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运动缺陷和空间忽视对脑卒中患者对侧顶后皮质功能和结构连接的影响。

Influence of Motor Deficiency and Spatial Neglect on the Contralesional Posterior Parietal Cortex Functional and Structural Connectivity in Stroke Patients.

机构信息

Neurorehabilitation Unit, Lille University Medical Center, 59000, Lille, France.

Inserm U1171-Degenerative and Vascular Cognitive Disorders, University Lille, 59000, Lille, France.

出版信息

Brain Topogr. 2020 Mar;33(2):176-190. doi: 10.1007/s10548-019-00749-1. Epub 2019 Dec 12.

DOI:10.1007/s10548-019-00749-1
PMID:31832813
Abstract

The posterior parietal cortex (PPC) is a key structure for visual attention and upper limb function, two features that could be impaired after stroke, and could be implied in their recovery. If it is well established that stroke is responsible for intra- and interhemispheric connectivity troubles, little is known about those existing for the contralesional PPC. In this study, we aimed at mapping the functional (using resting state fMRI) and structural (using diffusion tensor imagery) networks from 3 subparts of the PPC of the contralesional hemisphere (the anterior intraparietal sulcus), the posterior intraparietal sulcus and the superior parieto-occipital cortex to bilateral frontal areas and ipsilesional homologous PPC parts in 11 chronic stroke patients compared to 13 healthy controls. We also aimed at assessing the relationship between connectivity and the severity of visuospatial and motor deficiencies. We showed that interhemispheric functional and structural connectivity between PPCs was altered in stroke patients compared to controls, without any specificity among seeds. Alterations of parieto-frontal intra- and interhemispheric connectivity were less observed. Neglect severity was associated with several alterations in intra- and interhemispheric connectivity, whereas we did not find any behavioral/connectivity correlations for motor deficiency. The results of this exploratory study shed a new light on the influence of the contralesional PPC in post-stroke patients, they have to be confirmed and refined in further larger studies.

摘要

顶后皮质(PPC)是视觉注意力和上肢功能的关键结构,这两个特征在中风后可能会受损,并可能在其恢复中起作用。如果中风导致了半球内和半球间的连接问题已经得到很好的证实,那么对于对侧顶后皮质的这些连接问题知之甚少。在这项研究中,我们旨在从 11 名慢性中风患者的对侧顶后皮质的 3 个亚区(前顶内沟、后顶内沟和上顶枕皮质)到双侧额区和同侧同源顶后皮质部分,映射功能(使用静息状态 fMRI)和结构(使用弥散张量成像)网络,并与 13 名健康对照进行比较。我们还旨在评估连接性与视觉空间和运动缺陷严重程度之间的关系。与对照组相比,中风患者的顶后皮质之间的半球间功能和结构连接发生了改变,但种子之间没有任何特异性。观察到的顶叶-额叶内和半球间连接的改变较少。忽视的严重程度与半球内和半球间连接的多种改变有关,而我们没有发现运动缺陷的任何行为/连接相关性。这项探索性研究的结果为中风后患者对侧顶后皮质的影响提供了新的认识,这些结果需要在进一步的更大规模研究中得到证实和完善。

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引用本文的文献

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Posterior parietal cortical areas and recovery after motor stroke: a scoping review.顶叶后部皮质区域与运动性脑卒中后的恢复:一项范围综述
Brain Commun. 2023 Sep 28;5(5):fcad250. doi: 10.1093/braincomms/fcad250. eCollection 2023.
2
The Neurophysiological Features Associated with Unilateral Spatial Neglect Recovery: A Scoping Review.与单侧空间忽略恢复相关的神经生理学特征:范围综述。
Brain Topogr. 2023 Sep;36(5):631-643. doi: 10.1007/s10548-023-00980-x. Epub 2023 Jul 6.
3
Structural Covariance of the Ipsilesional Primary Motor Cortex in Subcortical Stroke Patients with Motor Deficits.
皮质下卒中运动障碍患者患侧初级运动皮层的结构协变。
Neural Plast. 2022 Mar 10;2022:1460326. doi: 10.1155/2022/1460326. eCollection 2022.
4
Functional connectivity drives stroke recovery: shifting the paradigm from correlation to causation.功能连接驱动中风康复:从相关性到因果关系的范式转变。
Brain. 2022 May 24;145(4):1211-1228. doi: 10.1093/brain/awab469.
5
Sensorimotor, Attentional, and Neuroanatomical Predictors of Upper Limb Motor Deficits and Rehabilitation Outcome after Stroke.中风后上肢运动功能障碍及康复结果的感觉运动、注意力和神经解剖学预测因素
Neural Plast. 2021 Apr 1;2021:8845685. doi: 10.1155/2021/8845685. eCollection 2021.