Correlated Resting-State Functional MRI Activity of Frontostriatal, Thalamic, Temporal, and Cerebellar Brain Regions Differentiates Stroke Survivors with High Compared to Low Depressive Symptom Scores.

Background: One in three survivors of stroke experience poststroke depression (PSD). PSD has been linked with poorer recovery of function and cognition, yet our understanding of potential mechanisms is currently limited. Alterations in resting-state functional MRI have been investigated to a limited extent. Fluctuations in low frequency signal are reported, but it is unknown if interactions are present between the level of depressive symptom score and intrinsic brain activity in varying brain regions. Objective: To investigate potential interaction effects between whole-brain resting-state activity and depressive symptoms in stroke survivors with low and high levels of depressive symptoms. Methods: A cross-sectional analysis of 63 stroke survivors who were assessed at 3 months poststroke for depression, using the Montgomery-Åsberg Depression Rating Scale (MÅDRS-SIGMA), and for brain activity using fMRI. A MÅDRS-SIGMA score of >8 was classified as high depressive symptoms. Fractional amplitude of frequency fluctuations (fALFF) data across three frequency bands (broadband, i.e., ~0.01-0.08; subbands, i.e., slow-5: ~0.01-0.027 Hz, slow-4: 0.027-0.07) was examined. Results: Of the 63 stroke survivors, 38 were classified as "low-depressive symptoms" and 25 as "high depressive symptoms." Six had a past history of depression. We found interaction effects across frequency bands in several brain regions that differentiated the two groups. The broadband analysis revealed interaction effects in the left insula and the left superior temporal lobe. The subband analysis showed contrasting fALFF response between the two groups in the left thalamus, right caudate, and left cerebellum. Across the three frequency bands, we found contrasting fALFF response in areas within the fronto-limbic-thalamic network and cerebellum. Conclusions: We provide evidence that fALFF is sensitive to changes in poststroke depressive symptom severity and implicates frontostriatal and cerebellar regions, consistent with previous studies. The use of multiband analysis could be an effective method to examine neural correlates of depression after stroke. The START-PrePARE trial is registered with the Australian New Zealand Clinical Trial Registry, number ACTRN12610000987066.

Considerations for improving diversity, equity and inclusivity within research designs and teams.

This article addresses the growing movement towards greater diversity, equity and inclusivity (DEI) within the research community. We present the case for increasing DEI among research teams and participants, discussing the benefits of this, as well as some of the current hindrances to achieving better DEI, particularly implicit biases. Lastly, we present some interventions that can be implemented within four key aspects of the research process: research methods, the research team, funding access and scientific dissemination. It is contingent on all players to engage in efforts to improve DEI in research settings, as they each are a critical step to improving the scientific method, rigor and accuracy of research outcomes.

Kinematic Studies of the Go/No-Go Task as a Dynamic Sensorimotor Inhibition Task for Assessment of Motor and Executive Function in Stroke Patients: An Exploratory Study in a Neurotypical Sample.

Inhibition of reaching and grasping actions as an element of cognitive control and executive function is a vital component of sensorimotor behaviour that is often impaired in patients who have lost sensorimotor function following a stroke. To date, there are few kinematic studies detailing the fine spatial and temporal upper limb movements associated with the millisecond temporal trajectory of correct and incorrect responses to visually driven Go/No-Go reaching and grasping tasks. Therefore, we aimed to refine the behavioural measurement of correct and incorrect inhibitory motor responses in a Go/No-Go task for future quantification and personalized rehabilitation in older populations and those with acquired motor disorders, such as stroke. An exploratory study mapping the kinematic profiles of hand movements in neurotypical participants utilizing such a task was conducted using high-speed biological motion capture cameras, revealing both within and between subject differences in a sample of healthy participants. These kinematic profiles and differences are discussed in the context of better assessment of sensorimotor function impairment in stroke survivors.

Predicting Post-Stroke Somatosensory Function from Resting-State Functional Connectivity: A Feasibility Study.

