Common behavioral clusters and subcortical anatomy in stroke.
Common behavioral clusters and subcortical anatomy in stroke.
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DOI：
10.1016/j.neuron.2015.02.027
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发表时间：
2015-03-04
期刊：
影响因子：
16.2
通讯作者：
Shulman GL
中科院分区：
文献类型：
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作者：
Corbetta M;Ramsey L;Callejas A;Baldassarre A;Hacker CD;Siegel JS;Astafiev SV;Rengachary J;Zinn K;Lang CE;Connor LT;Fucetola R;Strube M;Carter AR;Shulman GL
长期以来的观点认为，中风会导致许多不同的神经系统综合征，这是由于专门的皮质和皮质下中心的损伤。然而，尚不清楚基于综合征的描述是否有助于描述大量患者的行为缺陷。我们研究了一个大的前瞻性样本的首次中风患者的异质性病变在中风后1-2周。我们用结构MRI和白色物质通路的概率图谱测量了多个区域和病变解剖结构的行为。多变量方法估计的百分比解释的结构性损伤的行为变异。几组跨越多种功能的行为缺陷解释了神经功能障碍。卒中地形主要是皮质下的，并且白色物质束的断开对行为缺陷及其相关性有重要作用。损伤部位对运动和语言的解释比记忆或注意力缺陷的解释更多。我们的发现强调了需要更好的白色物质损害认知模型。
A long-held view is that stroke causes many distinct neurological syndromes due to damage of specialized cortical and subcortical centers. However, it is unknown if a syndrome-based description is helpful in characterizing behavioral deficits across a large number of patients. We studied a large prospective sample of first-time stroke patients with heterogeneous lesions at 1–2 weeks post-stroke. We measured behavior over multiple domains and lesion anatomy with structural MRI and a probabilistic atlas of white matter pathways. Multivariate methods estimated the percentage of behavioral variance explained by structural damage. A few clusters of behavioral deficits spanning multiple functions explained neurological impairment. Stroke topography was predominantly subcortical, and disconnection of white matter tracts critically contributed to behavioral deficits and their correlation. The locus of damage explained more variance for motor and language than memory or attention deficits. Our findings highlight the need for better models of white matter damage on cognition.