title: Disruptions of network connectivity predict impairment in multiple behavioral domains after stroke.
abstract: Deficits following stroke are classically attributed to focal damage, but recent evidence suggests a key role of distributed brain network disruption. We measured resting functional connectivity (FC), lesion topography, and behavior in multiple domains (attention, visual memory, verbal memory, language, motor, and visual) in a cohort of 132 stroke patients, and used machine-learning models to predict neurological impairment in individual subjects. We found that visual memory and verbal memory were better predicted by FC, whereas visual and motor impairments were better predicted by lesion topography. Attention and language deficits were well predicted by both. Next, we identified a general pattern of physiological network dysfunction consisting of decrease of interhemispheric integration and intrahemispheric segregation, which strongly related to behavioral impairment in multiple domains. Network-specific patterns of dysfunction predicted specific behavioral deficits, and loss of interhemispheric communication across a set of regions was associated with impairment across multiple behavioral domains. These results link key organizational features of brain networks to brain-behavior relationships in stroke.
authors.affiliation: Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110; jssiegel@wustl.edu.
authors.forename: Joshua Sarfaty
authors.identifier: 0000-0002-5752-3641
authors.initials: JS
authors.lastname: Siegel
authors.affiliation: Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110;
authors.forename: Lenny E
authors.initials: LE
authors.lastname: Ramsey
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110;
authors.forename: Abraham Z
authors.identifier: 0000-0002-3379-9627
authors.initials: AZ
authors.lastname: Snyder
authors.affiliation: Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110;
authors.forename: Nicholas V
authors.initials: NV
authors.lastname: Metcalf
authors.affiliation: Department of Biomedical Engineering, Washington University School of Medicine, St. Louis, MO 63110;
authors.forename: Ravi V
authors.initials: RV
authors.lastname: Chacko
authors.affiliation: Department of Computer Science, Washington University School of Medicine, St. Louis, MO 63110; Department of Computer Science, Cornell University, Ithaca, NY 14850;
authors.forename: Kilian
authors.initials: K
authors.lastname: Weinberger
authors.affiliation: Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110; Department of Neuroscience, Imaging, and Clinical Sciences, University of Chieti G. d'Annunzio, 66013 Chieti, Italy;
authors.forename: Antonello
authors.initials: A
authors.lastname: Baldassarre
authors.affiliation: Department of Biomedical Engineering, Washington University School of Medicine, St. Louis, MO 63110;
authors.forename: Carl D
authors.initials: CD
authors.lastname: Hacker
authors.affiliation: Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110;
authors.forename: Gordon L
authors.initials: GL
authors.lastname: Shulman
authors.affiliation: Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110; Department of Biomedical Engineering, Washington University School of Medicine, St. Louis, MO 63110; Department of Anatomy & Neurobiology, Washington University School of Medicine, St. Louis, MO 63110; Department of Neuroscience, University of Padua, 35128 Padova, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Corbetta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001288:Attention / Q000502:physiology; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D009415:Nerve Net / Q000000981:diagnostic imaging / Q000503:physiopathology*; D009434:Neural Pathways / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011597:Psychomotor Performance / Q000502:physiology; D012146:Rest / Q000502:physiology; D020521:Stroke / Q000000981:diagnostic imaging / Q000503:physiopathology*; D055815:Young Adult
keywords: functional connectivity; interhemispheric; language; memory; stroke