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Dominic H Ffytche - One of the best experts on this subject based on the ideXlab platform.
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REV IEW ARTICLE The rises and falls of disconnection syndromes
2014Co-Authors: Marco Catani, Dominic H FfytcheAbstract:In a brain composed of localized but connected specialized areas, disconnection leads to dysfunction. This simple formulation underlay a range of 19th century neurological disorders, referred to collectively as dis-connection syndromes. Although disconnectionism fell out of favour with the move against localized brain theories in the early 20th century, in 1965, an American neurologist brought disconnection to the fore once more in a paper entitled, ‘Disconnexion syndromes in animals and man’. In what was to become the manifesto of Behavioural Neurology, Norman Geschwind outlined a pure disconnectionist framework which revolution-ized both clinical Neurology and the neurosciences in general. For him, disconnection syndromes were higher function deficits that resulted from white matter lesions or lesions of the association cortices, the latter acting as relay stations between primary motor, sensory and limbic areas. From a clinical perspective, the work reawakened interest in single case studies by providing a useful framework for correlating lesion locations with clinical deficits. In the neurosciences, it helped develop contemporary distributed network and connec-tionist theories of brain function. Geschwind’s general disconnectionist paradigm ruled clinical Neurology for 20 years but in the late 1980s, with the re-emergence of specialized functional roles for association cortex, the orbit of its remit began to diminish and it became incorporated into more general models of higher dysfunction. By the 1990s, textbooks of Neurology were devoting only a few pages to classical disconnection theory. Today
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REVIEW ARTICLE The rises and falls of disconnection syndromes
2014Co-Authors: Marco Catani, Dominic H FfytcheAbstract:In a brain composed of localized but connected specialized areas, disconnection leads to dysfunction. This simple formulation underlay a range of 19th century neurological disorders, referred to collectively as disconnection syndromes. Although disconnectionism fell out of favour with the move against localized brain theories in the early 20th century, in 1965, an American neurologist brought disconnection to the fore once more in a paper entitled, ‘Disconnexion syndromes in animals and man’. In what was to become the manifesto of Behavioural Neurology, Norman Geschwind outlined a pure disconnectionist framework which revolutionized both clinical Neurology and the neurosciences in general. For him, disconnection syndromes were higher function deficits that resulted from white matter lesions or lesions of the association cortices, the latter acting as relay stations between primary motor, sensory and limbic areas. From a clinical perspective, the work reawakened interest in single case studies by providing a useful framework for correlating lesion locations with clinical deficits. In the neurosciences, it helped develop contemporary distributed network and connectionist theories of brain function. Geschwind’s general disconnectionist paradigm ruled clinical Neurology for 20 years but in the late 1980s, with the re-emergence of specialized functional roles for association cortex, the orbit of its remit began to diminish and it became incorporated into more general models of higher dysfunction. By the 1990s, textbooks of Neurology were devoting only a few pages to classical disconnection theory. Today
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the rises and falls of disconnection syndromes
Brain, 2005Co-Authors: Marco Catani, Dominic H FfytcheAbstract:In a brain composed of localized but connected specialized areas, disconnection leads to dysfunction. This simple formulation underlay a range of 19th century neurological disorders, referred to collectively as disconnection syndromes. Although disconnectionism fell out of favour with the move against localized brain theories in the early 20th century, in 1965, an American neurologist brought disconnection to the fore once more in a paper entitled, ‘Disconnexion syndromes in animals and man’. In what was to become the manifesto of Behavioural Neurology, Norman Geschwind outlined a pure disconnectionist framework which revolutionized both clinical Neurology and the neurosciences in general. For him, disconnection syndromes were higher function deficits that resulted from white matter lesions or lesions of the association cortices, the latter acting as relay stations between primary motor, sensory and limbic areas. From a clinical perspective, the work reawakened interest in single case studies by providing a useful framework for correlating lesion locations with clinical deficits. In the neurosciences, it helped develop contemporary distributed network and connectionist theories of brain function. Geschwind's general disconnectionist paradigm ruled clinical Neurology for 20 years but in the late 1980s, with the re-emergence of specialized functional roles for association cortex, the orbit of its remit began to diminish and it became incorporated into more general models of higher dysfunction. By the 1990s, textbooks of Neurology were devoting only a few pages to classical disconnection theory. Today, new techniques to study connections in the living human brain allow us, for the first time, to test the classical formulation directly and broaden it beyond disconnections to include disorders of hyperconnectivity. In this review, on the 40th anniversary of Geschwind's publication, we describe the changing fortunes of disconnection theory and adapt the general framework that evolved from it to encompass the entire spectrum of higher function disorders in Neurology and psychiatry.
