Brain Functional Topology Alteration in Right Lateral Occipital Cortex Is Associated With Upper Extremity Motor Recovery.

Qianqian Huang,Songhe Jiang,Lejian Huang,Dinghong Lin,Yun Jin,Bo Wu,Yungang Cao,Wenzhan Tu,Shishi Huang,Linyu Fan

doi:10.3389/fneur.2022.780966

Abstract

Stroke is a chief cause of sudden brain damage that severely disrupts the whole-brain network. However, the potential mechanisms of motor recovery after stroke are uncertain and the prognosis of poststroke upper extremity recovery is still a challenge. This study investigated the global and local topological properties of the brain functional connectome in patients with subacute ischemic stroke and their associations with the clinical measurements. A total of 57 patients, consisting of 29 left-sided and 28 right-sided stroke patients, and 32 age- and gender-matched healthy controls (HCs) were recruited to undergo a resting-state functional magnetic resonance imaging (rs-fMRI) study; patients were also clinically evaluated with the Upper Extremity Fugl-Meyer Assessment (FMA_UE). The assessment was repeated at 15 weeks to assess upper extremity functional recovery for the patient remaining in the study (12 left- 20 right-sided stroke patients). Global graph topological disruption indices of stroke patients were significantly decreased compared with HCs but these indices were not significantly associated with FMA_UE. In addition, local brain network structure of stroke patients was altered, and the altered regions were dependent on the stroke site. Significant associations between local degree and motor performance and its recovery were observed in the right lateral occipital cortex (R LOC) in the right-sided stroke patients. Our findings suggested that brain functional topologies alterations in R LOC are promising as prognostic biomarkers for right-sided subacute stroke. This cortical area might be a potential target to be further validated for non-invasive brain stimulation treatment to improve poststroke upper extremity recovery.

Highlights

Stroke, a common medical emergency, remains the main cause of long-term disability and death in the world [1]
All five graph topological disruption indexes of the left-sided stroke patients statistically significantly decreased compared to healthy controls (HCs) across all link densities
By virtue of an right lateral occipital cortex (R LOC)-based functional connectivity (FC) analysis, we identified the regions that connected to R LOC and the degree extracted from which was significantly increased compared to HCs at the subacute stage poststroke, left PRCUC and left and right MFG, and the regions with decreased connectivity, left supplementary motor cortex (L SMA), left postcentral gyrus (L PoCG), right supramarginal gyrus (R SMG), R PrCG, and right superior frontal gyrus (R SFG)

Summary

Introduction

A common medical emergency, remains the main cause of long-term disability and death in the world [1]. Independence of the patients in activities of daily living depends on the recovery of their upper limb motor functions [3], and accurate prognosis of the recovery would enable realistic goal-setting and guide the allocation of rehabilitation resources. The prognosis of poststroke upper extremity recovery is still a challenge. The most common neuroimaging biomarker to predict poststroke upper extremity recovery is measuring the integrity of the corticospinal tract [4–8]. Researchers have recently discovered that along with the disorders of structural connectivity [12], reorganization of functional networks is related to the prognosis of patients [13–17]. At present, there have been few reports on how the reorganization of brain functional networks predicts recovery of clinical motor function [18]

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Conclusion