title: Voxel-based lesion-symptom mapping of stroke lesions underlying somatosensory deficits.
abstract: The aim of this study was to investigate the relationship between stroke lesion location and the resulting somatosensory deficit. We studied exteroceptive and proprioceptive somatosensory symptoms and stroke lesions in 38 patients with first-ever acute stroke. The Erasmus modified Nottingham Sensory Assessment was used to clinically evaluate somatosensory functioning in the arm and hand within the first week after stroke onset. Additionally, more objective measures such as the perceptual threshold of touch and somatosensory evoked potentials were recorded. Non-parametric voxel-based lesion-symptom mapping was performed to investigate lesion contribution to different somatosensory deficits in the upper limb. Additionally, structural connectivity of brain areas that demonstrated the strongest association with somatosensory symptoms was determined, using probabilistic fiber tracking based on diffusion tensor imaging data from a healthy age-matched sample. Voxels with a significant association to somatosensory deficits were clustered in two core brain regions: the central parietal white matter, also referred to as the sensory component of the superior thalamic radiation, and the parietal operculum close to the insular cortex, representing the secondary somatosensory cortex. Our objective recordings confirmed findings from clinical assessments. Probabilistic tracking connected the first region to thalamus, internal capsule, brain stem, postcentral gyrus, cerebellum, and frontal pathways, while the second region demonstrated structural connections to thalamus, insular and primary somatosensory cortex. This study reveals that stroke lesions in the sensory fibers of the superior thalamocortical radiation and the parietal operculum are significantly associated with multiple exteroceptive and proprioceptive deficits in the arm and hand.
authors.affiliation: KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Tervuursevest 101/bus 1501, 3001 Leuven, Belgium.
authors.forename: Sarah
authors.initials: S
authors.lastname: Meyer
authors.affiliation: University Medical Center Hamburg-Eppendorf, Department of Neurology, Martinistraße 52, 20246 Hamburg, Germany.
authors.forename: Simon S
authors.initials: SS
authors.lastname: Kessner
authors.affiliation: University Medical Center Hamburg-Eppendorf, Department of Neurology, Martinistraße 52, 20246 Hamburg, Germany.
authors.forename: Bastian
authors.initials: B
authors.lastname: Cheng
authors.affiliation: University Medical Center Hamburg-Eppendorf, Department of Neurology, Martinistraße 52, 20246 Hamburg, Germany.
authors.forename: Marlene
authors.initials: M
authors.lastname: Bönstrup
authors.affiliation: University Medical Center Hamburg-Eppendorf, Department of Neurology, Martinistraße 52, 20246 Hamburg, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Schulz
authors.affiliation: University Medical Center Hamburg-Eppendorf, Department of Neurology, Martinistraße 52, 20246 Hamburg, Germany.
authors.forename: Friedhelm C
authors.initials: FC
authors.lastname: Hummel
authors.affiliation: KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Tervuursevest 101/bus 1501, 3001 Leuven, Belgium.
authors.forename: Nele
authors.initials: N
authors.lastname: De Bruyn
authors.affiliation: Cliniques Universitaires Saint-Luc, Department of Neurology, Hippokrateslaan 10, 1200 Brussels, Belgium.
authors.forename: Andre
authors.initials: A
authors.lastname: Peeters
authors.affiliation: Cliniques Universitaires Saint-Luc, Department of Neurology, Hippokrateslaan 10, 1200 Brussels, Belgium.
authors.forename: Vincent
authors.initials: V
authors.lastname: Van Pesch
authors.affiliation: Cliniques Universitaires Saint-Luc, Department of Radiology, Hippokrateslaan 10, 1200 Brussels, Belgium.
authors.forename: Thierry
authors.initials: T
authors.lastname: Duprez
authors.affiliation: KU Leuven - University of Leuven, Department of Imaging and Pathology, Herestraat 49, 3000 Leuven, Belgium; University Hospitals Leuven, Department of Radiology, Herestraat 49, 3000 Leuven, Belgium.
authors.forename: Stefan
authors.initials: S
authors.lastname: Sunaert
authors.affiliation: KU Leuven - University of Leuven, Department of Neurosciences, Herestraat 49, 3000 Leuven, Belgium; University Hospitals Leuven, Department of Neurology, Herestraat 49, 3000 Leuven, Belgium.
authors.forename: Maarten
authors.initials: M
authors.lastname: Schrooten
authors.affiliation: KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Tervuursevest 101/bus 1501, 3001 Leuven, Belgium.
authors.forename: Hilde
authors.initials: H
authors.lastname: Feys
authors.affiliation: University Medical Center Hamburg-Eppendorf, Department of Neurology, Martinistraße 52, 20246 Hamburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Gerloff
authors.affiliation: University Medical Center Hamburg-Eppendorf, Department of Neurology, Martinistraße 52, 20246 Hamburg, Germany.
authors.forename: Götz
authors.initials: G
authors.lastname: Thomalla
authors.affiliation: KU Leuven - University of Leuven, Department of Neurosciences, Herestraat 49, 3000 Leuven, Belgium; University Hospitals Leuven, Department of Neurology, Herestraat 49, 3000 Leuven, Belgium; Laboratory of Neurobiology, Vesalius Research Center, VIB, Herestraat 49, 3000 Leuven, Belgium; KU Leuven - University of Leuven, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND), Herestraat 49, 3000 Leuven, Belgium.
authors.forename: Vincent
authors.initials: V
authors.lastname: Thijs
authors.affiliation: KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Tervuursevest 101/bus 1501, 3001 Leuven, Belgium.
authors.forename: Geert
authors.initials: G
authors.lastname: Verheyden
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001132:Arm; D001921:Brain / Q000473:pathology*; D002545:Brain Ischemia / Q000473:pathology / Q000523:psychology; D056324:Diffusion Tensor Imaging / Q000379:methods; D005260:Female; D006225:Hand; D006801:Humans; D020300:Intracranial Hemorrhages / Q000473:pathology / Q000523:psychology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011434:Proprioception; D012684:Sensory Thresholds; D020521:Stroke / Q000150:complications / Q000473:pathology* / Q000523:psychology*; D055698:Touch Perception; D066127:White Matter / Q000473:pathology
keywords: Brain lesion; Somatosensory deficit; Stroke; Upper extremity; Voxel-based lesion-symptom mapping