Marco Catani - One of the best experts on this subject based on the ideXlab platform.
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REV IEW ARTICLE The rises and falls of disconnection syndromes
2014Co-Authors: Marco Catani, Dominic H FfytcheAbstract:In a brain composed of localized but connected specialized areas, disconnection leads to dysfunction. This simple formulation underlay a range of 19th century neurological disorders, referred to collectively as dis-connection syndromes. Although disconnectionism fell out of favour with the move against localized brain theories in the early 20th century, in 1965, an American neurologist brought disconnection to the fore once more in a paper entitled, ‘Disconnexion syndromes in animals and man’. In what was to become the manifesto of Behavioural Neurology, Norman Geschwind outlined a pure disconnectionist framework which revolution-ized both clinical Neurology and the neurosciences in general. For him, disconnection syndromes were higher function deficits that resulted from white matter lesions or lesions of the association cortices, the latter acting as relay stations between primary motor, sensory and limbic areas. From a clinical perspective, the work reawakened interest in single case studies by providing a useful framework for correlating lesion locations with clinical deficits. In the neurosciences, it helped develop contemporary distributed network and connec-tionist theories of brain function. Geschwind’s general disconnectionist paradigm ruled clinical Neurology for 20 years but in the late 1980s, with the re-emergence of specialized functional roles for association cortex, the orbit of its remit began to diminish and it became incorporated into more general models of higher dysfunction. By the 1990s, textbooks of Neurology were devoting only a few pages to classical disconnection theory. Today
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REVIEW ARTICLE The rises and falls of disconnection syndromes
2014Co-Authors: Marco Catani, Dominic H FfytcheAbstract:In a brain composed of localized but connected specialized areas, disconnection leads to dysfunction. This simple formulation underlay a range of 19th century neurological disorders, referred to collectively as disconnection syndromes. Although disconnectionism fell out of favour with the move against localized brain theories in the early 20th century, in 1965, an American neurologist brought disconnection to the fore once more in a paper entitled, ‘Disconnexion syndromes in animals and man’. In what was to become the manifesto of Behavioural Neurology, Norman Geschwind outlined a pure disconnectionist framework which revolutionized both clinical Neurology and the neurosciences in general. For him, disconnection syndromes were higher function deficits that resulted from white matter lesions or lesions of the association cortices, the latter acting as relay stations between primary motor, sensory and limbic areas. From a clinical perspective, the work reawakened interest in single case studies by providing a useful framework for correlating lesion locations with clinical deficits. In the neurosciences, it helped develop contemporary distributed network and connectionist theories of brain function. Geschwind’s general disconnectionist paradigm ruled clinical Neurology for 20 years but in the late 1980s, with the re-emergence of specialized functional roles for association cortex, the orbit of its remit began to diminish and it became incorporated into more general models of higher dysfunction. By the 1990s, textbooks of Neurology were devoting only a few pages to classical disconnection theory. Today
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the rises and falls of disconnection syndromes
Brain, 2005Co-Authors: Marco Catani, Dominic H FfytcheAbstract:In a brain composed of localized but connected specialized areas, disconnection leads to dysfunction. This simple formulation underlay a range of 19th century neurological disorders, referred to collectively as disconnection syndromes. Although disconnectionism fell out of favour with the move against localized brain theories in the early 20th century, in 1965, an American neurologist brought disconnection to the fore once more in a paper entitled, ‘Disconnexion syndromes in animals and man’. In what was to become the manifesto of Behavioural Neurology, Norman Geschwind outlined a pure disconnectionist framework which revolutionized both clinical Neurology and the neurosciences in general. For him, disconnection syndromes were higher function deficits that resulted from white matter lesions or lesions of the association cortices, the latter acting as relay stations between primary motor, sensory and limbic areas. From a clinical perspective, the work reawakened interest in single case studies by providing a useful framework for correlating lesion locations with clinical deficits. In the neurosciences, it helped develop contemporary distributed network and connectionist theories of brain function. Geschwind's general disconnectionist paradigm ruled clinical Neurology for 20 years but in the late 1980s, with the re-emergence of specialized functional roles for association cortex, the orbit of its remit began to diminish and it became incorporated into more general models of higher dysfunction. By the 1990s, textbooks of Neurology were devoting only a few pages to classical disconnection theory. Today, new techniques to study connections in the living human brain allow us, for the first time, to test the classical formulation directly and broaden it beyond disconnections to include disorders of hyperconnectivity. In this review, on the 40th anniversary of Geschwind's publication, we describe the changing fortunes of disconnection theory and adapt the general framework that evolved from it to encompass the entire spectrum of higher function disorders in Neurology and psychiatry.
