scholarly journals Connecting to motor recovery after stroke

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Jill H Fowler ◽  
Raj N Kalaria
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Brain Networks ◽  
Motor Recovery ◽  
Motor Outcome ◽  
Structural Brain

This scientific commentary refers to ‘Structural brain networks and functional motor outcome after stroke –a prospective cohort study’, by Schlemm et al. (https://doi.org/10.1093/braincomms/fcaa001) in Brain Communications and ‘Brain responsivity provides an individual readout for motor recovery after stroke’ by Tscherpel et al. (https://doi.org/10.1093/brain/awaa127) in Brain

scholarly journals Structural brain networks and functional motor outcome after stroke—a prospective cohort study

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Eckhard Schlemm ◽  
Robert Schulz ◽  
Marlene Bönstrup ◽  
Lutz Krawinkel ◽  
Jens Fiehler ◽  
...  
Keyword(s):  
Cohort Study ◽  
Ischaemic Stroke ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Brain Networks ◽  
Symptom Burden ◽  
Lesion Volume ◽  
Stroke Patients ◽  
Residual Symptom ◽  
Structural Brain

Abstract The time course of topological reorganization that occurs in the structural connectome after an ischaemic stroke is currently not well understood. We aimed to determine the evolution of structural brain networks in stroke patients with motor deficits and relate changes in their global topology to residual symptom burden and functional impairment. In this prospective cohort study, ischaemic stroke patients with supratentorial infarcts and motor symptoms were assessed longitudinally by advanced diffusion MRI and detailed clinical testing of upper extremity motor function at four time points from the acute to the chronic stage. For each time point, structural connectomes were reconstructed, and whole-hemisphere global network topology was quantified in terms of integration and segregation parameters. Using non-linear joint mixed-effects regression modelling, network evolution was related to lesion volume and clinical outcome. Thirty patients were included for analysis. Graph-theoretical analysis demonstrated that, over time, brain networks became less integrated and more segregated with decreasing global efficiency and increasing modularity. Changes occurred in both stroke and intact hemispheres and, in the latter, were positively associated with lesion volume. Greater change in topology was associated with larger residual symptom burden and greater motor impairment 1, 3 and 12 months after stroke. After ischaemic stroke, brain networks underwent characteristic changes in both ipsi- and contralesional hemispheres. Topological network changes reflect the severity of damage to the structural network and are associated with functional outcome beyond the impact of lesion volume.

scholarly journals Early parietofrontal network upregulation relates to future persistent deficits after severe stroke – a prospective cohort study

2021 ◽  
Author(s):  
Winifried Backhaus ◽  
Hanna Braaß ◽  
Focko L Higgen ◽  
Christian Gerloff ◽  
Robert Schulz
Keyword(s):  
Cohort Study ◽  
Functional Connectivity ◽  
Motor Cortex ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Primary Motor Cortex ◽  
Motor Recovery ◽  
Intraparietal Sulcus ◽  
Stroke Patients ◽  
Correlative Models

Abstract Recent brain imaging has evidenced that parietofrontal networks show alterations after stroke which also relate to motor recovery processes. There is converging evidence for an upregulation of parietofrontal coupling between parietal brain regions and frontal motor cortices. The majority of studies though have included only moderately to mildly affected patients, particularly in the subacute or chronic stage. Whether these network alterations will also be present in severely affected patients and early after stroke and whether such information can improve correlative models to infer motor recovery remains unclear. In this prospective cohort study, nineteen severely affected first-ever stroke patients (mean age 74 years, 12 females) were analysed which underwent resting-state functional MRI and clinical testing during the initial week after the event. Clinical evaluation of neurological and motor impairment as well as global disability was repeated after three and six months. Nineteen healthy participants of similar age and gender were also recruited. MRI data were used to calculate functional connectivity values between the ipsilesional primary motor cortex, the ventral premotor cortex, the supplementary motor area and the anterior and caudal intraparietal sulcus of the ipsilesional hemisphere. Linear regression models were estimated to compare parietofrontal functional connectivity between stroke patients and healthy controls and to relate them to motor recovery. The main finding was a significant increase in ipsilesional parietofrontal coupling between anterior intraparietal sulcus and the primary motor cortex in severely affected stroke patients (P < 0.003). This upregulation significantly contributed to correlative models explaining variability in subsequent neurological and global disability as quantified by National Institute of Health Stroke Scale and modified Rankin Scale, respectively. Patients with increased parietofrontal coupling in the acute stage showed higher levels of persistent deficits in the late subacute stage of recovery (P < 0.05). This study provides novel insights that parietofrontal networks of the ipsilesional hemisphere undergo neuroplastic alteration already very early after severe motor stroke. The association between early parietofrontal upregulation and future levels of persistent functional deficits and dependence from help in daily living might be useful in models to enhance clinical neurorehabilitative decision making.

Organizational Justice and Health of Employees: Prospective Cohort Study.

2013 ◽  
Author(s):  
Mika Kivimaki ◽  
Marko Elovainio ◽  
Jussi Vahtera ◽  
Marianna Virtanen ◽  
Jane E. Ferrie
Keyword(s):  
Cohort Study ◽  
Organizational Justice ◽  
Prospective Cohort Study ◽  
Prospective Cohort

Cynical distrust increases breast cancer risk: Evidence from a prospective cohort study

2002 ◽  
Author(s):  
A. R. Aro ◽  
H. J. de Koning ◽  
K. Vehkalahti ◽  
P. Absetz ◽  
M. Schreck ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Prospective Cohort Study ◽  
Prospective Cohort
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