Attention‐network specific alterations of structural connectivity in the undamaged white matter in acute neglect
Attention‐network specific alterations of structural connectivity in the undamaged white matter in acute neglect
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DOI：
10.1002/hbm.22503
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发表时间：
2014-09
影响因子：
4.8
通讯作者：
R. Umarova;M. Reisert;Tanja-Ute Beier;V. Kiselev;S. Klöppel;C. Kaller;V. Glauche;I. Mader;L. Beume;J. Hennig;C. Weiller
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作者：
R. Umarova;M. Reisert;Tanja-Ute Beier;V. Kiselev;S. Klöppel;C. Kaller;V. Glauche;I. Mader;L. Beume;J. Hennig;C. Weiller
视觉忽视是空间注意网络功能障碍的结果。到目前为止，忽视中未受损脑组织的结构连接几乎没有被研究过。在本研究中，我们探讨了急性脑卒中患者对侧半球的微结构白色物质特征与忽视严重程度和恢复的关系。我们比较了年龄匹配的健康受试者和三组急性卒中患者（卒中后9 ± 0.5天）：（i）未恢复忽视的患者（n = 12）;（ii）从初始忽视快速恢复的患者（卒中后第一周内，n = 7）;（iii）无忽视的卒中患者（n = 17）。我们分析了各组之间的灰色和白色物质密度和各向异性分数（FA）的差异，并使用纤维跟踪来识别受影响的纤维。未恢复忽视的患者与通过左下顶叶FA减少快速恢复的患者不同。穿过这一区域的纤维连接着腹侧注意系统的左半球类似物。与健康受试者相比，持续性忽视的忽视患者的左侧上级顶叶、视辐射和左侧胼胝体/扣带回FA减少。穿过这些区域的纤维连接左背注意系统的中心。确定区域的FA减少与忽视严重程度相关。该研究首次表明，远离病变的空间注意力系统内的白色物质发生变化，并与忽视的程度和持续性相关。这些数据支持忽视的概念，即整个注意力系统的解体，并说明了急性卒中中结构-功能相关因素的动态变化。《脑地图》35：4678-4692，2014年。© 2014 Wiley Periodicals，Inc.
Visual neglect results from dysfunction within the spatial attention network. The structural connectivity in undamaged brain tissue in neglect has barely been investigated until now. In the present study, we explored the microstructural white matter characteristics of the contralesional hemisphere in relation to neglect severity and recovery in acute stroke patients. We compared age‐matched healthy subjects and three groups of acute stroke patients (9 ± 0.5 days after stroke): (i) patients with nonrecovered neglect (n = 12); (ii) patients with rapid recovery from initial neglect (within the first week post‐stroke, n = 7), (iii) stroke patients without neglect (n = 17). We analyzed the differences between groups in grey and white matter density and fractional anisotropy (FA) and used fiber tracking to identify the affected fibers. Patients with nonrecovered neglect differed from those with rapid recovery by FA‐reduction in the left inferior parietal lobe. Fibers passing through this region connect the left‐hemispheric analogues of the ventral attention system. Compared with healthy subjects, neglect patients with persisting neglect had FA‐reduction in the left superior parietal lobe, optic radiation, and left corpus callosum/cingulum. Fibers passing through these regions connect centers of the left dorsal attention system. FA‐reduction in the identified regions correlated with neglect severity. The study shows for the first time white matter changes within the spatial attention system remote from the lesion and correlating with the extent and persistence of neglect. The data support the concept of neglect as disintegration within the whole attention system and illustrate the dynamics of structural‐functional correlates in acute stroke. Hum Brain Mapp 35:4678–4692, 2014. © 2014 Wiley Periodicals, Inc.