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Mapping causal functional contributions derived from the clinical assessment of brain damage after stroke.

Zavaglia M, Forkert ND, Cheng B, Gerloff C, Thomalla G, Hilgetag CC - Neuroimage Clin (2015)

Bottom Line: The results revealed regional functional contributions to essential behavioral and cognitive functions as reflected in the NIHSS, particularly by subcortical structures.There were also side specific differences of functional contributions between the right and left hemispheric brain regions which may reflect the dominance of the left hemispheric syndrome aphasia in the NIHSS.Comparison of MSA to established lesion inference methods demonstrated the feasibility of the approach for analyzing clinical data and indicated its capability for objectively inferring functional contributions from multiple injured, potentially interacting sites, at the cost of having to predict the outcome of unknown lesion configurations.

View Article: PubMed Central - PubMed

Affiliation: Department of Computational Neuroscience, University Medical Center Eppendorf, Hamburg University, Martinistraße 52, Hamburg 20246, Germany ; School of Engineering and Science, Jacobs University Bremen, Campus Ring 1, Bremen 28759, Germany.

ABSTRACT
Lesion analysis reveals causal contributions of brain regions to mental functions, aiding the understanding of normal brain function as well as rehabilitation of brain-damaged patients. We applied a novel lesion inference technique based on game theory, Multi-perturbation Shapley value Analysis (MSA), to a large clinical lesion dataset. We used MSA to analyze the lesion patterns of 148 acute stroke patients together with their neurological deficits, as assessed by the National Institutes of Health Stroke Scale (NIHSS). The results revealed regional functional contributions to essential behavioral and cognitive functions as reflected in the NIHSS, particularly by subcortical structures. There were also side specific differences of functional contributions between the right and left hemispheric brain regions which may reflect the dominance of the left hemispheric syndrome aphasia in the NIHSS. Comparison of MSA to established lesion inference methods demonstrated the feasibility of the approach for analyzing clinical data and indicated its capability for objectively inferring functional contributions from multiple injured, potentially interacting sites, at the cost of having to predict the outcome of unknown lesion configurations. The analysis of regional functional contributions to neurological symptoms measured by the NIHSS contributes to the interpretation of this widely used standardized stroke scale in clinical practice as well as clinical trials and provides a first approximation of a 'map of stroke'.

No MeSH data available.


Related in: MedlinePlus

Lesion size of VOIs and associated NIHSS. (a) Absolute and (b) relative lesion size (in % of lesioned voxels) of 2 × 8 VOIs and associated global NIHSS values for 148 patients. In each panel, the color scale indicates on its left axis the absolute (graded from zero to 13,202) or relative (graded from 0 to 100%) lesion size and on the right axis the range of associated NIHSS values (from zero to 21). The 148 cases (indicated by patient ID) were separated into left- and right-hemispheric lesions by sorting in descending order the difference between total lesion size in the left and right hemispheres.
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f0015: Lesion size of VOIs and associated NIHSS. (a) Absolute and (b) relative lesion size (in % of lesioned voxels) of 2 × 8 VOIs and associated global NIHSS values for 148 patients. In each panel, the color scale indicates on its left axis the absolute (graded from zero to 13,202) or relative (graded from 0 to 100%) lesion size and on the right axis the range of associated NIHSS values (from zero to 21). The 148 cases (indicated by patient ID) were separated into left- and right-hemispheric lesions by sorting in descending order the difference between total lesion size in the left and right hemispheres.

Mentions: Fig. 3 shows the absolute and relative lesion sizes of the 2 × 8 VOIs in all 148 patients together with the associated behavioral scores (global NIHSS). The absolute lesion size, in panel (a), was graded from zero to a value of 13,202, which represents the maximum number of lesioned voxels of a VOI in the dataset, while the relative lesion size of VOIs, in panel (b), was graded from 0 to 100%. The NIHSS ranged from zero to 21, where 0 indicates the absence of behavioral deficits and 21 indicates the most severe impairment found in the patient sample, out of a possible maximum score of 42.


