Investigating structure and function in the healthy human brain: validity of acute versus chronic lesion-symptom mapping
Investigating structure and function in the healthy human brain: validity of acute versus chronic lesion-symptom mapping
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DOI：
10.1007/s00429-016-1325-7
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发表时间：
2017-07-01
影响因子：
3.1
通讯作者：
Rennig, Johannes
中科院分区：
文献类型：
--
作者：
Karnath, Hans-Otto;Rennig, Johannes
现代基于体素的病变症状映射（VLSM）分析技术提供了强大的工具来检查健康人脑的结构和功能之间的关系。然而，此类分析的成像和行为测试的类型和适当的时间点仍然存在不确定性。在这里，我们测试了 VLSM 分析中使用的结构成像数据和行为评分的三种最常见组合的有效性。鉴于对人类初级运动系统神经基础的既定知识，我们提出了一个常见问题：运动系统在正常人脑中的代表位置，分析了 60 名未选择的中风患者的个体手臂运动功能。只有结合急性行为评分和急性结构成像才能准确识别中风后出现偏瘫的主要脑区，即皮质脊髓束（CST）。相比之下，基于慢性行为的 VLSM 分析（结合慢性或急性成像）需要排除从初始麻痹中恢复的患者，以揭示有效的解剖结果。因此，如果 VLSM 病变分析的主要研究目的是揭示健康人脑中某种功能的神经基础，并且如果没有计划进行重复评估的纵向设计，那么急性成像和行为的组合代表了理想的数据集。
Modern voxel-based lesion-symptom mapping (VLSM) analyses techniques provide powerful tools to examine the relationship between structure and function of the healthy human brain. However, there is still uncertainty on the type of and the appropriate time point of imaging and of behavioral testing for such analyses. Here we tested the validity of the three most common combinations of structural imaging data and behavioral scores used in VLSM analyses. Given the established knowledge about the neural substrate of the primary motor system in humans, we asked the mundane question of where the motor system is represented in the normal human brain, analyzing individual arm motor function of 60 unselected stroke patients. Only the combination of acute behavioral scores and acute structural imaging precisely identified the principal brain area for the emergence of hemiparesis after stroke, i.e., the corticospinal tract (CST). In contrast, VLSM analyses based on chronic behavior-in combination with either chronic or acute imaging-required the exclusion of patients who had recovered from an initial paresis to reveal valid anatomical results. Thus, if the primary research aim of a VLSM lesion analysis is to uncover the neural substrates of a certain function in the healthy human brain and if no longitudinal designs with repeated evaluations are planned, the combination of acute imaging and behavior represents the ideal dataset.