Lambon Ralph Matthew - One of the best experts on this subject based on the ideXlab platform.
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Evaluating the granularity and statistical structure of lesions and behaviour in post-stroke aphasia.
'Organisation for Economic Co-Operation and Development (OECD)', 2020Co-Authors: Zhao Ying, Halai Ajay, Lambon Ralph MatthewAbstract:The pursuit of relating the location of neural damage to the pattern of acquired language and general cognitive deficits post-stroke stems back to 19th century Behavioural Neurology. Whilst spatial specificity has improved dramatically over time, from the large areas of damage specified by post-mortem investigation to the millimetre precision of modern MRI, there is an underlying issue that is rarely addressed, which relates to the fact that damage to a given area of the brain is not random but constrained by the brain’s vasculature. Accordingly, the aim of this study was to uncover the statistical structure underlying the lesion profile in chronic aphasia post-stroke. By applying varimax-rotated principal component analysis to the lesions of 70 patients with chronic post-stroke aphasia, we identified 17 interpretable clusters, largely reflecting the vascular supply of middle cerebral artery sub-branches and other sources of individual variation in vascular supply as shown in classical angiography studies. This vascular parcellation produced smaller displacement error in simulated lesion-symptom analysis compared with individual voxels and Brodmann regions. A second principal component analysis of the patients’ detailed neuropsychological data revealed a four factor solution reflecting phonological, semantic, executive-demand and speech fluency abilities. As a preliminary exploration, stepwise regression was used to relate Behavioural factor scores to the lesion principal components. Phonological ability was related to two components, which covered the posterior temporal region including the posterior segment of the arcuate fasciculus, and the inferior frontal gyrus. Three components were linked to semantic ability and were located in the white matter underlying the anterior temporal lobe, the supramarginal gyrus and angular gyrus. Executive-demand related to two components covering the dorsal edge of the middle cerebral artery territory, while speech fluency was linked to two components that were located in the middle frontal gyrus, precentral gyrus, and subcortical regions (putamen and thalamus). Future studies can explore in formal terms the utility of these PCA-derived lesion components for relating post-stroke lesions and symptoms
Morrissey Ann-marie - One of the best experts on this subject based on the ideXlab platform.
