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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

Functional interactions among VOIs. Matrix representation of (symmetric) mean functional interactions of (a) left and (b) right VOIs. The color scales indicate the range of variation of left (a) and right (b) mean functional interactions. In (a), all interactions are significantly different from zero (after Bonferroni correction), except between parietal–occipital, parietal–putamen and parietal–temporal regions (represented as gray entries in the matrix). In (b), all interactions are significantly different from zero (after Bonferroni correction), except between temporal–occipital, temporal–thalamus, thalamus–parietal, thalamus–putamen regions (represented as gray entries in the matrix).
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f0025: Functional interactions among VOIs. Matrix representation of (symmetric) mean functional interactions of (a) left and (b) right VOIs. The color scales indicate the range of variation of left (a) and right (b) mean functional interactions. In (a), all interactions are significantly different from zero (after Bonferroni correction), except between parietal–occipital, parietal–putamen and parietal–temporal regions (represented as gray entries in the matrix). In (b), all interactions are significantly different from zero (after Bonferroni correction), except between temporal–occipital, temporal–thalamus, thalamus–parietal, thalamus–putamen regions (represented as gray entries in the matrix).

Mentions: Based on the MSA values, functional interactions were computed from the lesion data. Fig. 5 shows the mean functional interactions based on the contribution values for the global inverse NIHSS pictured in Fig. 4. The quantities are mean values, computed from the contributions values obtained with the leave-one-out technique. For the left hemisphere, the strongest positive interactions that are significantly different from zero (after Bonferroni correction, adjusted p < 0.0018) were between the insula and putamen, insula and parietal cortex, thalamus and caudate, thalamus and parietal cortex, as well as the frontal and occipital cortex. The strongest negative interactions, indicating functional redundancies, were found between the parietal cortex and caudate, as well as the frontal cortex and caudate. For the right hemisphere, the strongest positive interactions significantly different from zero (after Bonferroni correction, adjusted p < 0.0018) were found between the caudate and frontal cortex, caudate and insula, and frontal cortex and putamen. The strongest negative interactions were found between the frontal cortex and insula, thalamus and parietal cortex, respectively.


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)

Functional interactions among VOIs. Matrix representation of (symmetric) mean functional interactions of (a) left and (b) right VOIs. The color scales indicate the range of variation of left (a) and right (b) mean functional interactions. In (a), all interactions are significantly different from zero (after Bonferroni correction), except between parietal–occipital, parietal–putamen and parietal–temporal regions (represented as gray entries in the matrix). In (b), all interactions are significantly different from zero (after Bonferroni correction), except between temporal–occipital, temporal–thalamus, thalamus–parietal, thalamus–putamen regions (represented as gray entries in the matrix).
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

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

f0025: Functional interactions among VOIs. Matrix representation of (symmetric) mean functional interactions of (a) left and (b) right VOIs. The color scales indicate the range of variation of left (a) and right (b) mean functional interactions. In (a), all interactions are significantly different from zero (after Bonferroni correction), except between parietal–occipital, parietal–putamen and parietal–temporal regions (represented as gray entries in the matrix). In (b), all interactions are significantly different from zero (after Bonferroni correction), except between temporal–occipital, temporal–thalamus, thalamus–parietal, thalamus–putamen regions (represented as gray entries in the matrix).
Mentions: Based on the MSA values, functional interactions were computed from the lesion data. Fig. 5 shows the mean functional interactions based on the contribution values for the global inverse NIHSS pictured in Fig. 4. The quantities are mean values, computed from the contributions values obtained with the leave-one-out technique. For the left hemisphere, the strongest positive interactions that are significantly different from zero (after Bonferroni correction, adjusted p < 0.0018) were between the insula and putamen, insula and parietal cortex, thalamus and caudate, thalamus and parietal cortex, as well as the frontal and occipital cortex. The strongest negative interactions, indicating functional redundancies, were found between the parietal cortex and caudate, as well as the frontal cortex and caudate. For the right hemisphere, the strongest positive interactions significantly different from zero (after Bonferroni correction, adjusted p < 0.0018) were found between the caudate and frontal cortex, caudate and insula, and frontal cortex and putamen. The strongest negative interactions were found between the frontal cortex and insula, thalamus and parietal cortex, respectively.

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