Behavioral deficits in left hemispatial neglect are related to a reduction of spontaneous neuronal activity in the right superior parietal lobule
Behavioral deficits in left hemispatial neglect are related to a reduction of spontaneous neuronal activity in the right superior parietal lobule
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DOI：
10.1016/j.neuropsychologia.2020.107356
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发表时间：
2020-02-17
期刊：
影响因子：
2.6
通讯作者：
Muente, Thomas F.
中科院分区：
文献类型：
--
作者：
Machner, Bjoern;von der Gablentz, Janina;Muente, Thomas F.
局灶性脑损伤可能会导致远端大脑区域的功能障碍，导致行为障碍。基于这种错位的概念，卒中后的空间忽视与右侧腹侧注意网络(VAN)的结构损伤和双侧背侧注意网络(DAN)的大脑半球间功能连接中断有关。我们质疑与忽视相关的行为缺陷是否可能由这些大脑网络中特定区域的局部功能障碍决定。我们使用静息状态功能磁共振成像、空间注意的神经心理学测试和忽视相关功能障碍的临床评估来调查伴有左半球忽视的急性右半球中风患者。除了传统的DAN/VAN不同皮质感兴趣区(ROI)之间的FC分析外，我们还从每个ROI中提取低频波动的分数幅度(FALFF)作为局部自发神经元活动的标志。尽管DAN区(与VAN区相反)在很大程度上没有受到结构性脑损伤，但它们显示出大脑半球间FC显著减少。然而，右侧顶上小叶(SPL)中一个DAN-ROI的fALFF与显著的fMRI行为相关：右侧顶后沟的fALFF越小，患者的病理性注意力偏向和与忽视相关的功能障碍越严重。我们的发现证实了无损害但功能障碍的右侧SPL在空间忽视及其行为后果的出现中起着至关重要的作用。他们进一步支持通过非侵入性脑刺激在忽视康复中针对SPL功能障碍。
Focal brain lesions may induce dysfunctions in distant brain regions leading to behavioral impairments. Based on this concept of 'diaschisis', spatial neglect following stroke has been related to structural damage of the right-lateralized ventral attention network (VAN) and disrupted inter-hemispheric functional connectivity (FC) in the bilateral dorsal attention network (DAN). We questioned whether neglect-related behavioral deficits may be determined by local dysfunction of a specific region within these brain networks.We investigated acute right-hemisphere stroke patients with left hemispatial neglect using resting-state functional MRI, neuropsychological tests of spatial attention and clinical assessment of neglect-related functional disability. In addition to conventional FC analyses between different cortical regions of interest (ROIs) in the DAN/VAN, we extracted the fractional amplitude of low frequency fluctuations (fALFF) from each ROI as a marker of regional spontaneous neuronal activity. Although DAN regions (as opposed to the VAN regions) were largely spared from structural brain damage, they exhibited a significant reduction of inter-hemispheric FC. However, significant fMRI-behavior correlations were revealed specifically for the fALFF of one DAN-ROI in the right superior parietal lobule (SPL): the smaller the fALFF in the right posterior intraparietal sulcus, the more severe the patient's pathological attention bias and neglect-related functional impairment.In line with 'diaschisis', our findings confirm a crucial role of the non-lesioned but dysfunctional right SPL for the emergence of spatial neglect and its behavioral consequences. They further support targeting the SPL dysfunction by non-invasive brain stimulation in neglect rehabilitation.