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. 2023 May 2;146(5):1950-1962.
doi: 10.1093/brain/awac388.

Using in vivo functional and structural connectivity to predict chronic stroke aphasia deficits

Affiliations

Using in vivo functional and structural connectivity to predict chronic stroke aphasia deficits

Ying Zhao et al. Brain. .

Abstract

Focal brain damage caused by stroke can result in aphasia and advances in cognitive neuroscience suggest that impairment may be associated with network-level disorder rather than just circumscribed cortical damage. Several studies have shown meaningful relationships between brain-behaviour using lesions; however, only a handful of studies have incorporated in vivo structural and functional connectivity. Patients with chronic post-stroke aphasia were assessed with structural (n = 68) and functional (n = 39) MRI to assess whether predicting performance can be improved with multiple modalities and if additional variance can be explained compared to lesion models alone. These neural measurements were used to construct models to predict four key language-cognitive factors: (i) phonology; (ii) semantics; (iii) executive function; and (iv) fluency. Our results showed that each factor (except executive ability) could be significantly related to each neural measurement alone; however, structural and functional connectivity models did not explain additional variance above the lesion models. We did find evidence that the structural and functional predictors may be linked to the core lesion sites. First, the predictive functional connectivity features were found to be located within functional resting-state networks identified in healthy controls, suggesting that the result might reflect functionally specific reorganization (damage to a node within a network can result in disruption to the entire network). Second, predictive structural connectivity features were located within core lesion sites, suggesting that multimodal information may be redundant in prediction modelling. In addition, we observed that the optimum sparsity within the regularized regression models differed for each behavioural component and across different imaging features, suggesting that future studies should consider optimizing hyperparameters related to sparsity per target. Together, the results indicate that the observed network-level disruption was predicted by the lesion alone and does not significantly improve model performance in predicting the profile of language impairment.

Keywords: diffusion tensor imaging; functional connectivity; resting-state fMRI; stroke aphasia; structural connectivity.

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Conflict of interest statement

The authors report no competing interests.

Figures

Figure 1
Figure 1
Illustration of the analyses pipeline. T1, FC from rs-fMRI, SC from DWI were used to predict behavioural factor scores in a LOOCV. FC and SC were also used to predict the residual behavioural scores.
Figure 2
Figure 2
Lesion overlap map for 68 patients in the study. The figure represents the number of cases with damage to a voxel (scale 3–59). The voxel with maximum lesion is show with the crosshairs.
Figure 3
Figure 3
Neural correlates of behavioural components. Neural correlates of principal component scores related to phonology, semantics, executive function and speech fluency using LOOCV VBCM (68 patients). For each loop, the threshold was voxel false-discovery rate corrected P < 0.05 and cluster >2 cm3. The significant regions from each loop were overlapped and mapped on the brain. Hot colours indicate a consistent/stable mapping with the behaviour across all loops.
Figure 4
Figure 4
FC models predicting behavioural components. Regularized regression model of FC for phonology (top row), semantics (middle row) and fluency (bottom row). The leftcolumn shows connections in the model that had z-weights >3.29 (P < 0.001) (averaged across all folds). The middle column shows nodal degree (sum of absolute weight at each node) (top 10 shown). The scale (0–1) indicates the proportion of positive weights. The right column shows the significant connections filtered through the top 10 nodes. L = left; R = right; P = posterior; A = anterior. Left is left.
Figure 5
Figure 5
SC models predicting behavioural components. Regularized regression model of SC for phonology (top row), semantics (middle row) and fluency (bottom row). The ‘Connection’ brain figure (left) shows connections in the model that had z-weights >3.29 (P < 0.001) (averaged across all folds). The ‘Nodes’ brain figure (middle) shows nodal degree, which reflects the nodes with the highest cumulative absolute connection weights (top 10 shown). The scale 0 to 1 indicates the percentage of positive connections that were predictive. The ‘Filtered connection’ brain figure (right) shows the significant connections from the top 10 nodes as a way to filter the number of connections. L = left; R = right.
Figure 6
Figure 6
Seed-based FC. Healthy whole-brain FC maps using lesion correlates as seeds (restricted to grey matter) for (A) phonology, (B) semantics and (C) fluency. The scale denotes t-scores based on a one-sample t-test at the group level. Superimposed on each map are the most predictive nodes from the patient regularized regression analysis, nodes are indicated by percentage of positive connections.

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