Lesion Network Mapping for Neurological Deficit in Acute Ischemic Stroke

IF 7.5 1区医学 Q1 CLINICAL NEUROLOGY

Annals of Neurology Pub Date : 2023-06-14 DOI:10.1002/ana.26721

Lingling Ding MD, Hao Liu PhD, Jing Jing MD, Yong Jiang PhD, Xia Meng MD, Yaojing Chen PhD, Xingquan Zhao MD, Haijun Niu PhD, Tao Liu PhD, Yongjun Wang MD, Zixiao Li MD

{"title":"Lesion Network Mapping for Neurological Deficit in Acute Ischemic Stroke","authors":"Lingling Ding MD, Hao Liu PhD, Jing Jing MD, Yong Jiang PhD, Xia Meng MD, Yaojing Chen PhD, Xingquan Zhao MD, Haijun Niu PhD, Tao Liu PhD, Yongjun Wang MD, Zixiao Li MD","doi":"10.1002/ana.26721","DOIUrl":null,"url":null,"abstract":"<div>\n \n <section>\n \n <h3> Objective</h3>\n \n <p>To create a comprehensive map of strategic lesion network localizations for neurological deficits, and identify prognostic neuroimaging biomarkers to facilitate the early detection of patients with a high risk of poor functional outcomes in acute ischemic stroke (AIS).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>In a large-scale multicenter study of 7,807 patients with AIS, we performed voxel-based lesion-symptom mapping, functional disconnection mapping (FDC), and structural disconnection mapping (SDC) to identify distinct lesion and network localizations for National Institutes of Health Stroke Scale (NIHSS) score. Impact scores were calculated based on the odds ratios or <i>t</i>-values of voxels from voxel-based lesion-symptom mapping, FDC, and SDC results. Ordinal regression models were used to investigate the predictive value of the impact scores on functional outcome (defined as the modified Rankin score at 3 months).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>We constructed lesion, FDC, and SDC maps for each item of the NIHSS score, which provided insights into the neuroanatomical substrate and network localization of neurological function deficits after AIS. The lesion impact score of limb ataxia, the SDC impact score of limb deficit, and FDC impact score of sensation and dysarthria were significantly associated with modified Rankin Scale at 3 months. Adding the SDC impact score, FDC impact score, and lesion impact score to the NIHSS total score improved the performance in predicting functional outcomes, as compared with using the NIHSS score alone.</p>\n </section>\n \n <section>\n \n <h3> Interpretation</h3>\n \n <p>We constructed comprehensive maps of strategic lesion network localizations for neurological deficits that were predictive of functional outcomes in AIS. These results may provide specifically localized targets for future neuromodulation therapies. ANN NEUROL 2023;94:572–584</p>\n </section>\n </div>","PeriodicalId":127,"journal":{"name":"Annals of Neurology","volume":"94 3","pages":"572-584"},"PeriodicalIF":7.5000,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Neurology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ana.26721","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 1

Abstract

Objective

To create a comprehensive map of strategic lesion network localizations for neurological deficits, and identify prognostic neuroimaging biomarkers to facilitate the early detection of patients with a high risk of poor functional outcomes in acute ischemic stroke (AIS).

Methods

In a large-scale multicenter study of 7,807 patients with AIS, we performed voxel-based lesion-symptom mapping, functional disconnection mapping (FDC), and structural disconnection mapping (SDC) to identify distinct lesion and network localizations for National Institutes of Health Stroke Scale (NIHSS) score. Impact scores were calculated based on the odds ratios or t-values of voxels from voxel-based lesion-symptom mapping, FDC, and SDC results. Ordinal regression models were used to investigate the predictive value of the impact scores on functional outcome (defined as the modified Rankin score at 3 months).

Results

We constructed lesion, FDC, and SDC maps for each item of the NIHSS score, which provided insights into the neuroanatomical substrate and network localization of neurological function deficits after AIS. The lesion impact score of limb ataxia, the SDC impact score of limb deficit, and FDC impact score of sensation and dysarthria were significantly associated with modified Rankin Scale at 3 months. Adding the SDC impact score, FDC impact score, and lesion impact score to the NIHSS total score improved the performance in predicting functional outcomes, as compared with using the NIHSS score alone.

Interpretation

We constructed comprehensive maps of strategic lesion network localizations for neurological deficits that were predictive of functional outcomes in AIS. These results may provide specifically localized targets for future neuromodulation therapies. ANN NEUROL 2023;94:572–584

查看原文本刊更多论文

急性缺血性脑卒中神经功能缺损的病变网络定位

目的建立神经功能缺损战略性病变网络定位的综合图谱，并确定预后神经影像学生物标志物，以促进急性缺血性卒中(AIS)中功能不良预后高风险患者的早期发现。方法在一项涉及7807例AIS患者的大规模多中心研究中，我们采用基于体素的病变症状制图、功能断开制图(FDC)和结构断开制图(SDC)来识别不同的病变和网络定位，用于美国国立卫生研究院卒中量表(NIHSS)评分。影响评分是根据基于体素的病变-症状映射、FDC和SDC结果的体素的比值比或t值计算的。采用有序回归模型研究影响评分对功能预后的预测价值(定义为3个月时的修正Rankin评分)。结果我们为NIHSS评分的每个项目构建了病变、FDC和SDC图，为AIS后神经功能缺陷的神经解剖学基础和网络定位提供了见解。肢体共济失调的损伤影响评分、肢体缺陷的SDC影响评分、感觉和构音障碍的FDC影响评分在3个月时与改良Rankin量表显著相关。与单独使用NIHSS评分相比，将SDC影响评分、FDC影响评分和病变影响评分添加到NIHSS总分中，可以提高预测功能预后的性能。我们为AIS患者的神经功能缺损构建了战略性病变网络定位的综合地图，该地图可预测AIS患者的功能结局。这些结果可能为未来的神经调节治疗提供特异性的局部靶点。神经科学学报(英文版);2009;44 (4):572 - 584

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Annals of Neurology 医学-临床神经学

CiteScore

18.00

自引率

1.80%

发文量

270

审稿时长

3-8 weeks

期刊介绍： Annals of Neurology publishes original articles with potential for high impact in understanding the pathogenesis, clinical and laboratory features, diagnosis, treatment, outcomes and science underlying diseases of the human nervous system. Articles should ideally be of broad interest to the academic neurological community rather than solely to subspecialists in a particular field. Studies involving experimental model system, including those in cell and organ cultures and animals, of direct translational relevance to the understanding of neurological disease are also encouraged.