基于连接体的脑卒中视觉空间类比推理功能磁共振成像研究。

IF 3.4 3区 医学 Q1 REHABILITATION
Takamichi Tohyama, Masaki Fukunaga, Yohei Otaka
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引用次数: 0

摘要

背景:视觉空间功能是脑卒中功能认知的一个核心领域。脑卒中后认知障碍扰乱了康复实践,强调了高阶视觉空间功能障碍患者特征的重要性,以告知个性化的康复策略。尽管神经影像学提供了对疾病相关机制的见解,但其临床应用仍然有限。目的:研究脑卒中后静息状态功能连接是否支持高阶视觉空间功能,以及连接改变是否可以表征脑卒中患者的视觉空间功能障碍。设计:观察性研究。地点:日本藤田保健大学医院住院康复病房。人群:58例中风患者。方法:采用Raven’s Colored Progressive Matrices (RCPM)评价视觉空间类比推理能力。静息状态功能连通性评估采用功能磁共振成像(fMRI)。从fMRI数据中计算经验协方差矩阵和群稀疏逆协方差(GSIC)矩阵,后者被否定以估计代表直接连通性的部分相关性。分析连接性测量与RCPM评分之间的相关性,以及数据驱动的聚类来对患者进行分层。结果:经验协方差连通性与RCPM评分无显著相关。然而,基于gsic的分析显示,后内侧和左侧顶叶下皮层的连通性与RCPM评分之间存在显著的负相关。较高的顶叶连通性与较低的RCPM性能相关。最高连接簇的患者在视觉空间类比推理方面表现出严重的损伤,特别是在需要将离散数字整合为空间相关整体的任务中。这些患者的病变主要局限于左皮层下。结论:中外侧顶叶连接可能是脑卒中后视觉空间类比推理的基础。临床康复影响:聚类分析强调了顶叶连通性增加的患者得分低的明显模式,表明顶叶连通性改变可能是严重功能障碍患者的特征。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

A connectome-based functional magnetic resonance imaging study of visuospatial analogical reasoning in stroke.

A connectome-based functional magnetic resonance imaging study of visuospatial analogical reasoning in stroke.

A connectome-based functional magnetic resonance imaging study of visuospatial analogical reasoning in stroke.

A connectome-based functional magnetic resonance imaging study of visuospatial analogical reasoning in stroke.

Background: Visuospatial function is a core domain of functional cognition in stroke. Post-stroke cognitive impairment disrupts rehabilitation practice, highlighting the importance of characterizing patients with higher-order visuospatial dysfunction to inform personalized rehabilitation strategies. Although neuroimaging offers insights into disease-related mechanisms, its clinical application remains limited.

Aim: The aim of this paper was to investigate whether the residual resting-state functional connectivity supports higher-order visuospatial function after stroke and whether changes in connectivity can characterize patients with visuospatial dysfunction.

Design: Observational study.

Setting: Inpatient rehabilitation ward at Fujita Health University Hospital in Japan.

Population: Fifty-eight patients with stroke.

Methods: Visuospatial analogical reasoning was assessed using Raven's Colored Progressive Matrices (RCPM). Resting-state functional connectivity was evaluated using functional magnetic resonance imaging (fMRI). Empirical covariance matrices and group-sparse inverse covariance (GSIC) matrices were computed from the fMRI data, with the latter negated to estimate partial correlations representing direct connectivity. Correlations between connectivity measures and RCPM scores were analyzed, alongside data-driven clustering to stratify patients.

Results: No significant correlation was found between empirical covariance connectivity and RCPM scores. However, GSIC-based analysis revealed a significant inverse correlation between connectivity of the posteromedial and the left inferior parietal cortex and RCPM scores. Higher parietal connectivity was associated with lower RCPM performance. Patients in the highest connectivity cluster exhibited severe impairments in visuospatial analogical reasoning, particularly in tasks requiring the integration of discrete figures into spatially related wholes. The lesions in these patients were predominantly localized in the left subcortex.

Conclusions: Medio-lateral parietal connectivity may underlie visuospatial analogical reasoning after stroke.

Clinical rehabilitation impact: Clustering analysis highlighted a distinct pattern of low scores in patients with increased parietal connectivity, suggesting that parietal connectivity changes have the potential for characterizing patients with severe dysfunction.

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来源期刊
CiteScore
8.50
自引率
4.40%
发文量
162
审稿时长
6-12 weeks
期刊介绍: The European Journal of Physical and Rehabilitation Medicine publishes papers of clinical interest in physical and rehabilitation medicine.
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