Functional connectivity in relation to motor performance and recovery after stroke.

Plasticity after stroke has traditionally been studied by observing changes only in the spatial distribution and laterality of focal brain activation during affected limb movement. However, neural reorganization is multifaceted and our understanding may be enhanced by examining dynamics of activity within large-scale networks involved in sensorimotor control of the limbs. Here, we review functional connectivity as a promising means of assessing the consequences of a stroke lesion on the transfer of activity within large-scale neural networks. We first provide a brief overview of techniques used to assess functional connectivity in subjects with stroke. Next, we review task-related and resting-state functional connectivity studies that demonstrate a lesion-induced disruption of neural networks, the relationship of the extent of this disruption with motor performance, and the potential for network reorganization in the presence of a stroke lesion. We conclude with suggestions for future research and theories that may enhance the interpretation of changing functional connectivity. Overall findings suggest that a network level assessment provides a useful framework to examine brain reorganization and to potentially better predict behavioral outcomes following stroke

Resting state functional thalamic connectivity abnormalities in patients with post-stroke sleep apnoea: a pilot case-control study

OBJECTIVE: Sleep apnoea is common after stroke, and has adverse effects on the clinical outcome of affected cases. Its pathophysiological mechanisms are only partially known. Increases in brain connectivity after stroke might influence networks involved in arousal modulation and breathing control. The aim of this study was to investigate the resting state functional MRI thalamic hyper connectivity of stroke patients affected by sleep apnoea (SA) with respect to cases not affected, and to healthy controls (HC). PATIENTS AND METHODS: A series of stabilized strokes were submitted to 3T resting state functional MRI imaging and full polysomnography. The ventral-posterior-lateral thalamic nucleus was used as seed. RESULTS: At the between groups comparison analysis, in SA cases versus HC, the regions significantly hyper-connected with the seed were those encoding noxious threats (frontal eye field, somatosensory association, secondary visual cortices). Comparisons between SA cases versus those without SA, revealed in the former group significantly increased connectivity with regions modulating the response to stimuli independently to their potentiality of threat (prefrontal, primary and somatosensory association, superolateral and medial-inferior temporal, associative and secondary occipital ones). Further significantly functionally hyper connections were documented with regions involved also in the modulation of breathing during sleep (pons, midbrain, cerebellum, posterior cingulate cortices), and in the modulation of breathing response to chemical variations (anterior, posterior and para-hippocampal cingulate cortices). CONCLUSIONS: Our preliminary data support the presence of functional hyper connectivity in thalamic circuits modulating sensorial stimuli, in patients with post-stroke sleep apnoea, possibly influencing both their arousal ability and breathing modulation during sleep

Functional Connectivity Analysis on Resting-State Electroencephalography Signals Following Chiropractic Spinal Manipulation in Stroke Patients

Stroke impairments often present as cognitive and motor deficits, leading to a decline in quality of life. Recovery strategy and mechanisms, such as neuroplasticity, are important factors, as these can help improve the effectiveness of rehabilitation. The present study investigated chiropractic spinal manipulation (SM) and its effects on resting-state functional connectivity in 24 subacute to chronic stroke patients monitored by electroencephalography (EEG). Functional connectivity of both linear and non-linear coupling was estimated by coherence and phase lag index (PLI), respectively. Non-parametric cluster-based permutation tests were used to assess the statistical significance of the changes in functional connectivity following SM. Results showed a significant increase in functional connectivity from the PLI metric in the alpha band within the default mode network (DMN). The functional connectivity between the posterior cingulate cortex and parahippocampal regions increased following SM, t (23) = 10.45, p = 0.005. No significant changes occurred following the sham control procedure. These findings suggest that SM may alter functional connectivity in the brain of stroke patients and highlights the potential of EEG for monitoring neuroplastic changes following SM. Furthermore, the altered connectivity was observed between areas which may be affected by factors such as decreased pain perception, episodic memory, navigation, and space representation in the brain. However, these factors were not directly monitored in this study. Therefore, further research is needed to elucidate the underlying mechanisms and clinical significance of the observed changes

EEG Characterization of Sensorimotor Networks: Implications in Stroke

The purpose of this dissertation was to use electroencephalography (EEG) to characterize sensorimotor networks and examine the effects of stroke on sensorimotor networks. Sensorimotor networks play an essential role in completion of everyday tasks, and when damaged, as in stroke survivors, the successful completion of seemingly simple motor tasks becomes fantasy. When sensorimotor networks are impaired as a result of stroke, varying degrees of sensorimotor deficits emerge, most often including loss of sensation and difficulty generating upper extremity movements. Although sensory therapies, such as the application of tendon vibration, have been shown to reduce the sensorimotor deficits after stroke, the underlying sensorimotor mechanisms associated with such improvements are unknown. While sensorimotor networks have been studied extensively, unanswered questions still surround their role in basic control paradigms and how their role changes after stroke. EEG provides a way to probe the high-speed temporal dynamics of sensorimotor networks that other more common imaging modalities lack. Sensorimotor network function was examined in controls during a task designed to differentiate potential mechanisms of arm stabilization and determine to what degree the sensorimotor network is involved. After sensorimotor network function was characterized in controls, we examined the effect of stroke on the sensorimotor network during rest and described the reorganization that occurs. Lastly, we explored tendon vibration as a sensory therapy for stroke survivors and determined if sensorimotor network mechanisms underlie improvements in arm tracking performance due to wrist tendon vibration. We observed cortical activity and connectivity that suggests sensorimotor networks are involved in the control of arm stability, cortical networks reorganize to more asymmetric, local networks after stroke, and tendon vibration normalizes sensorimotor network activity and connectivity during motor control after stroke. This dissertation was among the first studies using EEG to characterize the high-speed temporal dynamics of sensorimotor networks following stroke. This new knowledge has led to a better understanding of how sensorimotor networks function under ordinary circumstances as well as extreme situations such as stroke and revealed previously unknown mechanisms by which tendon vibration improves motor control in stroke survivors, which will lead to better therapeutic approaches