Mapping causal functional contributions derived from the clinical assessment of brain damage after stroke.

Zavaglia M, Forkert ND, Cheng B, Gerloff C, Thomalla G, Hilgetag CC - Neuroimage Clin (2015)

Lesion size of VOIs and associated NIHSS. (a) Absolute and (b) relative lesion size (in % of lesioned voxels) of 2 × 8 VOIs and associated global NIHSS values for 148 patients. In each panel, the color scale indicates on its left axis the absolute (graded from zero to 13,202) or relative (graded from 0 to 100%) lesion size and on the right axis the range of associated NIHSS values (from zero to 21). The 148 cases (indicated by patient ID) were separated into left- and right-hemispheric lesions by sorting in descending order the difference between total lesion size in the left and right hemispheres.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4544394&req=5

f0015: Lesion size of VOIs and associated NIHSS. (a) Absolute and (b) relative lesion size (in % of lesioned voxels) of 2 × 8 VOIs and associated global NIHSS values for 148 patients. In each panel, the color scale indicates on its left axis the absolute (graded from zero to 13,202) or relative (graded from 0 to 100%) lesion size and on the right axis the range of associated NIHSS values (from zero to 21). The 148 cases (indicated by patient ID) were separated into left- and right-hemispheric lesions by sorting in descending order the difference between total lesion size in the left and right hemispheres.
Mentions: Fig. 3 shows the absolute and relative lesion sizes of the 2 × 8 VOIs in all 148 patients together with the associated behavioral scores (global NIHSS). The absolute lesion size, in panel (a), was graded from zero to a value of 13,202, which represents the maximum number of lesioned voxels of a VOI in the dataset, while the relative lesion size of VOIs, in panel (b), was graded from 0 to 100%. The NIHSS ranged from zero to 21, where 0 indicates the absence of behavioral deficits and 21 indicates the most severe impairment found in the patient sample, out of a possible maximum score of 42.

Bottom Line: The results revealed regional functional contributions to essential behavioral and cognitive functions as reflected in the NIHSS, particularly by subcortical structures.There were also side specific differences of functional contributions between the right and left hemispheric brain regions which may reflect the dominance of the left hemispheric syndrome aphasia in the NIHSS.Comparison of MSA to established lesion inference methods demonstrated the feasibility of the approach for analyzing clinical data and indicated its capability for objectively inferring functional contributions from multiple injured, potentially interacting sites, at the cost of having to predict the outcome of unknown lesion configurations.

View Article: PubMed Central - PubMed

Affiliation: Department of Computational Neuroscience, University Medical Center Eppendorf, Hamburg University, Martinistraße 52, Hamburg 20246, Germany ; School of Engineering and Science, Jacobs University Bremen, Campus Ring 1, Bremen 28759, Germany.

ABSTRACT
Lesion analysis reveals causal contributions of brain regions to mental functions, aiding the understanding of normal brain function as well as rehabilitation of brain-damaged patients. We applied a novel lesion inference technique based on game theory, Multi-perturbation Shapley value Analysis (MSA), to a large clinical lesion dataset. We used MSA to analyze the lesion patterns of 148 acute stroke patients together with their neurological deficits, as assessed by the National Institutes of Health Stroke Scale (NIHSS). The results revealed regional functional contributions to essential behavioral and cognitive functions as reflected in the NIHSS, particularly by subcortical structures. There were also side specific differences of functional contributions between the right and left hemispheric brain regions which may reflect the dominance of the left hemispheric syndrome aphasia in the NIHSS. Comparison of MSA to established lesion inference methods demonstrated the feasibility of the approach for analyzing clinical data and indicated its capability for objectively inferring functional contributions from multiple injured, potentially interacting sites, at the cost of having to predict the outcome of unknown lesion configurations. The analysis of regional functional contributions to neurological symptoms measured by the NIHSS contributes to the interpretation of this widely used standardized stroke scale in clinical practice as well as clinical trials and provides a first approximation of a 'map of stroke'.

No MeSH data available.


Related in: MedlinePlus