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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

Relative functional contributions indicated by MSA. Normalized mean MSA contribution values (±SD) for inverse global NIHSS, computed separately for left- and right-sided lesion cases, using the binary dataset for the prediction of all performance scores corresponding to the full lesion configuration set by linear kernel SVM. Significant contributions (after Bonferroni correction) are shown in gray (all contributions are significant except for right temporal lobe).
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f0020: Relative functional contributions indicated by MSA. Normalized mean MSA contribution values (±SD) for inverse global NIHSS, computed separately for left- and right-sided lesion cases, using the binary dataset for the prediction of all performance scores corresponding to the full lesion configuration set by linear kernel SVM. Significant contributions (after Bonferroni correction) are shown in gray (all contributions are significant except for right temporal lobe).

Mentions: Fig. 4 shows the normalized mean MSA contribution values for the inverse global NIHSS. As left- and right-hemispheric lesions were strictly separated in the present patient sample, contributions of VOIs were computed separately for the left and right hemisphere. Standard deviation bars were derived from the leave-one-out technique during the prediction of performance scores (cf. Section 2.4). Positive contributions indicate that VOIs contribute to the success of the performance of a task. Thus, if they are lesioned, the performance is lowered. By contrast, negative contribution values imply that regions may be hindering the performance of a task.


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)

Relative functional contributions indicated by MSA. Normalized mean MSA contribution values (±SD) for inverse global NIHSS, computed separately for left- and right-sided lesion cases, using the binary dataset for the prediction of all performance scores corresponding to the full lesion configuration set by linear kernel SVM. Significant contributions (after Bonferroni correction) are shown in gray (all contributions are significant except for right temporal lobe).
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

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

f0020: Relative functional contributions indicated by MSA. Normalized mean MSA contribution values (±SD) for inverse global NIHSS, computed separately for left- and right-sided lesion cases, using the binary dataset for the prediction of all performance scores corresponding to the full lesion configuration set by linear kernel SVM. Significant contributions (after Bonferroni correction) are shown in gray (all contributions are significant except for right temporal lobe).
Mentions: Fig. 4 shows the normalized mean MSA contribution values for the inverse global NIHSS. As left- and right-hemispheric lesions were strictly separated in the present patient sample, contributions of VOIs were computed separately for the left and right hemisphere. Standard deviation bars were derived from the leave-one-out technique during the prediction of performance scores (cf. Section 2.4). Positive contributions indicate that VOIs contribute to the success of the performance of a task. Thus, if they are lesioned, the performance is lowered. By contrast, negative contribution values imply that regions may be hindering the performance of a task.

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