Global brain health modulates the impact of lesion damage on post-stroke sensorimotor outcomes
Global brain health modulates the impact of lesion damage on post-stroke sensorimotor outcomes
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全球大脑健康调节病变损伤对中风后感觉运动结果的影响
DOI：
10.1101/2022.04.27.489791
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Liew S
中科院分区：
文献类型：
--
作者：
Liew S
中风后的感觉运动表现与皮质脊髓束损伤负荷等局灶性损伤指标密切相关。然而，全球大脑健康的作用尚不清楚。在这里，我们研究了大脑年龄（一种从全脑结构神经成像得出的神经生物学衰老指标）对感觉运动结果的影响。我们假设中风病变损伤会导致大脑年龄变老，这反过来又与感觉运动结果较差有关。我们还预计，大脑年龄将介导病变损伤对感觉运动结果的影响，并且这些关系将由中风后继发性萎缩（例如，慢性中风中的同侧半球最强）驱动。我们进一步假设，结构性大脑复原力（在中风的背景下，我们将其定义为大脑在局灶性病变损伤的情况下维持其整体完整性的能力）将区分预后较好和较差的人。我们使用稳健的线性混合效应回归分析了来自全球 38 个队列的 963 名中风患者的横截面高分辨率脑 MRI 和结果数据，以检查感觉运动行为、病变损伤和大脑年龄之间的关系。我们使用中介分析来检查大脑年龄是否介导病变损伤对中风结果的影响，以及这种关联是否是由慢性（≥180天）中风的同病变措施驱动的。我们使用逻辑回归和倾向评分匹配对病变损伤评估了大脑弹性对感觉运动结果的影响。中风病变损伤与大脑年龄较大有关，而大脑年龄较大又与较差的感觉运动结果相关。在慢性卒中的同侧半球中，大脑年龄介导皮质脊髓束损伤负荷对感觉运动结果的影响最为强烈。以更年轻的大脑年龄为指标的更强的大脑弹性解释了为什么当病变损伤修复时，人们的感觉运动结果更好而不是更差。我们提出了新的证据，表明整体大脑健康与中风后良好的感觉运动结果相关，并改变了局灶性损伤的影响。这种关系似乎是由于中风后继发性变性所致。大脑恢复能力让我们深入了解为什么有些人中风后尽管局灶性损伤程度相似，但仍能获得更好的结果。与单独的局灶性损伤测量相比，纳入基于成像的全球大脑健康评估可能会改善对中风后感觉运动结果的预测。这项研究很重要，因为它引入了应用新的治疗干预措施来预防或减缓从其他领域（例如阿尔茨海默病）到中风的大脑衰老的潜力。
Sensorimotor performance after stroke is strongly related to focal injury measures such as corticospinal tract lesion load. However, the role of global brain health is less clear. Here, we examined the impact of brain age, a measure of neurobiological aging derived from whole brain structural neuroimaging, on sensorimotor outcomes. We hypothesized that stroke lesion damage would result in older brain age, which would in turn be associated with poorer sensorimotor outcomes. We also expected that brain age would mediate the impact of lesion damage on sensorimotor outcomes and that these relationships would be driven by post-stroke secondary atrophy (e.g., strongest in the ipsilesional hemisphere in chronic stroke). We further hypothesized that structural brain resilience, which we define in the context of stroke as the brain’s ability to maintain its global integrity despite focal lesion damage, would differentiate people with better versus worse outcomes.We analyzed cross-sectional high-resolution brain MRI and outcomes data from 963 people with stroke from 38 cohorts worldwide using robust linear mixed-effects regressions to examine the relationship between sensorimotor behavior, lesion damage, and brain age. We used a mediation analysis to examine whether brain age mediates the impact of lesion damage on stroke outcomes and if associations are driven by ipsilesional measures in chronic (≥180 days) stroke. We assessed the impact of brain resilience on sensorimotor outcome using logistic regression with propensity score matching on lesion damage.Stroke lesion damage was associated with older brain age, which in turn was associated with poorer sensorimotor outcomes. Brain age mediated the impact of corticospinal tract lesion load on sensorimotor outcomes most strongly in the ipsilesional hemisphere in chronic stroke. Greater brain resilience, as indexed by younger brain age, explained why people have better versus worse sensorimotor outcomes when lesion damage was fixed.We present novel evidence that global brain health is associated with superior post-stroke sensorimotor outcomes and modifies the impact of focal damage. This relationship appears to be due to post-stroke secondary degeneration. Brain resilience provides insight into why some people have better outcomes after stroke, despite similar amounts of focal injury. Inclusion of imaging-based assessments of global brain health may improve prediction of post-stroke sensorimotor outcomes compared to focal injury measures alone. This investigation is important because it introduces the potential to apply novel therapeutic interventions to prevent or slow brain aging from other fields (e.g., Alzheimer’s disease) to stroke.
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DOI：
10.1057/978-1-349-95988-4_645
发表时间：
2020
期刊：
The Grants Register 2021
影响因子：
--
作者：
通讯作者：
--
影响因子：
8.3
作者：
Bu, Ning;Khlif, Mohamed Salah;Thijs, Vincent
通讯作者：
Thijs, Vincent
影响因子：
4.3
作者：
Woytowicz EJ;Rietschel JC;Goodman RN;Conroy SS;Sorkin JD;Whitall J;McCombe Waller S
通讯作者：
McCombe Waller S
影响因子：
5.4
作者：
Zavaliangos-Petropulu, Artemis;Lo, Bethany;Donnelly, Miranda R.;Schweighofer, Nicolas;Lohse, Keith;Jahanshad, Neda;Barisano, Giuseppe;Banaj, Nerisa;Borich, Michael R.;Boyd, Lara A.;Buetefisch, Cathrin M.;Byblow, Winston D.;Cassidy, Jessica M.;Charalambous, Charalambos C.;Conforto, Adriana B.;DiCarlo, Julie A.;Dula, Adrienne N.;Egorova-Brumley, Natalia;Etherton, Mark R.;Feng, Wuwei;Fercho, Kelene A.;Geranmayeh, Fatemeh;Hanlon, Colleen A.;Hayward, Kathryn S.;Hordacre, Brenton;Kautz, Steven A.;Khlif, Mohamed Salah;Kim, Hosung;Kuceyeski, Amy;Lin, David J.;Liu, Jingchun;Lotze, Martin;MacIntosh, Bradley J.;Margetis, John L.;Mohamed, Feroze B.;Piras, Fabrizio;Ramos-Murguialday, Ander;Revill, Kate P.;Roberts, Pamela S.;Robertson, Andrew D.;Schambra, Heidi M.;Seo, Na Jin;Shiroishi, Mark S.;Stinear, Cathy M.;Soekadar, Surjo R.;Spalletta, Gianfranco;Taga, Myriam;Tang, Wai Kwong;Thielman, Gregory T.;Vecchio, Daniela;Ward, Nick S.;Westlye, Lars T.;Werden, Emilio;Winstein, Carolee;Wittenberg, George F.;Wolf, Steven L.;Wong, Kristin A.;Yu, Chunshui;Brodtmann, Amy;Cramer, Steven C.;Thompson, Paul M.;Liew, Sook-Lei
通讯作者：
Liew, Sook-Lei
使用静息态功能磁共振成像，通过基于功能性脑连接组的机器学习分类来预测超级衰老者。
影响因子：
3.7
作者：
Chang;Bori R Kim;Heesoon Park;Soo Mee Lim;E. Kim;J. Jeong;G. Kim
通讯作者：
G. Kim