Accumulating evidence shows that brain functional deficits may be impacted by damage to remote brain regions. Recent advances in neuroimaging suggest that stroke impairment can be better predicted based on disruption to brain networks rather than from lesion locations or volumes only. Our aim was to explore the feasibility of predicting post-stroke somatosensory function from brain functional connectivity through the application of machine learning techniques. Somatosensory impairment was measured using the Tactile Discrimination Test. Functional connectivity was employed to model the global brain function. Behavioral measures and MRI were collected at the same timepoint. Two machine learning models (linear regression and support vector regression) were chosen to predict somatosensory impairment from disrupted networks. Along with two feature pools (i.e., low-order and high-order functional connectivity, or low-order functional connectivity only) engineered, four predictive models were built and evaluated in the present study. Forty-three chronic stroke survivors participated this study. Results showed that the regression model employing both low-order and high-order functional connectivity can predict outcomes based on correlation coefficient of r = 0.54 (p = 0.0002). A machine learning predictive approach, involving high- and low-order modelling, is feasible for the prediction of residual somatosensory function in stroke patients using functional brain networks.

Decreased Response to Positive Facial Affect in a Depressed Cohort in the Dorsal Striatum During a Working Memory Task-A Preliminary fMRI Study.

People with depression have shown alterations in processing emotional information and working memory functionality. There is some evidence that emotional content may interact with working memory update processes, however neurological correlates are current unknown. In this preliminary study we utilized a novel version of the emotional variant of the n-back working memory task in fMRI. We examined BOLD response of 14 healthy controls and 13 depressed participants in response to happy, sad, and neutral displays of facial affect. No accuracy or reaction time differences were found between the two groups. The depressed group showed significantly decreased BOLD response to happy faces compared to the control group areas of the dorsal striatum and anterior cingulate. Significant, moderate, positive associations were found between right caudate activation with anxiety score and anterior cingulate activation with depression score in those with depression. Our novel task was able to elicit group level differences in emotional processing during working memory update. These results suggest those with depression fail to differentiate between positive emotional stimuli and stimuli with no emotional content.

Activation of Bilateral Secondary Somatosensory Cortex With Right Hand Touch Stimulation: A Meta-Analysis of Functional Neuroimaging Studies.

Background: Brain regions involved in processing somatosensory information have been well documented through lesion, post-mortem, animal, and more recently, structural and functional neuroimaging studies. Functional neuroimaging studies characterize brain activation related to somatosensory processing; yet a meta-analysis synthesis of these findings is currently lacking and in-depth knowledge of the regions involved in somatosensory-related tasks may also be confounded by motor influences. Objectives: Our Activation Likelihood Estimate (ALE) meta-analysis sought to quantify brain regions that are involved in the tactile processing of the right (RH) and left hands (LH) separately, with the exclusion of motor related activity. Methods: The majority of studies (n = 41) measured activation associated with RH tactile stimulation. RH activation studies were grouped into those which conducted whole-brain analyses (n = 29) and those which examined specific regions of interest (ROI; n = 12). Few studies examined LH activation, though all were whole-brain studies (N = 7). Results: Meta-analysis of brain activation associated with RH tactile stimulation (whole-brain studies) revealed large clusters of activation in the left primary somatosensory cortex (S1) and bilaterally in the secondary somatosensory cortex (S2; including parietal operculum) and supramarginal gyrus (SMG), as well as the left anterior cingulate. Comparison between findings from RH whole-brain and ROI studies revealed activation as expected, but restricted primarily to S1 and S2 regions. Further, preliminary analyses of LH stimulation studies only, revealed two small clusters within the right S1 and S2 regions, likely limited due to the small number of studies. Contrast analyses revealed the one area of overlap for RH and LH, was right secondary somatosensory region. Conclusions: Findings from the whole-brain meta-analysis of right hand tactile stimulation emphasize the importance of taking into consideration bilateral activation, particularly in secondary somatosensory cortex. Further, the right parietal operculum/S2 region was commonly activated for right and left hand tactile stimulation, suggesting a lateralized pattern of somatosensory activation in right secondary somatosensory region. Implications for further research and for possible differences in right and left hemispheric stroke lesions are discussed.

