Large-scale changes in network interactions as a physiological signature of spatial neglect
Large-scale changes in network interactions as a physiological signature of spatial neglect
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DOI：
10.1093/brain/awu297
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发表时间：
2014-12-01
期刊：
影响因子：
14.5
通讯作者：
Corbetta, Maurizio
中科院分区：
文献类型：
--
作者：
Baldassarre, Antonello;Ramsey, Lenny;Corbetta, Maurizio
局灶性损伤后自发性脑活动和行为之间的关系还不清楚。在这里，我们报告了一个大规模的研究静息状态功能连接MRI和空间忽视中风后的大样本（n = 84）首次中风患者（1-2周内）的异质性。空间忽视，通常在右半球损伤后比左半球损伤更严重，包括损伤对侧的空间注意力和运动动作的缺陷，以及由于警觉/唤醒受损而导致的一般注意力低下。患者进行结构和静息状态功能性MRI扫描，并使用Posner空间提示任务，Mesulam和行为疏忽测试取消测试测量空间忽视。行为测试的主成分分析揭示了一个主要因素占34%的方差，捕获三个相关的行为缺陷：视觉忽视的contralesional视野，视觉忽视的contralesional领域，和低的整体性能。在一个独立的样本（21名健康受试者）中，我们定义了10个静息状态网络，由169个大脑区域组成：视觉中心凹和视觉周边，感觉运动，听觉，背侧注意，腹侧注意，语言，额顶叶控制，扣带-鳃盖控制和默认模式。我们将忽略因子得分与10个静息状态网络内部和之间的静息状态功能连接强度相关联。从功能连接：行为相关分析中去除所有受损的脑体素。我们发现，由因子得分总结的相关行为缺陷与涉及大片皮层的异常功能连接的相关多网络模式相关。具体而言，背侧注意和感觉运动网络显示：（i）半球间功能连接减少;（ii）与右半球额顶和默认模式网络的反相关减少;（iii）与基底神经节的半球内连接增加。这些模式的功能连接：行为的相关性更强的患者与右半球相比，左半球的损害，是独立的病变体积。我们的研究结果确定了静息状态网络相互作用的大规模变化，这是空间忽略的生理特征，可能与其右半球偏侧化有关。
The relationship between spontaneous brain activity and behaviour following focal injury is not well understood. Here, we report a large-scale study of resting state functional connectivity MRI and spatial neglect following stroke in a large (n = 84) heterogeneous sample of first-ever stroke patients (within 1-2 weeks). Spatial neglect, which is typically more severe after right than left hemisphere injury, includes deficits of spatial attention and motor actions contralateral to the lesion, and low general attention due to impaired vigilance/arousal. Patients underwent structural and resting state functional MRI scans, and spatial neglect was measured using the Posner spatial cueing task, and Mesulam and Behavioural Inattention Test cancellation tests. A principal component analysis of the behavioural tests revealed a main factor accounting for 34% of variance that captured three correlated behavioural deficits: visual neglect of the contralesional visual field, visuomotor neglect of the contralesional field, and low overall performance. In an independent sample (21 healthy subjects), we defined 10 resting state networks consisting of 169 brain regions: visual-fovea and visual-periphery, sensory-motor, auditory, dorsal attention, ventral attention, language, fronto-parietal control, cingulo-opercular control, and default mode. We correlated the neglect factor score with the strength of resting state functional connectivity within and across the 10 resting state networks. All damaged brain voxels were removed from the functional connectivity: behaviour correlational analysis. We found that the correlated behavioural deficits summarized by the factor score were associated with correlated multi-network patterns of abnormal functional connectivity involving large swaths of cortex. Specifically, dorsal attention and sensory-motor networks showed: (i) reduced interhemispheric functional connectivity; (ii) reduced anti-correlation with frontoparietal and default mode networks in the right hemisphere; and (iii) increased intrahemispheric connectivity with the basal ganglia. These patterns of functional connectivity: behaviour correlations were stronger in patients with right-as compared to left-hemisphere damage and were independent of lesion volume. Our findings identify large-scale changes in resting state network interactions that are a physiological signature of spatial neglect and may relate to its right hemisphere lateralization.