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Covert Cognition in Disorders of Consciousness: A Meta-Analysis
'MDPI AG', 2020Co-Authors: Schnakers Caroline, Hirsch Michaela, Noé Enrique, Llorens Rodríguez Roberto, Lejeune Nicolas, Veeramuthu Vigneswaran, De Marco Sabrina, Demertzi Athena, Duclos Catherine, Morrissey Ann-marieAbstract:[EN] Covert cognition in patients with disorders of consciousness represents a real diagnostic conundrum for clinicians. In this meta-analysis, our main objective was to identify clinical and demographic variables that are more likely to be associated with responding to an active paradigm. Among 2018 citations found on PubMed, 60 observational studies were found relevant. Based on the QUADAS-2, 49 studies were considered. Data from 25 publications were extracted and included in the meta-analysis. Most of these studies used electrophysiology as well as counting tasks or mental imagery. According to our statistical analysis, patients clinically diagnosed as being in a vegetative state and in a minimally conscious state minus (MCS-) show similar likelihood in responding to active paradigm and responders are most likely suffering from a traumatic brain injury. In the future, multi-centric studies should be performed in order to increase sample size, with similar methodologies and include structural and functional neuroimaging in order to identify cerebral markers related to such a challenging diagnosis.C.S. would like to thank Felice Loverso, the Casa Colina Board of Directors, the Casa Colina Foundation and the International Brain Injury Association for supporting this research.Schnakers, C.; Hirsch, M.; Noé, E.; Llorens Rodríguez, R.; Lejeune, N.; Veeramuthu, V.; De Marco, S.... (2020). Covert Cognition in Disorders of Consciousness: A Meta-Analysis. Brain Sciences. 10(12):1-11. https://doi.org/10.3390/brainsci10120930S1111012Giacino, J. T., Ashwal, S., Childs, N., Cranford, R., Jennett, B., Katz, D. I., … Zasler, N. D. (2002). The minimally conscious state: Definition and diagnostic criteria. Neurology, 58(3), 349-353. doi:10.1212/wnl.58.3.349Thibaut, A., Bodien, Y. G., Laureys, S., & Giacino, J. T. (2019). Minimally conscious state «plus»: diagnostic criteria and relation to functional recovery. Journal of Neurology, 267(5), 1245-1254. doi:10.1007/s00415-019-09628-yWade, D. T. (2018). How often is the diagnosis of the permanent vegetative state incorrect? A review of the evidence. European Journal of Neurology, 25(4), 619-625. doi:10.1111/ene.13572Schnakers, C. (2020). Update on diagnosis in disorders of consciousness. Expert Review of Neurotherapeutics, 20(10), 997-1004. doi:10.1080/14737175.2020.1796641Kondziella, D., Bender, A., Diserens, K., van Erp, W., Estraneo, A., … Formisano, R. (2020). European Academy of Neurology guideline on the diagnosis of coma and other disorders of consciousness. European Journal of Neurology, 27(5), 741-756. doi:10.1111/ene.14151Seel, R. T., Sherer, M., Whyte, J., Katz, D. I., Giacino, J. T., Rosenbaum, A. M., … Zasler, N. (2010). Assessment Scales for Disorders of Consciousness: Evidence-Based Recommendations for Clinical Practice and Research. Archives of Physical Medicine and Rehabilitation, 91(12), 1795-1813. doi:10.1016/j.apmr.2010.07.218Owen, A. M., Coleman, M. R., Boly, M., Davis, M. H., Laureys, S., & Pickard, J. D. (2006). Detecting Awareness in the Vegetative State. Science, 313(5792), 1402-1402. doi:10.1126/science.1130197Monti, M. M., Vanhaudenhuyse, A., Coleman, M. R., Boly, M., Pickard, J. D., Tshibanda, L., … Laureys, S. (2010). Willful Modulation of Brain Activity in Disorders of Consciousness. New England Journal of Medicine, 362(7), 579-589. doi:10.1056/nejmoa0905370Owen, A. M. (2019). The Search for Consciousness. Neuron, 102(3), 526-528. doi:10.1016/j.neuron.2019.03.024Schiff, N. D. (2015). Cognitive Motor Dissociation Following Severe Brain Injuries. JAMA Neurology, 72(12), 1413. doi:10.1001/jamaneurol.2015.2899Kondziella, D., Friberg, C. K., Frokjaer, V. G., Fabricius, M., & Møller, K. (2015). Preserved consciousness in vegetative and minimal conscious states: systematic review and meta-analysis. Journal of Neurology, Neurosurgery & Psychiatry, 87(5), 485-492. doi:10.1136/jnnp-2015-310958Schardt, C., Adams, M. B., Owens, T., Keitz, S., & Fontelo, P. (2007). Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Medical Informatics and Decision Making, 7(1). doi:10.1186/1472-6947-7-16Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gotzsche, P. C., Ioannidis, J. P. A., … Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ, 339(jul21 1), b2700-b2700. doi:10.1136/bmj.b2700Whiting, P. F. (2011). QUADAS-2: A Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies. Annals of Internal Medicine, 155(8), 529. doi:10.7326/0003-4819-155-8-201110180-00009Giacino, J. T., Katz, D. I., Schiff, N. D., Whyte, J., Ashman, E. J., Ashwal, S., … Armstrong, M. J. (2018). Practice guideline update recommendations summary: Disorders of consciousness. Neurology, 91(10), 450-460. doi:10.1212/wnl.0000000000005926Bekinschtein, T. A., Dehaene, S., Rohaut, B., Tadel, F., Cohen, L., & Naccache, L. (2009). Neural signature of the conscious processing of auditory regularities. Proceedings of the National Academy of Sciences, 106(5), 1672-1677. doi:10.1073/pnas.0809667106Chennu, S., Finoia, P., Kamau, E., Monti, M. M., Allanson, J., Pickard, J. D., … Bekinschtein, T. A. (2013). Dissociable endogenous and exogenous attention in disorders of consciousness. NeuroImage: Clinical, 3, 450-461. doi:10.1016/j.nicl.2013.10.008Chennu, S., Finoia, P., Kamau, E., Allanson, J., Williams, G. B., Monti, M. M., … Bekinschtein, T. A. (2014). Spectral Signatures of Reorganised Brain Networks in Disorders of Consciousness. PLoS Computational Biology, 10(10), e1003887. doi:10.1371/journal.pcbi.1003887Cruse, D., Chennu, S., Chatelle, C., Bekinschtein, T. A., Fernández-Espejo, D., Pickard, J. D., … Owen, A. M. (2011). Bedside detection of awareness in the vegetative state: a cohort study. The Lancet, 378(9809), 2088-2094. doi:10.1016/s0140-6736(11)61224-5Cruse, D., Chennu, S., Chatelle, C., Fernandez-Espejo, D., Bekinschtein, T. A., Pickard, J. D., … Owen, A. M. (2012). Relationship between etiology and covert cognition in the minimally conscious state. Neurology, 78(11), 816-822. doi:10.1212/wnl.0b013e318249f764Edlow, B. L., Chatelle, C., Spencer, C. A., Chu, C. J., Bodien, Y. G., O’Connor, K. L., … Wu, O. (2017). Early detection of consciousness in patients with acute severe traumatic brain injury. Brain, 140(9), 2399-2414. doi:10.1093/brain/awx176Faugeras, F., Rohaut, B., Weiss, N., Bekinschtein, T. A., Galanaud, D., Puybasset, L., … Naccache, L. (2011). Probing consciousness with event-related potentials in the vegetative state. Neurology, 77(3), 264-268. doi:10.1212/wnl.0b013e3182217ee8Gibson, R. M., Fernández-Espejo, D., Gonzalez-Lara, L. E., Kwan, B. Y., Lee, D. H., Owen, A. M., & Cruse, D. (2014). Multiple tasks and neuroimaging modalities increase the likelihood of detecting covert awareness in patients with disorders of consciousness. Frontiers in Human Neuroscience, 8. doi:10.3389/fnhum.2014.00950Habbal, D., Gosseries, O., Noirhomme, Q., Renaux, J., Lesenfants, D., Bekinschtein, T. A., … Schnakers, C. (2014). Volitional electromyographic responses in disorders of consciousness. Brain Injury, 28(9), 1171-1179. doi:10.3109/02699052.2014.920519Hauger, S. L., Schnakers, C., Andersson, S., Becker, F., Moberget, T., Giacino, J. T., … Løvstad, M. (2015). Neurophysiological Indicators of Residual Cognitive Capacity in the Minimally Conscious State. Behavioural Neurology, 2015, 1-12. doi:10.1155/2015/145913Hauger, S. L., Schanke, A.