Illusory limb movements activate different brain networks than imposed limb movements: an ALE meta-analysis.

Proprioceptive information allows us to perform smooth coordinated movements by constantly updating us with knowledge of the position of our limbs in space. How this information is combined and processed to form conscious perceptions of limb position is still relatively unknown. Several functional neuroimaging studies have attempted to tease out the brain areas responsible for proprioceptive processing in the human brain. Yet there still exists some disagreement in the specific brain regions involved. In order to consolidate the current knowledge in the field, we performed a systematic review of the literature and an activation likelihood estimation (ALE) meta-analysis of functional neuroimaging studies of proprioception. We identified 12 studies that used a proprioceptive stimulus of the upper extremity for ALE analysis (n = 141 participants). Two types of stimuli (illusion of movement induced through muscle tendon vibration and passive/imposed movements) were found to be most commonly used to probe proprioceptive networks in the brain. ALE analysis of these two stimulus types revealed that both were associated with activation in the left precentral, postcentral, and anterior cingulate gyri. Interestingly, different patterns of activation were also observed between illusions of movement and imposed movement. In the left hemisphere, imposed movements resulted in activations that were more inferior in the post-central gyrus. In the right hemisphere, imposed movements resulted in two clusters of activation in the inferior aspect of the precentral gyrus and the hand area of the post-central gyrus, while illusions of movement resulted in a single cluster of activation in the inferior parietal lobule. These results suggest that illusions of movement without limb displacement may activate different brain areas compared with actual limb displacement. Careful consideration should be made in future studies when selecting a proprioceptive stimulus to probe these brain networks.

Altered functional connectivity differs in stroke survivors with impaired touch sensation following left and right hemisphere lesions.

One in two survivors experience impairment in touch sensation after stroke. The nature of this impairment is likely associated with changes associated with the functional somatosensory network of the brain; however few studies have examined this. In particular, the impact of lesioned hemisphere has not been investigated. We examined resting state functional connectivity in 28 stroke survivors, 14 with left hemisphere and 14 with right hemisphere lesion, and 14 healthy controls. Contra-lesional hands showed significantly decreased touch discrimination. Whole brain functional connectivity (FC) data was extracted from four seed regions, i.e. primary (S1) and secondary (S2) somatosensory cortices in both hemispheres. Whole brain FC maps and Laterality Indices (LI) were calculated for subgroups. Inter-hemispheric FC was greater in healthy controls compared to the combined stroke cohort from the left S1 seed and bilateral S2 seeds. The left lesion subgroup showed decreased FC, relative to controls, from left ipsi-lesional S1 to contra-lesional S1 and to distributed temporal, occipital and parietal regions. In comparison, the right lesion group showed decreased connectivity from contra-lesional left S1 and bilateral S2 to ipsi-lesional parietal operculum (S2), and to occipital and temporal regions. The right lesion group also showed increased intra-hemispheric FC from ipsi-lesional right S1 to inferior parietal regions compared to controls. In comparison to the left lesion group, those with right lesion showed greater intra-hemispheric connectivity from left S1 to left parietal and occipital regions and from right S1 to right angular and parietal regions. Laterality Indices were significantly greater for stroke subgroups relative to matched controls for contra-lesional S1 (left lesion group) and contra-lesional S2 (both groups). We provide evidence of altered functional connectivity within the somatosensory network, across both hemispheres, and to other networks in stroke survivors with impaired touch sensation. Hemisphere of lesion was associated with different patterns of altered functional connectivity within the somatosensory network and with related function was associated with different patterns of altered functional connectivity within the somatosensory network and with related functional networks.

The State-of-the-Science on Somatosensory Function and Its Impact on Daily Life in Adults and Older Adults, and Following Stroke: A Scoping Review.

