Chronic post-stroke aphasia severity is determined by fragmentation of residual white matter networks

Abstract Many stroke survivors with aphasia in the acute period experience spontaneous recovery within the first six months after the stroke. However, approximately 30–40% sustain permanent aphasia and the factors determining incomplete recovery are unclear. Suboptimal recovery may be influenced by...

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Autores principales:	Barbara K. Marebwa, Julius Fridriksson, Grigori Yourganov, Lynda Feenaughty, Chris Rorden, Leonardo Bonilha
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/783c628380b348e5aa516b6121c3d6d0
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spelling	oai:doaj.org-article:783c628380b348e5aa516b6121c3d6d02021-12-02T11:52:39ZChronic post-stroke aphasia severity is determined by fragmentation of residual white matter networks10.1038/s41598-017-07607-92045-2322https://doaj.org/article/783c628380b348e5aa516b6121c3d6d02017-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-07607-9https://doaj.org/toc/2045-2322Abstract Many stroke survivors with aphasia in the acute period experience spontaneous recovery within the first six months after the stroke. However, approximately 30–40% sustain permanent aphasia and the factors determining incomplete recovery are unclear. Suboptimal recovery may be influenced by disruption of areas seemingly spared by the stroke due to loss of white matter connectivity and network integrity. We reconstructed individual anatomical whole-brain connectomes from 90 left hemisphere stroke survivors using diffusion MR images. We measured the modularity of the residual white matter network organization, the probability of brain regions clustering together, and the degree of fragmentation of left hemisphere networks. Greater post-stroke left hemisphere network fragmentation and higher modularity index were associated with more severe chronic aphasia, controlling for the size of the stroke lesion. Even when the left hemisphere was relatively spared, subjects with disorganized community structure had significantly worse aphasia, particularly when key temporal lobe regions were isolated into segregated modules. These results suggest that white matter integrity and disorganization of neuronal networks could be important determinants of chronic aphasia severity. Connectome white matter organization measured through modularity and other topological features could be used as a personalized variable for clinical staging and aphasia treatment planning.Barbara K. MarebwaJulius FridrikssonGrigori YourganovLynda FeenaughtyChris RordenLeonardo BonilhaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-13 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Barbara K. Marebwa Julius Fridriksson Grigori Yourganov Lynda Feenaughty Chris Rorden Leonardo Bonilha Chronic post-stroke aphasia severity is determined by fragmentation of residual white matter networks
description	Abstract Many stroke survivors with aphasia in the acute period experience spontaneous recovery within the first six months after the stroke. However, approximately 30–40% sustain permanent aphasia and the factors determining incomplete recovery are unclear. Suboptimal recovery may be influenced by disruption of areas seemingly spared by the stroke due to loss of white matter connectivity and network integrity. We reconstructed individual anatomical whole-brain connectomes from 90 left hemisphere stroke survivors using diffusion MR images. We measured the modularity of the residual white matter network organization, the probability of brain regions clustering together, and the degree of fragmentation of left hemisphere networks. Greater post-stroke left hemisphere network fragmentation and higher modularity index were associated with more severe chronic aphasia, controlling for the size of the stroke lesion. Even when the left hemisphere was relatively spared, subjects with disorganized community structure had significantly worse aphasia, particularly when key temporal lobe regions were isolated into segregated modules. These results suggest that white matter integrity and disorganization of neuronal networks could be important determinants of chronic aphasia severity. Connectome white matter organization measured through modularity and other topological features could be used as a personalized variable for clinical staging and aphasia treatment planning.
format	article
author	Barbara K. Marebwa Julius Fridriksson Grigori Yourganov Lynda Feenaughty Chris Rorden Leonardo Bonilha
author_facet	Barbara K. Marebwa Julius Fridriksson Grigori Yourganov Lynda Feenaughty Chris Rorden Leonardo Bonilha
author_sort	Barbara K. Marebwa
title	Chronic post-stroke aphasia severity is determined by fragmentation of residual white matter networks
title_short	Chronic post-stroke aphasia severity is determined by fragmentation of residual white matter networks
title_full	Chronic post-stroke aphasia severity is determined by fragmentation of residual white matter networks
title_fullStr	Chronic post-stroke aphasia severity is determined by fragmentation of residual white matter networks
title_full_unstemmed	Chronic post-stroke aphasia severity is determined by fragmentation of residual white matter networks
title_sort	chronic post-stroke aphasia severity is determined by fragmentation of residual white matter networks
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/783c628380b348e5aa516b6121c3d6d0
work_keys_str_mv	AT barbarakmarebwa chronicpoststrokeaphasiaseverityisdeterminedbyfragmentationofresidualwhitematternetworks AT juliusfridriksson chronicpoststrokeaphasiaseverityisdeterminedbyfragmentationofresidualwhitematternetworks AT grigoriyourganov chronicpoststrokeaphasiaseverityisdeterminedbyfragmentationofresidualwhitematternetworks AT lyndafeenaughty chronicpoststrokeaphasiaseverityisdeterminedbyfragmentationofresidualwhitematternetworks AT chrisrorden chronicpoststrokeaphasiaseverityisdeterminedbyfragmentationofresidualwhitematternetworks AT leonardobonilha chronicpoststrokeaphasiaseverityisdeterminedbyfragmentationofresidualwhitematternetworks
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Chronic post-stroke aphasia severity is determined by fragmentation of residual white matter networks

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