-K., Andersson, S., Chatelle, C., Schnakers, C., & Løvstad, M. (2017). The Clinical Diagnostic Utility of Electrophysiological Techniques in Assessment of Patients With Disorders of Consciousness Following Acquired Brain Injury: A Systematic Review. Journal of Head Trauma Rehabilitation, 32(3), 185-196. doi:10.1097/htr.0000000000000267Höller, Y., Bergmann, J., Thomschewski, A., Kronbichler, M., Höller, P., Crone, J. S., … Trinka, E. (2013). Comparison of EEG-Features and Classification Methods for Motor Imagery in Patients with Disorders of Consciousness. PLoS ONE, 8(11), e80479. doi:10.1371/journal.pone.0080479King, J. R., Faugeras, F., Gramfort, A., Schurger, A., El Karoui, I., Sitt, J. D., … Dehaene, S. (2013). Single-trial decoding of auditory novelty responses facilitates the detection of residual consciousness. NeuroImage, 83, 726-738. doi:10.1016/j.neuroimage.2013.07.013Schnakers, C., Giacino, J. T., Løvstad, M., Habbal, D., Boly, M., Di, H., … Laureys, S. (2014). Preserved Covert Cognition in Noncommunicative Patients With Severe Brain Injury? Neurorehabilitation and Neural Repair, 29(4), 308-317. doi:10.1177/1545968314547767Schnakers, C., Perrin, F., Schabus, M., Majerus, S., Ledoux, D., Damas, P., … Laureys, S. (2008). Voluntary brain processing in disorders of consciousness. Neurology, 71(20), 1614-1620. doi:10.1212/01.wnl.0000334754.15330.69Stender, J., Gosseries, O., Bruno, M.-A., Charland-Verville, V., Vanhaudenhuyse, A., Demertzi, A., … Laureys, S. (2014). Diagnostic precision of PET imaging and functional MRI in disorders of consciousness: a clinical validation study. The Lancet, 384(9942), 514-522. doi:10.1016/s0140-6736(14)60042-8Vogel, D., Markl, A., Yu, T., Kotchoubey, B., Lang, S., & Müller, F. (2013). Can Mental Imagery Functional Magnetic Resonance Imaging Predict Recovery in Patients With Disorders of Consciousness? Archives of Physical Medicine and Rehabilitation, 94(10), 1891-1898. doi:10.1016/j.apmr.2012.11.053Yu, T., Lang, S., Vogel, D., Markl, A., Muller, F., & Kotchoubey, B. (2012). Patients with unresponsive wakefulness syndrome respond to the pain cries of other people. Neurology, 80(4), 345-352. doi:10.1212/wnl.0b013e31827f0846Chatelle, C., Spencer, C. A., Cash, S. S., Hochberg, L. R., & Edlow, B. L. (2018). Feasibility of an EEG-based brain-computer interface in the intensive care unit. Clinical Neurophysiology, 129(8), 1519-1525. doi:10.1016/j.clinph.2018.04.747Curley, W. H., Forgacs, P. B., Voss, H. U., Conte, M. M., & Schiff, N. D. (2018). Characterization of EEG signals revealing covert cognition in the injured brain. Brain, 141(5), 1404-1421. doi:10.1093/brain/awy070Spataro, R., Heilinger, A., Allison, B., De Cicco, D., Marchese, S., Gregoretti, C., … Guger, C. (2018). Preserved somatosensory discrimination predicts consciousness recovery in unresponsive wakefulness syndrome. Clinical Neurophysiology, 129(6), 1130-1136. doi:10.1016/j.clinph.2018.02.131Xie, Q., Pan, J., Chen, Y., He, Y., Ni, X., Zhang, J., … Yu, R. (2018). A gaze-independent audiovisual brain-computer Interface for detecting awareness of patients with disorders of consciousness. BMC Neurology, 18(1). doi:10.1186/s12883-018-1144-yAubinet, C., Murphy, L., Bahri, M. A., Larroque, S. K., Cassol, H., Annen, J., … Gosseries, O. (2018). Brain, Behavior, and Cognitive Interplay in Disorders of Consciousness: A Multiple Case Study. Frontiers in Neurology, 9. doi:10.3389/fneur.2018.00665Aubinet, C., Larroque, S. K., Heine, L., Martial, C., Majerus, S., Laureys, S., & Di Perri, C. (2018). Clinical subcategorization of minimally conscious state according to resting functional connectivity. Human Brain Mapping, 39(11), 4519-4532. doi:10.1002/hbm.24303Aubinet, C., Cassol, H., Gosseries, O., Bahri, M. A., Larroque, S. K., Majerus, S., … Thibaut, A. (2020). Brain Metabolism but Not Gray Matter Volume Underlies the Presence of Language Function in the Minimally Conscious State (MCS): MCS+ Versus MCS− Neuroimaging Differences. Neurorehabilitation and Neural Repair, 34(2), 172-184. doi:10.1177/1545968319899914Fernández-Espejo, D., Rossit, S., & Owen, A. M. (2015). A Thalamocortical Mechanism for the Absence of Overt Motor Behavior in Covertly Aware Patients. JAMA Neurology, 72(12), 1442. doi:10.1001/jamaneurol.2015.2614Schnakers, C., & Monti, M. M. (2017). Disorders of consciousness after severe brain injury: therapeutic options. Current Opinion in Neurology, 30(6), 573-579. doi:10.1097/wco.0000000000000495Pignat, J.