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Connectomic insight into unique stroke patient recovery after rTMS treatment.

作者信息

Chen Rong, Dadario Nicholas B, Cook Brennan, Sun Lichun, Wang Xiaolong, Li Yujie, Hu Xiaorong, Zhang Xia, Sughrue Michael E

机构信息

The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China.

Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, United States.

出版信息

Front Neurol. 2023 Jul 6;14:1063408. doi: 10.3389/fneur.2023.1063408. eCollection 2023.


DOI:10.3389/fneur.2023.1063408
PMID:37483442
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10359072/
Abstract

An improved understanding of the neuroplastic potential of the brain has allowed advancements in neuromodulatory treatments for acute stroke patients. However, there remains a poor understanding of individual differences in treatment-induced recovery. Individualized information on connectivity disturbances may help predict differences in treatment response and recovery phenotypes. We studied the medical data of 22 ischemic stroke patients who received MRI scans and started repetitive transcranial magnetic stimulation (rTMS) treatment on the same day. The functional and motor outcomes were assessed at admission day, 1 day after treatment, 30 days after treatment, and 90 days after treatment using four validated standardized stroke outcome scales. Each patient underwent detailed baseline connectivity analyses to identify structural and functional connectivity disturbances. An unsupervised machine learning (ML) agglomerative hierarchical clustering method was utilized to group patients according to outcomes at four-time points to identify individual phenotypes in recovery trajectory. Differences in connectivity features were examined between individual clusters. Patients were a median age of 64, 50% female, and had a median hospital length of stay of 9.5 days. A significant improvement between all time points was demonstrated post treatment in three of four validated stroke scales utilized. ML-based analyses identified distinct clusters representing unique patient trajectories for each scale. Quantitative differences were found to exist in structural and functional connectivity analyses of the motor network and subcortical structures between individual clusters which could explain these unique trajectories on the Barthel Index (BI) scale but not on other stroke scales. This study demonstrates for the first time the feasibility of using individualized connectivity analyses in differentiating unique phenotypes in rTMS treatment responses and recovery. This personalized connectomic approach may be utilized in the future to better understand patient recovery trajectories with neuromodulatory treatment.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3790/10359072/679b66f45a2a/fneur-14-1063408-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3790/10359072/5daa54ac105f/fneur-14-1063408-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3790/10359072/cd6e76727920/fneur-14-1063408-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3790/10359072/4369369b35d7/fneur-14-1063408-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3790/10359072/679b66f45a2a/fneur-14-1063408-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3790/10359072/5daa54ac105f/fneur-14-1063408-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3790/10359072/cd6e76727920/fneur-14-1063408-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3790/10359072/4369369b35d7/fneur-14-1063408-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3790/10359072/679b66f45a2a/fneur-14-1063408-g0004.jpg

相似文献

[1]
Connectomic insight into unique stroke patient recovery after rTMS treatment.

Front Neurol. 2023-7-6

[2]
The effect of coupled inhibitory-facilitatory repetitive transcranial magnetic stimulation on shaping early reorganization of the motor network after stroke.

Brain Res. 2022-9-1

[3]
Evaluation of fMRI activation in post-stroke patients with movement disorders after repetitive transcranial magnetic stimulation: a scoping review.

Front Neurol. 2023-6-19

[4]
Low-frequency rTMS in patients with subacute ischemic stroke: clinical evaluation of short and long-term outcomes and neurophysiological assessment of cortical excitability.

J Med Life. 2015

[5]
Cerebral Functional Reorganization in Ischemic Stroke after Repetitive Transcranial Magnetic Stimulation: An fMRI Study.

CNS Neurosci Ther. 2016-12

[6]
Distinction of High- and Low-Frequency Repetitive Transcranial Magnetic Stimulation on the Functional Reorganization of the Motor Network in Stroke Patients.

Neural Plast. 2021

[7]
Effectiveness of repetitive transcranial magnetic stimulation (rTMS) after acute stroke: A one-year longitudinal randomized trial.

CNS Neurosci Ther. 2017-10-2

[8]
Motor Network Reorganization After Repetitive Transcranial Magnetic Stimulation in Early Stroke Patients: A Resting State fMRI Study.

Neurorehabil Neural Repair. 2022-1

[9]
Effects of corticospinal tract integrity on upper limb motor function recovery in stroke patients treated with repetitive transcranial magnetic stimulation.

J Integr Neurosci. 2022-3-21

[10]
Effects of high- and low-frequency repetitive transcranial magnetic stimulation on motor recovery in early stroke patients: Evidence from a randomized controlled trial with clinical, neurophysiological and functional imaging assessments.

Neuroimage Clin. 2018-12-3

引用本文的文献

[1]
The Brain Connectome for Clinical Neuroscience.

Adv Exp Med Biol. 2024

[2]
Improvements in Sleep Quality in Patients With Major Depressive and Generalized Anxiety Disorders Treated With Individualized, Parcel-Guided Transcranial Magnetic Stimulation.

Brain Behav. 2024-10

[3]
Translational Connectomics: overview of machine learning in macroscale Connectomics for clinical insights.

BMC Neurol. 2024-9-28

本文引用的文献

[1]
Using machine learning to evaluate large-scale brain networks in patients with brain tumors: Traditional and non-traditional eloquent areas.

Neurooncol Adv. 2022-9-19

[2]
Supplementary Motor Area Syndrome After Brain Tumor Surgery: A Systematic Review.

World Neurosurg. 2022-9

[3]
Parcellation-based tractographic modeling of the salience network through meta-analysis.

Brain Behav. 2022-7

[4]
Should Neurosurgeons Try to Preserve Non-Traditional Brain Networks? A Systematic Review of the Neuroscientific Evidence.

J Pers Med. 2022-4-6

[5]
Transcranial magnetic stimulation for post-operative neurorehabilitation in neuro-oncology: a review of the literature and future directions.

J Neurooncol. 2022-5

[6]
Interventional neurorehabilitation for promoting functional recovery post-craniotomy: a proof-of-concept.

Sci Rep. 2022-2-23

[7]
Connectivity-based parcellation of normal and anatomically distorted human cerebral cortex.

Hum Brain Mapp. 2022-3

[8]
Lesion-symptom mapping with NIHSS sub-scores in ischemic stroke patients.

Stroke Vasc Neurol. 2022-4

[9]
Postoperative Focal Lower Extremity Supplementary Motor Area Syndrome: Case Report and Review of the Literature.

Neurodiagn J. 2021-12

[10]
Functional connectome reorganization relates to post-stroke motor recovery and structural and functional disconnection.

Neuroimage. 2021-12-15

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