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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, Martinistra├če 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

Comparison of indicators of functional contributions. Normalized indicators of functional contributions, computed for sampled and complete-predicted datasets, sorted by increasing range of variation, for left and right hemispheres.
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f0035: Comparison of indicators of functional contributions. Normalized indicators of functional contributions, computed for sampled and complete-predicted datasets, sorted by increasing range of variation, for left and right hemispheres.

Mentions: In order to obtain a more comprehensive overview of the functional contributions indicated by different lesion inference methods, Fig. 7 shows the normalized indicators of functional contributions (VLSM, VLSC, MAPP and MSA) for both hemispheres, sorted by increasing range of variation among them (VLSM-complete and MSA-complete indicators were computed as mean values over 77 (for left) and 72 (for right) leave-one-out predictions). The contribution values in each approach were normalized, by the sum of all regional contributions, to yield relative functional contributions.


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)

Comparison of indicators of functional contributions. Normalized indicators of functional contributions, computed for sampled and complete-predicted datasets, sorted by increasing range of variation, for left and right hemispheres.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

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

f0035: Comparison of indicators of functional contributions. Normalized indicators of functional contributions, computed for sampled and complete-predicted datasets, sorted by increasing range of variation, for left and right hemispheres.
Mentions: In order to obtain a more comprehensive overview of the functional contributions indicated by different lesion inference methods, Fig. 7 shows the normalized indicators of functional contributions (VLSM, VLSC, MAPP and MSA) for both hemispheres, sorted by increasing range of variation among them (VLSM-complete and MSA-complete indicators were computed as mean values over 77 (for left) and 72 (for right) leave-one-out predictions). The contribution values in each approach were normalized, by the sum of all regional contributions, to yield relative functional contributions.

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, Martinistra├če 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