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. 2015 Aug;138(Pt 8):2359-69.
doi: 10.1093/brain/awv156. Epub 2015 Jun 11.

Connectivity measures are robust biomarkers of cortical function and plasticity after stroke

Jennifer Wu  1 , Erin Burke Quinlan  1 , Lucy Dodakian  2 , Alison McKenzie  3 , Nikhita Kathuria  2 , Robert J Zhou  2 , Renee Augsburger  2 , Jill See  2 , Vu H Le  2 , Ramesh Srinivasan  4 , Steven C Cramer  5
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Connectivity measures are robust biomarkers of cortical function and plasticity after stroke

"VSports app下载" Jennifer Wu et al. Brain. 2015 Aug.

Abstract

Valid biomarkers of motor system function after stroke could improve clinical decision-making. Electroencephalography-based measures are safe, inexpensive, and accessible in complex medical settings and so are attractive candidates. This study examined specific electroencephalography cortical connectivity measures as biomarkers by assessing their relationship with motor deficits across 28 days of intensive therapy. Resting-state connectivity measures were acquired four times using dense array (256 leads) electroencephalography in 12 hemiparetic patients (7. 3 ± 4. 0 months post-stroke, age 26-75 years, six male/six female) across 28 days of intensive therapy targeting arm motor deficits. Structural magnetic resonance imaging measured corticospinal tract injury and infarct volume. At baseline, connectivity with leads overlying ipsilesional primary motor cortex (M1) was a robust and specific marker of motor status, accounting for 78% of variance in impairment; ipsilesional M1 connectivity with leads overlying ipsilesional frontal-premotor (PM) regions accounted for most of this (R(2) = 0. 51) and remained significant after controlling for injury VSports手机版. Baseline impairment also correlated with corticospinal tract injury (R(2) = 0. 52), though not infarct volume. A model that combined a functional measure of connectivity with a structural measure of injury (corticospinal tract injury) performed better than either measure alone (R(2) = 0. 93). Across the 28 days of therapy, change in connectivity with ipsilesional M1 was a good biomarker of motor gains (R(2) = 0. 61). Ipsilesional M1-PM connectivity increased in parallel with motor gains, with greater gains associated with larger increases in ipsilesional M1-PM connectivity (R(2) = 0. 34); greater gains were also associated with larger decreases in M1-parietal connectivity (R(2) = 0. 36). In sum, electroencephalography measures of motor cortical connectivity-particularly between ipsilesional M1 and ipsilesional premotor-are strongly related to motor deficits and their improvement with therapy after stroke and so may be useful biomarkers of cortical function and plasticity. Such measures might provide a biological approach to distinguishing patient subgroups after stroke. .

Keywords: coherence; connectivity; motor; stroke V体育安卓版. .

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Valid biomarkers of motor system function after stroke would assist with tailoring and optimisation of treatment. Wu et al. show that EEG measures of motor cortical connectivity – particularly between ipsilesional M1 and ipsilesional frontal-premotor regions – correlate strongly with motor deficits and their improvement over the course of intensive therapy.
Figure 1
Figure 1
Experimental setup. (A) Experiment timeline. Behavioural and EEG assessments were performed at baseline, then after 2 weeks of therapy, following the 1 week break, and at end of 28 days of therapy. A baseline structural MRI scan was also acquired. (B) The group showed statistically and clinically significant gains in upper-extremity motor status, as measured by the Fugl-Meyer Arm Motor Assessment (FM) (mean ± standard error), across therapy [t(11) = 5.89, P = 0.0001].
Figure 2
Figure 2
Cortical connectivity with ipsilesional M1 was a good marker of Fugl-Meyer score at baseline. (A) Topographic map of correlation coefficients of PLS model correlating baseline ipsilesional M1 connectivity across whole scalp and baseline Fugl-Meyer (FM) score (fitted R2 = 0.96, cross-validated R2 = 0.78). The left side of the figure is ipsilesional, the right side is contralesional, green electrodes indicate the ipsilesional M1 seed, and the black dots indicate leads overlying the ipsilesional frontal-premotor cortical region (PM). (B) Greater degree of ipsilesional M1–premotor connectivity was correlated with higher Fugl-Meyer score (R2 = 0.51, P = 0.009).
Figure 3
Figure 3
Change in ipsilesional M1 connectivity was a significant biomarker of motor gains across therapy. (A) Topographic map of correlation coefficients in the PLS model correlating change in ipsilesional M1 connectivity across whole scalp and change in Fugl-Meyer score across the 28 days of therapy (fitted R2 = 0.92, cross-validated R2 = 0.61). (B) Greater degree of ipsilesional M1 connectivity with ipsilesional frontal-premotor cortical regions (PM) was correlated with higher Fugl-Meyer (FM) gains (R2 = 0.34, P = 0.04); compared to the ipsilesional premotor electrodes identified in the Exam 1 PLS model, premotor electrodes in this change PLS model were more ventrally located. (C) Greater degree of ipsilesional M1 connectivity with ipsilesional parietal (PAR) cortical regions was correlated with smaller Fugl-Meyer gains (R2 = 0.36, P = 0.04).
Figure 4
Figure 4
Cortical connectivity with ipsilesional M1 at baseline predicted motor gains across therapy. (A) Topographic map of correlation coefficients in the PLS model correlating ipsilesional M1 connectivity across whole scalp at baseline with change in Fugl-Meyer score across the 28 days of therapy (fitted R2 = 0.97, cross-validated R2 = 0.79). (B) Greater degree of ipsilesional M1 connectivity with ipsilesional parietal operculum (PARoperc) predicted smaller Fugl-Meyer gains (R2 = 0.60, P = 0.003).
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