Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Aug;12(8):e2707.
doi: 10.1002/brb3.2707. Epub 2022 Jul 21.

Structural disconnectome mapping of cognitive function in poststroke patients

Knut K Kolskår  1   2   3 , Kristine M Ulrichsen  1   2   3 , Genevieve Richard  1 , Erlend S Dørum  1   2   3 , Michel Thiebaut de Schotten  4   5 , Jaroslav Rokicki  1   2   6 , Jennifer Monereo-Sánchez  1   7   8 , Andreas Engvig  9   10 , Hege Ihle Hansen  11 , Jan Egil Nordvik  12   13 , Lars T Westlye  1   2   14 , Dag Alnaes  1   15
Affiliations

Structural disconnectome mapping of cognitive function in poststroke patients

Knut K Kolskår et al. Brain Behav. 2022 Aug.

Abstract

Background and purpose: Sequalae following stroke represents a significant challenge in current rehabilitation. The location and size of focal lesions are only moderately predictive of the diverse cognitive outcome after stroke. One explanation building on recent work on brain networks proposes that the cognitive consequences of focal lesions are caused by damages to anatomically distributed brain networks supporting cognition rather than specific lesion locations.

Methods: To investigate the association between poststroke structural disconnectivity and cognitive performance, we estimated individual level whole-brain disconnectivity probability maps based on lesion maps from 102 stroke patients using normative data from healthy controls. Cognitive performance was assessed in the whole sample using Montreal Cognitive Assessment, and a more comprehensive computerized test protocol was performed on a subset (n = 82).

Results: Multivariate analysis using Partial Least Squares on the disconnectome maps revealed that higher disconnectivity in right insular and frontal operculum, superior temporal gyrus and putamen was associated with poorer MoCA performance, indicating that lesions in regions connected with these brain regions are more likely to cause cognitive impairment. Furthermore, our results indicated that disconnectivity within these clusters was associated with poorer performance across multiple cognitive domains.

Conclusions: These findings demonstrate that the extent and distribution of structural disconnectivity following stroke are sensitive to cognitive deficits and may provide important clinical information predicting poststroke cognitive sequalae.

Keywords: DTI; cognitive sequelae; prediction; stroke.

PubMed Disclaimer

Conflict of interest statement

We declare no competing financial interests. We obtained appropriate ethical approval from the local ethics committee, and all procedures were in line with the declaration of Helsinki.

Figures

FIGURE 1
FIGURE 1
Lesion overlap across 102 stroke patients. 12 transversal slices, with 5‐mm thickness. Color scale indicates number of participants overlapping. Z coordinates denotes transversal slices in the MNI152‐coordinate system
FIGURE 2
FIGURE 2
Histogram depicting the distribution of MoCA scores across the sample
FIGURE 3
FIGURE 3
Distribution of MoCA scores by patient group
FIGURE 4
FIGURE 4
Voxel‐wise disconnectome bootstrap ratio maps for the MoCA association, thresholded at pseudo‐z > 3
FIGURE 5
FIGURE 5
Correlation between MoCA, PLS‐weights, disconnectivity within the significant clusters, and CabPad performance
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Aben, H. P. , Biessels, G. J. , Weaver, N. A. , Spikman, J. M. , Visser‐Meily, J. M. A. , de Kort, P. L. M. , Reijmer, Y. D. , & Jansen, B. P. W. (2019). Extent to which network hubs are affected by ischemic stroke predicts cognitive recovery. Stroke, 50(10), 2768–2774. 10.1161/STROKEAHA.119.025637 - DOI - PubMed
    1. Alstott, J. , Breakspear, M. , Hagmann, P. , Cammoun, L. , & Sporns, O. (2009). Modeling the impact of lesions in the human brain. PLoS Computational Biology, 5(6), e1000408. 10.1371/journal.pcbi.1000408 - DOI - PMC - PubMed
    1. Avants, B. B. , Tustison, N. J. , Song, G. , Cook, P. A. , Klein, A. , & Gee, J. C. (2011). A reproducible evaluation of ANTs similarity metric performance in brain image registration. NeuroImage, 54(3), 2033–2044. doi: 10.1016/j.neuroimage.2010.09.025 - DOI - PMC - PubMed
    1. Bennett, I. J. , & Madden, D. J. (2014). Disconnected aging: Cerebral white matter integrity and age‐related differences in cognition. Neuroscience, 276, 187–205. doi: 10.1016/j.neuroscience.2013.11.026 - DOI - PMC - PubMed
    1. Bentley, P. , Kumar, G. , Rinne, P. , Buddha, S. , Kallingal, J. , Hookway, C. , Sharma, P. , Mehta, A. , & Beckmann, C. (2014). Lesion locations influencing baseline severity and early recovery in ischaemic stroke. European Journal of Neurology, 21(9), 1226–1232. 10.1111/ene.12464 - DOI - PubMed

Publication types