The aim was to identify and synthesize research evidence about how adults and older adults process somatosensory information in daily activities, and the interventions available to regain somatosensory function following stroke. We developed two interacting concept maps to address the research questions. The scoping review was conducted from 2005 to 2015 across Web of Science, AMED, CINAHL, Embase, Medline, and PsychInfo databases. Search terms included somatosensory, perception, performance, participation, older adult, stroke, intervention, discrimination, learning, and neuroplasticity. Contributions from 103 articles for Concept 1 and 14 articles for Concept 2 are reported. Measures of somatosensory processing, performance, and participation used are identified. Interventions available to treat somatosensory loss are summarized in relation to approach, outcome measures, and theory/mechanisms underlying. A gap exists in the current understanding of how somatosensory function affects the daily lives of adults. A multidisciplinary approach that includes performance and participation outcomes is recommended to advance the field.

Mapping of the Underlying Neural Mechanisms of Maintenance and Manipulation in Visuo-Spatial Working Memory Using An n-back Mental Rotation Task: A Functional Magnetic Resonance Imaging Study.

Mapping of the underlying neural mechanisms of visuo-spatial working memory (WM) has been shown to consistently elicit activity in right hemisphere dominant fronto-parietal networks. However to date, the bulk of neuroimaging literature has focused largely on the maintenance aspect of visuo-spatial WM, with a scarcity of research into the aspects of WM involving manipulation of information. Thus, this study aimed to compare maintenance-only with maintenance and manipulation of visuo-spatial stimuli (3D cube shapes) utilizing a 1-back task while functional magnetic resonance imaging (fMRI) scans were acquired. Sixteen healthy participants (9 women, M = 23.94 years, SD = 2.49) were required to perform the 1-back task with or without mentally rotating the shapes 90° on a vertical axis. When no rotation was required (maintenance-only condition), a right hemispheric lateralization was revealed across fronto-parietal areas. However, when the task involved maintaining and manipulating the same stimuli through 90° rotation, activation was primarily seen in the bilateral parietal lobe and left fusiform gyrus. The findings confirm that the well-established right lateralized fronto-parietal networks are likely to underlie simple maintenance of visuo-spatial stimuli. The results also suggest that the added demand of manipulation of information maintained online appears to require further neural recruitment of functionally related areas. In particular mental rotation of visuospatial stimuli required bilateral parietal areas, and the left fusiform gyrus potentially to maintain a categorical or object representation. It can be concluded that WM is a complex neural process involving the interaction of an increasingly large network.

Same Intervention-Different Reorganization: The Impact of Lesion Location on Training-Facilitated Somatosensory Recovery After Stroke.

BACKGROUND: The brain may reorganize to optimize stroke recovery. Yet relatively little is known about neural correlates of training-facilitated recovery, particularly after loss of body sensations. OBJECTIVE: Our aim was to characterize changes in brain activation following clinically effective touch discrimination training in stroke patients with somatosensory loss after lesions of primary/secondary somatosensory cortices or thalamic/capsular somatosensory regions using functional magnetic resonance imaging (fMRI). METHODS: Eleven stroke patients with somatosensory loss, 7 with lesions involving primary (S1) and/or secondary (S2) somatosensory cortex (4 male, 58.7 ± 13.3 years) and 4 with lesions primarily involving somatosensory thalamus and/or capsular/white matter regions (2 male, 58 ± 8.6 years) were studied. Clinical and MRI testing occurred at 6 months poststroke (preintervention), and following 15 sessions of clinically effective touch discrimination training (postintervention). RESULTS: Improved touch discrimination of a magnitude similar to previous clinical studies and approaching normal range was found. Patients with thalamic/capsular somatosensory lesions activated preintervention in left ipsilesional supramarginal gyrus, and postintervention in ipsilesional insula and supramarginal gyrus. In contrast, those with S1/S2 lesions did not show common activation preintervention, only deactivation in contralesional superior parietal lobe, including S1, and cingulate cortex postintervention. The S1/S2 group did, however, show significant change over time involving ipsilesional precuneus. This change was greater than for the thalamic/capsular group (P = .012; d = -2.43; CI = -0.67 to -3.76). CONCLUSION: Different patterns of change in activation are evident following touch discrimination training with thalamic/capsular lesions compared with S1/S2 cortical somatosensory lesions, despite common training and similar improvement.