Abstract:
BACKGROUND:The extent of brain damage in chronic stroke patients is traditionally defined as the necrotic tissue observed on magnetic resonance image (MRI). However, patients often exhibit symptoms suggesting that functional impairment may affect areas beyond the cortical necrotic lesion, for example, when cortical symptoms ensue after subcortical damage. This observation suggests that disconnection or diaschisis can lead to remote cortical dysfunction that can be functionally equivalent to direct cortical lesions. Objective. To directly measure subcortical disconnection after stroke. METHODS:We describe a principled approach utilizing the whole brain connectome reconstructed from diffusion MRI to evaluate the reduction of apparent white matter fiber density in the hemisphere affected by the stroke compared with the spared hemisphere. RESULTS:In eight chronic stroke patients, we observed subcortical disconnection extending beyond the location of tissue necrosis and affecting major white matter pathways underlying the necrotic area. CONCLUSIONS:We suggest that it is possible to detect and quantify previously unappreciated areas of subcortical and cortical disconnection. Specifically, this method can be used to evaluate the relationship between lesion location and symptoms, with emphasis on a connectivity-based approach.
journal_name
Behav Neuroljournal_title
Behavioural neurologyauthors
Bonilha L,Nesland T,Rorden C,Fillmore P,Ratnayake RP,Fridriksson Jdoi
10.1155/2014/215380subject
Has Abstractpub_date
2014-01-01 00:00:00pages
215380eissn
0953-4180issn
1875-8584journal_volume
2014pub_type
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