipp; Schulz, Robert; Hummel, Friedhelm C.

doi:10.1002/acn3.278

Cited by 93 publications

(105 citation statements)

References 87 publications

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“…Further work could usefully explore other neuroimaging biomarkers that might provide important prognostic information for MEP− patients. These may involve measures of alternative descending motor pathways,25, 26, 27, 28 and of the wider ipsilesional and contralesional sensorimotor networks, including the corpus callosum 29, 30, 31, 32, 33. However, more sophisticated measures may also require expertise not readily available in most clinical settings.…”

Section: Discussionmentioning

confidence: 99%

PREP2: A biomarker‐based algorithm for predicting upper limb function after stroke

Stinear

Byblow

Ackerley

et al. 2017

Ann Clin Transl Neurol

257

338

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ObjectiveRecovery of motor function is important for regaining independence after stroke, but difficult to predict for individual patients. Our aim was to develop an efficient, accurate, and accessible algorithm for use in clinical settings. Clinical, neurophysiological, and neuroimaging biomarkers of corticospinal integrity obtained within days of stroke were combined to predict likely upper limb motor outcomes 3 months after stroke.MethodsData from 207 patients recruited within 3 days of stroke [103 females (50%), median age 72 (range 18–98) years] were included in a Classification and Regression Tree analysis to predict upper limb function 3 months poststroke.ResultsThe analysis produced an algorithm that sequentially combined a measure of upper limb impairment; age; the presence or absence of upper limb motor evoked potentials elicited with transcranial magnetic stimulation; and stroke lesion load obtained from MRI or stroke severity assessed with the NIHSS score. The algorithm makes correct predictions for 75% of patients. A key biomarker obtained with transcranial magnetic stimulation is required for one third of patients. This biomarker combined with NIHSS score can be used in place of more costly magnetic resonance imaging, with no loss of prediction accuracy.InterpretationThe new algorithm is more accurate, efficient, and accessible than its predecessors, which may support its use in clinical practice. While further work is needed to potentially incorporate sensory and cognitive factors, the algorithm can be used within days of stroke to provide accurate predictions of upper limb functional outcomes at 3 months after stroke. www.presto.auckland.ac.nz

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Section: Discussionmentioning

confidence: 99%

PREP2: A biomarker‐based algorithm for predicting upper limb function after stroke

Stinear

Byblow

Ackerley

et al. 2017

Ann Clin Transl Neurol

257

338

View full text Add to dashboard Cite

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“…Early after stroke, secondary motor areas may contribute to recovery via taking over of functionality from lesion‐damaged or decoupled areas or via stronger integration of specific areas in the network. Corresponding reconfiguration of the movement‐related activation patterns (Rehme, Eickhoff, Rottschy, Fink, & Grefkes, ) as well as white matter associations (Koch & Hummel, ; Koch, Schulz, & Hummel, ; Schulz, Park, et al, ) and functional connections are detectable in chronic stroke patients.…”

Section: Discussionmentioning

confidence: 99%

The functional role of beta‐oscillations in the supplementary motor area during reaching and grasping after stroke: A question of structural damage to the corticospinal tract

Quandt

Bönstrup

Schulz

et al. 2019

Human Brain Mapping

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Hand motor function is often severely affected in stroke patients. Non‐satisfying recovery limits reintegration into normal daily life. Understanding stroke‐related network changes and identifying common principles that might underlie recovered motor function is a prerequisite for the development of interventional therapies to support recovery. Here, we combine the evaluation of functional activity (multichannel electroencephalography) and structural integrity (diffusion tensor imaging) in order to explain the degree of residual motor function in chronic stroke patients. By recording neural activity during a reaching and grasping task that mimics activities of daily living, the study focuses on deficit‐related neural activation patterns. The study showed that the functional role of movement‐related beta desynchronization in the supplementary motor area (SMA) for residual hand motor function in stroke patients depends on the microstructural integrity of the corticospinal tract (CST). In particular, in patients with damaged CST, stronger task‐related activity in the SMA was associated with worse residual motor function. Neither CST damage nor functional brain activity alone sufficiently explained residual hand motor function. The findings suggest a central role of the SMA in the motor network during reaching and grasping in stroke patients, the degree of functional relevance of the SMA is depending on CST integrity.

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“…Studies on patients with ischemic stroke showed that the integrity of the corticospinal tract can be quantified to robustly predict motor outcome. 292 Furthermore, alternate corticofugal and cortico-cortical networks are implicated in motor recovery, suggesting more complex mechanisms in neurorehabilitation that go beyond current models. [293][294][295][296][297][298] Data on neurosurgical patients are not so extensive.…”

Section: Gap Analysismentioning

confidence: 99%

Tractography in Neurosurgery: A Systematic Review of Current Applications

Wende

Hoffmann

Meixensberger

2020

J Neurol Surg A Cent Eur Neurosurg

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The ability to visualize the brain's fiber connections noninvasively in vivo is relatively young compared with other possibilities of functional magnetic resonance imaging. Although many studies showed tractography to be of promising value for neurosurgical care, the implications remain inconclusive. An overview of current applications is presented in this systematic review. A search was conducted for ((“tractography” or “fiber tracking” or “fibre tracking”) and “neurosurgery”) that produced 751 results. We identified 260 relevant articles and added 20 more from other sources. Most publications concerned surgical planning for resection of tumors (n = 193) and vascular lesions (n = 15). Preoperative use of transcranial magnetic stimulation was discussed in 22 of these articles. Tractography in skull base surgery presents a special challenge (n = 29). Fewer publications evaluated traumatic brain injury (TBI) (n = 25) and spontaneous intracranial bleeding (n = 22). Twenty-three articles focused on tractography in pediatric neurosurgery. Most authors found tractography to be a valuable addition in neurosurgical care. The accuracy of the technique has increased over time. There are articles suggesting that tractography improves patient outcome after tumor resection. However, no reliable biomarkers have yet been described. The better rehabilitation potential after TBI and spontaneous intracranial bleeding compared with brain tumors offers an insight into the process of neurorehabilitation. Tractography and diffusion measurements in some studies showed a correlation with patient outcome that might help uncover the neuroanatomical principles of rehabilitation itself. Alternative corticofugal and cortico-cortical networks have been implicated in motor recovery after ischemic stroke, suggesting more complex mechanisms in neurorehabilitation that go beyond current models. Hence tractography may potentially be able to predict clinical deficits and rehabilitation potential, as well as finding possible explanations for neurologic disorders in retrospect. However, large variations of the results indicate a lack of data to establish robust diagnostical concepts at this point. Therefore, in vivo tractography should still be interpreted with caution and by experienced surgeons.

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Structural connectivity analyses in motor recovery research after stroke

Cited by 93 publications

References 87 publications

PREP2: A biomarker‐based algorithm for predicting upper limb function after stroke

PREP2: A biomarker‐based algorithm for predicting upper limb function after stroke

The functional role of beta‐oscillations in the supplementary motor area during reaching and grasping after stroke: A question of structural damage to the corticospinal tract

Tractography in Neurosurgery: A Systematic Review of Current Applications

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