1531-8249/asset/cover.gif?v=1&s=685ec69724c5ed4c8847ce939e70ceb45065856f "Annals of Neurology")
A.R.C. performed the analysis of most imaging data (BOLD functional connectivity analysis and stroke lesion segmentation analysis), imaging-behavior correlations, and statistical analysis, assisted in the recruitment and scanning of subjects, and wrote the paper.
1531-8249/asset/olbannerleft.gif?v=1&s=d36d5ebb3caa1b29d7f078a97c52973b0963daf2)
1531-8249/asset/olbannerright.gif?v=1&s=078041b213f6959d63575a593f880457c45116f0)
Original Article
Resting interhemispheric functional magnetic resonance imaging connectivity predicts performance after stroke
Article first published online: 27 OCT 2009
DOI: 10.1002/ana.21905
Copyright © 2010 American Neurological Association
Additional Information
How to Cite
Carter, A. R., Astafiev, S. V., Lang, C. E., Connor, L. T., Rengachary, J., Strube, M. J., Pope, D. L. W., Shulman, G. L. and Corbetta, M. (2010), Resting interhemispheric functional magnetic resonance imaging connectivity predicts performance after stroke. Ann Neurol., 67: 365–375. doi: 10.1002/ana.21905
- †
A.R.C. performed the analysis of most imaging data (BOLD functional connectivity analysis and stroke lesion segmentation analysis), imaging-behavior correlations, and statistical analysis, assisted in the recruitment and scanning of subjects, and wrote the paper.
- ‡
S.V.A. assisted in the scanning of subjects, image analysis, ROI creation, and encoding of behavioral data, and developed the composite functional connectivity scores.
- §
C.E.L. contributed to the experimental design and development of an appropriate battery for testing motor behavior.
- ¶
L.T.C. contributed to the experimental design and behavioral battery and helped with the statistical analysis.
- ‖
J.R. recruited and obtained consent from patients, assisted in the scanning, administered the behavioral battery, and analyzed the behavioral data.
- ††
M.J.S. instructed the authors in statistical methods for comparing nonindependent correlations.
- ‡‡
D.L.W.P. assisted in scanning and behavioral testing.
- §§
G.L.S. and M.C. designed the study, oversaw data acquisition and analysis, and were principal editors of the paper. All authors discussed the results and commented on the paper.
Publication History
- Issue published online: 29 MAR 2010
- Article first published online: 27 OCT 2009
- Accepted manuscript online: 27 OCT 2009 12:00AM EST
- Manuscript Accepted: 20 OCT 2009
- Manuscript Revised: 12 OCT 2009
- Manuscript Received: 14 APR 2009
Funded by
- National Institute of Mental Health. Grant Number: R01 MH71920-06
- National Institute of Neurological Disorders and Stroke. Grant Numbers: R01 NS48013, R01 HD061117-05A2, 1K08NS064365-01A1
- Robert Wood Johnson Foundation Amos Faculty Development Program
- James S. McDonnell Foundation in supporting the Cognitive Rehabilitation Research Group
- Rehabilitation Institute of St. Louis
Abstract
Objective
Focal brain lesions can have important remote effects on the function of distant brain regions. The resulting network dysfunction may contribute significantly to behavioral deficits observed after stroke. This study investigates the behavioral significance of changes in the coherence of spontaneous activity in distributed networks after stroke by measuring resting state functional connectivity (FC) using functional magnetic resonance imaging.
Methods
In acute stroke patients, we measured FC in a dorsal attention network and an arm somatomotor network, and determined the correlation of FC with performance obtained in a separate session on tests of attention and motor function. In particular, we compared the behavioral correlation with intrahemispheric FC to the behavioral correlation with interhemispheric FC.
Results
In the attention network, disruption of interhemispheric FC was significantly correlated with abnormal detection of visual stimuli (Pearson r with field effect = −0.624, p = 0.002). In the somatomotor network, disruption of interhemispheric FC was significantly correlated with upper extremity impairment (Pearson r with contralesional Action Research Arm Test = 0.527, p = 0.036). In contrast, intrahemispheric FC within the normal or damaged hemispheres was not correlated with performance in either network. Quantitative lesion analysis demonstrated that our results could not be explained by structural damage alone.
Interpretation
These results suggest that lesions cause state changes in the spontaneous functional architecture of the brain, and constrain behavioral output. Clinically, these results validate using FC for assessing the health of brain networks, with implications for prognosis and recovery from stroke, and underscore the importance of interhemispheric interactions. ANN NEUROL 2010;67:365–375