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Smaller spared subcortical nuclei are associated with worse post-stroke sensorimotor outcomes in 28 cohorts worldwide.

ABSTRACT: Up to two-thirds of stroke survivors experience persistent sensorimotor impairments. Recovery relies on the integrity of spared brain areas to compensate for damaged tissue. Deep grey matter structures play a critical role in the control and regulation of sensorimotor circuits. The goal of this work is to identify associations between volumes of spared subcortical nuclei and sensorimotor behaviour at different timepoints after stroke. We pooled high-resolution T₁-weighted MRI brain scans and behavioural data in 828 individuals with unilateral stroke from 28 cohorts worldwide. Cross-sectional analyses using linear mixed-effects models related post-stroke sensorimotor behaviour to non-lesioned subcortical volumes (Bonferroni-corrected, P < 0.004). We tested subacute (≤90 days) and chronic (≥180 days) stroke subgroups separately, with exploratory analyses in early stroke (≤21 days) and across all time. Sub-analyses in chronic stroke were also performed based on class of sensorimotor deficits (impairment, activity limitations) and side of lesioned hemisphere. Worse sensorimotor behaviour was associated with a smaller ipsilesional thalamic volume in both early (n = 179; d = 0.68) and subacute (n = 274, d = 0.46) stroke. In chronic stroke (n = 404), worse sensorimotor behaviour was associated with smaller ipsilesional putamen (d = 0.52) and nucleus accumbens (d = 0.39) volumes, and a larger ipsilesional lateral ventricle (d = -0.42). Worse chronic sensorimotor impairment specifically (measured by the Fugl-Meyer Assessment; n = 256) was associated with smaller ipsilesional putamen (d = 0.72) and larger lateral ventricle (d = -0.41) volumes, while several measures of activity limitations (n = 116) showed no significant relationships. In the full cohort across all time (n = 828), sensorimotor behaviour was associated with the volumes of the ipsilesional nucleus accumbens (d = 0.23), putamen (d = 0.33), thalamus (d = 0.33) and lateral ventricle (d = -0.23). We demonstrate significant relationships between post-stroke sensorimotor behaviour and reduced volumes of deep grey matter structures that were spared by stroke, which differ by time and class of sensorimotor measure. These findings provide additional insight into how different cortico-thalamo-striatal circuits support post-stroke sensorimotor outcomes.

SUBMITTER: Liew SL

PROVIDER: S-EPMC8598999 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Smaller spared subcortical nuclei are associated with worse post-stroke sensorimotor outcomes in 28 cohorts worldwide.

Liew Sook-Lei SL Zavaliangos-Petropulu Artemis A Schweighofer Nicolas N Jahanshad Neda N Lang Catherine E CE Lohse Keith R KR Banaj Nerisa N Barisano Giuseppe G Baugh Lee A LA Bhattacharya Anup K AK Bigjahan Bavrina B Borich Michael R MR Boyd Lara A LA Brodtmann Amy A Buetefisch Cathrin M CM Byblow Winston D WD Cassidy Jessica M JM Charalambous Charalambos C CC Ciullo Valentina V Conforto Adriana B AB Craddock Richard C RC Dula Adrienne N AN Egorova Natalia N Feng Wuwei W Fercho Kelene A KA Gregory Chris M CM Hanlon Colleen A CA Hayward Kathryn S KS Holguin Jess A JA Hordacre Brenton B Hwang Darryl H DH Kautz Steven A SA Khlif Mohamed Salah MS Kim Bokkyu B Kim Hosung H Kuceyeski Amy A Lo Bethany B Liu Jingchun J Lin David D Lotze Martin M MacIntosh Bradley J BJ Margetis John L JL Mohamed Feroze B FB Nordvik Jan Egil JE Petoe Matthew A MA Piras Fabrizio F Raju Sharmila S Ramos-Murguialday Ander A Revill Kate P KP Roberts Pamela P Robertson Andrew D AD Schambra Heidi M HM Seo Na Jin NJ Shiroishi Mark S MS Soekadar Surjo R SR Spalletta Gianfranco G Stinear Cathy M CM Suri Anisha A Tang Wai Kwong WK Thielman Gregory T GT Thijs Vincent N VN Vecchio Daniela D Ward Nick S NS Westlye Lars T LT Winstein Carolee J CJ Wittenberg George F GF Wong Kristin A KA Yu Chunshui C Wolf Steven L SL Cramer Steven C SC Thompson Paul M PM

Brain communications 20211027 4

Up to two-thirds of stroke survivors experience persistent sensorimotor impairments. Recovery relies on the integrity of spared brain areas to compensate for damaged tissue. Deep grey matter structures play a critical role in the control and regulation of sensorimotor circuits. The goal of this work is to identify associations between volumes of spared subcortical nuclei and sensorimotor behaviour at different timepoints after stroke. We pooled high-resolution T<sub>1</sub>-weighted MRI brain sc ...[more]

PMID: 34805997

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Project description:Background Persistent sensorimotor impairments after stroke can negatively impact quality of life. The hippocampus is vulnerable to poststroke secondary degeneration and is involved in sensorimotor behavior but has not been widely studied within the context of poststroke upper-limb sensorimotor impairment. We investigated associations between non-lesioned hippocampal volume and upper limb sensorimotor impairment in people with chronic stroke, hypothesizing that smaller ipsilesional hippocampal volumes would be associated with greater sensorimotor impairment. Methods and Results Cross-sectional T1-weighted magnetic resonance images of the brain were pooled from 357 participants with chronic stroke from 18 research cohorts of the ENIGMA (Enhancing NeuoImaging Genetics through Meta-Analysis) Stroke Recovery Working Group. Sensorimotor impairment was estimated from the FMA-UE (Fugl-Meyer Assessment of Upper Extremity). Robust mixed-effects linear models were used to test associations between poststroke sensorimotor impairment and hippocampal volumes (ipsilesional and contralesional separately; Bonferroni-corrected, P<0.025), controlling for age, sex, lesion volume, and lesioned hemisphere. In exploratory analyses, we tested for a sensorimotor impairment and sex interaction and relationships between lesion volume, sensorimotor damage, and hippocampal volume. Greater sensorimotor impairment was significantly associated with ipsilesional (P=0.005; β=0.16) but not contralesional (P=0.96; β=0.003) hippocampal volume, independent of lesion volume and other covariates (P=0.001; β=0.26). Women showed progressively worsening sensorimotor impairment with smaller ipsilesional (P=0.008; β=-0.26) and contralesional (P=0.006; β=-0.27) hippocampal volumes compared with men. Hippocampal volume was associated with lesion size (P<0.001; β=-0.21) and extent of sensorimotor damage (P=0.003; β=-0.15). Conclusions The present study identifies novel associations between chronic poststroke sensorimotor impairment and ipsilesional hippocampal volume that are not caused by lesion size and may be stronger in women.

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Smaller spared subcortical nuclei are associated with worse post-stroke sensorimotor outcomes in 28 cohorts worldwide.

Publications

Smaller spared subcortical nuclei are associated with worse post-stroke sensorimotor outcomes in 28 cohorts worldwide.

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