Queensland Brain Institute & School of Psychology, The University of Queensland, St Lucia, 4072, Australia.
Queensland Brain Institute & School of Psychology, The University of Queensland, St Lucia, 4072, Australia; Canadian Institute for Advanced Research, Toronto, Canada.
Neuropsychologia. 2024 Nov 5;204:109007. doi: 10.1016/j.neuropsychologia.2024.109007. Epub 2024 Oct 2.
The purpose of this study was to identify patterns of structural disconnection and multivariate lesion-behaviour relationships associated with post-stroke deficits across six commonly impacted cognitive domains: executive function, language, memory, numerical processing, praxis, and visuospatial attention.
Stroke survivors (n = 593) completed a brief domain-specific cognitive assessment (the Oxford Cognitive Screen (OCS)) during acute hospitalisation. Network-level and multivariate (sparce canonical correlation) lesion mapping analyses were conducted to identify focal neural correlates and distributed patterns of structural disconnection associated with impairment on each of the 16 OCS measures.
Network-level and multivariate lesion mapping analyses identified significant correlates for 12/16 and 10/16 OCS measures, respectively which were largely consistent with correlates reported in past work. Language impairments were reliably localised to network- and voxel-level correlates centred in left fronto-temporal regions. Memory impairments were associated with disconnection in a large network of left hemisphere regions. Number processing deficits were associated with damage to voxels centred in the left insular/opercular cortex, as well as disconnection within the surrounding white matter tracts. Within the domain of attention, different subtypes of visuospatial neglect were linked to distinct but partially overlapping patterns of disconnection and voxel-level damage. Praxis impairment was not linked to any voxel-level regions but was significantly associated with disconnection within the left hemisphere dorsal attention network.
These results highlight the utility of routine, domain-specific cognitive assessment and imaging data for theoretically-driven lesion mapping analyses, while providing novel insight into the complex anatomical correlates of common and debilitating post-stroke cognitive impairments.
本研究旨在识别与 6 个常见受影响认知领域（执行功能、语言、记忆、数值处理、动作和视空间注意力）的卒中后缺陷相关的结构连接中断模式和多变量损伤-行为关系。
卒中幸存者（n=593）在急性住院期间完成了简短的特定领域认知评估（牛津认知筛查（OCS））。进行网络水平和多变量（稀疏正则相关）损伤映射分析，以确定与 16 项 OCS 测量中每一项损伤相关的焦点神经关联和结构连接中断的分布式模式。
网络水平和多变量损伤映射分析分别确定了 12/16 和 10/16 OCS 测量的显著相关因素，这些因素在很大程度上与过去研究报告的相关因素一致。语言损伤可靠地定位于以左额颞区域为中心的网络和体素水平相关因素。记忆损伤与左半球区域内的连接中断有关。数字处理缺陷与以左岛叶/脑岛皮质为中心的体素损伤以及周围白质束内的连接中断有关。在注意力领域，不同类型的视觉空间忽视与不同但部分重叠的连接和体素损伤模式有关。动作障碍与任何体素水平区域均无关，但与左半球背侧注意网络内的连接中断显著相关。
这些结果突出了常规、特定领域认知评估和影像学数据对于理论驱动的损伤映射分析的效用，同时为常见且使人衰弱的卒中后认知障碍的复杂解剖学关联提供了新的见解。
