Predicting future brain tissue loss from white matter connectivity disruption in ischemic stroke.
Predicting future brain tissue loss from white matter connectivity disruption in ischemic stroke.
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DOI：
10.1161/strokeaha.113.003645
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发表时间：
2014-03
期刊：
影响因子：
8.3
通讯作者：
Iadecola C
中科院分区：
文献类型：
--
作者：
Kuceyeski A;Kamel H;Navi BB;Raj A;Iadecola C
网络修改 (NeMo) 工具使用正常受试者的大脑连接图库来量化局灶性脑损伤引起的结构连接损失量。我们假设 NeMo 工具可以预测中风后连接丧失导致的远程脑组织丧失。收集了 26 名急性缺血性卒中患者（年龄 74.6±14.1 岁，初始 NIH 卒中量表 3.1±3.1）的基线和随访 MRI（相隔 10.7±7.5 个月）。将源自扩散加权图像的病变掩模叠加在 NeMo Tool 的连通性图上，并通过连通性变化 (ChaCo) 分数（即连接到穿过病变掩模的给定区域的轨迹的百分比）来估计区域结构连通性损失。 ChaCo 评分与随后的萎缩相关。中风病变的大小和位置各不相同，但在左半球更常见。 ChaCo 评分通常在中风病变附近的区域较高，反映了这种偏侧化和异质性。 ChaCo 评分在中央后回和中央前回、岛叶、中扣带回、丘脑、壳核、尾状核和苍白球中最高。在基线 ChaCo 评分和随后的组织损失测量之间发现中等、显着的部分相关性（r=0.43，p=4.6×10−9；r=0.61，p=1.4×10−18），校正扫描之间的时间。 ChaCo 得分各不相同，但受影响最严重的区域包括那些具有感觉运动、知觉、学习和记忆功能的区域。基线 ChaCo 与随后的组织损失之间的相关性表明 NeMo 工具可用于识别最容易因急性梗塞而发生远程退化的区域。
The Network Modification (NeMo) Tool uses a library of brain connectivity maps from normal subjects to quantify the amount of structural connectivity loss caused by focal brain lesions. We hypothesized that the NeMo Tool could predict remote brain tissue loss caused by post-stroke loss of connectivity. Baseline and follow-up MRIs (10.7±7.5 months apart) from 26 patients with acute ischemic stroke (age 74.6±14.1 years, initial NIH Stroke Scale 3.1±3.1) were collected. Lesion masks derived from diffusion-weighted images were superimposed on the NeMo Tool’s connectivity maps, and regional structural connectivity losses were estimated via the Change in Connectivity (ChaCo) score (i.e., the percent of tracks connecting to a given region that pass through the lesion mask). ChaCo scores were correlated with subsequent atrophy. Stroke lesions’ size and location varied, but they were more frequent in the left hemisphere. ChaCo scores, generally higher in regions near stroke lesions, reflected this lateralization and heterogeneity. ChaCo scores were highest in the postcentral and precentral gyri, insula, middle cingulate, thalami, putamen, caudate nuclei, and pallidum. Moderate, significant partial correlations were found between baseline ChaCo scores and measures of subsequent tissue loss (r=0.43, p=4.6×10−9; r=0.61, p=1.4×10−18), correcting for the time between scans. ChaCo scores varied, but the most affected regions included those with sensorimotor, perception, learning and memory functions. Correlations between baseline ChaCo and subsequent tissue loss suggest that the NeMo Tool could be used to identify regions most susceptible to remote degeneration from acute infarcts.