Language impairments and resting-state EEG in brain tumour patients:Revealing connections

Intact language functions are crucial for everyday communication. A brain tumour can impair these functions. We studied language abilities and their relation to resting-state brain activity in low-grade brain tumour patients, in search for predictors of language outcome after surgery. The brain tumours in this thesis include gliomas, which originate in the brain, and meningiomas, which arise from the meninges. Glioma and meningioma patients underwent thorough language assessments and brain activity registrations by electroencephalography (EEG). Two aspects of brain activity were evaluated: slow-wave activity, concerning activity with a low frequency, and functional connectivity brain networks, reflecting the extent to which brain areas interact.It is concluded that low-grade gliomas can cause impairments in a variety of language abilities. Furthermore, meningiomas can induce language impairments (primarily in speech production and writing), despite that these tumours do not infiltrate brain tissue. Many glioma and meningioma patients are presented with language impairments 1 year after surgery, but there is large interpatient variation. Our findings underline the importance of extensive language testing before and after brain tumour surgery. With regard to the EEG analyses, the outcomes indicate that increased slow-wave activity and particular characteristics of the functional connectivity networks are associated with poorer language functioning before surgery in glioma patients, unlike in meningioma patients. Moreover, two predictors of language outcome after glioma surgery are identified. This line of research requires further investigation because it has the potential to improve clinical procedures, such as treatment planning, patient counselling, and language rehabilitation

Multiscale Topological Properties Of Functional Brain Networks During Motor Imagery After Stroke

In recent years, network analyses have been used to evaluate brain reorganization following stroke. However, many studies have often focused on single topological scales, leading to an incomplete model of how focal brain lesions affect multiple network properties simultaneously and how changes on smaller scales influence those on larger scales. In an EEG-based experiment on the performance of hand motor imagery (MI) in 20 patients with unilateral stroke, we observed that the anatomic lesion affects the functional brain network on multiple levels. In the beta (13-30 Hz) frequency band, the MI of the affected hand (Ahand) elicited a significantly lower smallworldness and local efficiency (Eloc) versus the unaffected hand (Uhand). Notably, the abnormal reduction in Eloc significantly depended on the increase in interhemispheric connectivity, which was in turn determined primarily by the rise in regional connectivity in the parieto-occipital sites of the affected hemisphere. Further, in contrast to the Uhand MI, in which significantly high connectivity was observed for the contralateral sensorimotor regions of the unaffected hemisphere, the regions that increased in connection during the Ahand MI lay in the frontal and parietal regions of the contralaterally affected hemisphere. Finally, the overall sensorimotor function of our patients, as measured by Fugl-Meyer Assessment (FMA) index, was significantly predicted by the connectivity of their affected hemisphere. These results increase our understanding of stroke-induced alterations in functional brain networks.Comment: Neuroimage, accepted manuscript (unedited version) available online 19-June-201

Advances in EEG-based functional connectivity approaches to the study of the central nervous system in health and disease

Functional brain connectivity is closely linked to the complex interactions between brain networks. In the last two decades, measures of functional connectivity based on electroencephalogram (EEG) data have proved to be an important tool for neurologists and clinical and non-clinical neuroscientists. Indeed, EEG-based functional connectivity may reveal the neurophysiological processes and networks underlying human cognition and the pathophysiology of neuropsychiatric disorders. This editorial discusses recent advances and future prospects in the study of EEG-based functional connectivity, with a focus on the main methodological approaches to studying brain networks in health and disease

Small-World Propensity Reveals the Frequency Specificity of Resting State Networks

Goal: Functional connectivity (FC) is an important indicator of the brain's state in different conditions, such as rest/task or health/pathology. Here we used high-density electroencephalography coupled to source reconstruction to assess frequency-specific changes of FC during resting state. Specifically, we computed the Small-World Propensity (SWP) index to characterize network small-world architecture across frequencies. Methods: We collected resting state data from healthy participants and built connectivity matrices maintaining the heterogeneity of connection strengths. For a subsample of participants, we also investigated whether the SWP captured FC changes after the execution of a working memory (WM) task. Results: We found that SWP demonstrates a selective increase in the alpha and low beta bands. Moreover, SWP was modulated by a cognitive task and showed increased values in the bands entrained by the WM task. Conclusions: SWP is a valid metric to characterize the frequency-specific behavior of resting state networks. ispartof: IEEE Open Journal of Engineering in Medicine and Biology status: accepte