-M., Mauron, E., Jöhr, J., Gilart de Keranflec’h, C., Van De Ville, D., Preti, M. G., … Diserens, K. (2016). Outcome Prediction of Consciousness Disorders in the Acute Stage Based on a Complementary Motor Behavioural Tool. PLOS ONE, 11(6), e0156882. doi:10.1371/journal.pone.0156882Pincherle, A., Jöhr, J., Chatelle, C., Pignat, J.-M., Du Pasquier, R., Ryvlin, P., … Diserens, K. (2019). Motor behavior unmasks residual cognition in disorders of consciousness. Annals of Neurology, 85(3), 443-447. doi:10.1002/ana.25417Pincherle, A., Rossi, F., Jöhr, J., Dunet, V., Ryvlin, P., Oddo, M., … Diserens, K. (2020). Early discrimination of cognitive motor dissociation from disorders of consciousness: pitfalls and clues. Journal of Neurology, 268(1), 178-188. doi:10.1007/s00415-020-10125-
Zhao Ying - One of the best experts on this subject based on the ideXlab platform.
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Evaluating the granularity and statistical structure of lesions and behaviour in post-stroke aphasia.
'Organisation for Economic Co-Operation and Development (OECD)', 2020Co-Authors: Zhao Ying, Halai Ajay, Lambon Ralph MatthewAbstract:The pursuit of relating the location of neural damage to the pattern of acquired language and general cognitive deficits post-stroke stems back to 19th century Behavioural Neurology. Whilst spatial specificity has improved dramatically over time, from the large areas of damage specified by post-mortem investigation to the millimetre precision of modern MRI, there is an underlying issue that is rarely addressed, which relates to the fact that damage to a given area of the brain is not random but constrained by the brain’s vasculature. Accordingly, the aim of this study was to uncover the statistical structure underlying the lesion profile in chronic aphasia post-stroke. By applying varimax-rotated principal component analysis to the lesions of 70 patients with chronic post-stroke aphasia, we identified 17 interpretable clusters, largely reflecting the vascular supply of middle cerebral artery sub-branches and other sources of individual variation in vascular supply as shown in classical angiography studies. This vascular parcellation produced smaller displacement error in simulated lesion-symptom analysis compared with individual voxels and Brodmann regions. A second principal component analysis of the patients’ detailed neuropsychological data revealed a four factor solution reflecting phonological, semantic, executive-demand and speech fluency abilities. As a preliminary exploration, stepwise regression was used to relate Behavioural factor scores to the lesion principal components. Phonological ability was related to two components, which covered the posterior temporal region including the posterior segment of the arcuate fasciculus, and the inferior frontal gyrus. Three components were linked to semantic ability and were located in the white matter underlying the anterior temporal lobe, the supramarginal gyrus and angular gyrus. Executive-demand related to two components covering the dorsal edge of the middle cerebral artery territory, while speech fluency was linked to two components that were located in the middle frontal gyrus, precentral gyrus, and subcortical regions (putamen and thalamus). Future studies can explore in formal terms the utility of these PCA-derived lesion components for relating post-stroke lesions and symptoms