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Poststroke acute dysexecutive syndrome, a disorder resulting from minor stroke due to disruption of network dynamics

Stroke patients with small central nervous system infarcts often demonstrate an acute dysexecutive syndrome characterized by difficulty with attention, concentration, and processing speed, independent of lesion size or location. We use magnetoencephalography (MEG) to show that disruption of network...

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Autores principales: Marsh, Elisabeth B., Brodbeck, Christian, Llinas, Rafael H., Mallick, Dania, Kulasingham, Joshua P., Simon, Jonathan Z., Llinás, Rodolfo R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: National Academy of Sciences 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7776947/
https://www.ncbi.nlm.nih.gov/pubmed/33318200
http://dx.doi.org/10.1073/pnas.2013231117
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author Marsh, Elisabeth B.
Brodbeck, Christian
Llinas, Rafael H.
Mallick, Dania
Kulasingham, Joshua P.
Simon, Jonathan Z.
Llinás, Rodolfo R.
author_facet Marsh, Elisabeth B.
Brodbeck, Christian
Llinas, Rafael H.
Mallick, Dania
Kulasingham, Joshua P.
Simon, Jonathan Z.
Llinás, Rodolfo R.
author_sort Marsh, Elisabeth B.
collection PubMed
description Stroke patients with small central nervous system infarcts often demonstrate an acute dysexecutive syndrome characterized by difficulty with attention, concentration, and processing speed, independent of lesion size or location. We use magnetoencephalography (MEG) to show that disruption of network dynamics may be responsible. Nine patients with recent minor strokes and eight age-similar controls underwent cognitive screening using the Montreal cognitive assessment (MoCA) and MEG to evaluate differences in cerebral activation patterns. During MEG, subjects participated in a visual picture–word matching task. Task complexity was increased as testing progressed. Cluster-based permutation tests determined differences in activation patterns within the visual cortex, fusiform gyrus, and lateral temporal lobe. At visit 1, MoCA scores were significantly lower for patients than controls (median [interquartile range] = 26.0 [4] versus 29.5 [3], P = 0.005), and patient reaction times were increased. The amplitude of activation was significantly lower after infarct and demonstrated a pattern of temporal dispersion independent of stroke location. Differences were prominent in the fusiform gyrus and lateral temporal lobe. The pattern suggests that distributed network dysfunction may be responsible. Additionally, controls were able to modulate their cerebral activity based on task difficulty. In contrast, stroke patients exhibited the same low-amplitude response to all stimuli. Group differences remained, to a lesser degree, 6 mo later; while MoCA scores and reaction times improved for patients. This study suggests that function is a globally distributed property beyond area-specific functionality and illustrates the need for longer-term follow-up studies to determine whether abnormal activation patterns ultimately resolve or another mechanism underlies continued recovery.
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spelling pubmed-77769472021-01-12 Poststroke acute dysexecutive syndrome, a disorder resulting from minor stroke due to disruption of network dynamics Marsh, Elisabeth B. Brodbeck, Christian Llinas, Rafael H. Mallick, Dania Kulasingham, Joshua P. Simon, Jonathan Z. Llinás, Rodolfo R. Proc Natl Acad Sci U S A Biological Sciences Stroke patients with small central nervous system infarcts often demonstrate an acute dysexecutive syndrome characterized by difficulty with attention, concentration, and processing speed, independent of lesion size or location. We use magnetoencephalography (MEG) to show that disruption of network dynamics may be responsible. Nine patients with recent minor strokes and eight age-similar controls underwent cognitive screening using the Montreal cognitive assessment (MoCA) and MEG to evaluate differences in cerebral activation patterns. During MEG, subjects participated in a visual picture–word matching task. Task complexity was increased as testing progressed. Cluster-based permutation tests determined differences in activation patterns within the visual cortex, fusiform gyrus, and lateral temporal lobe. At visit 1, MoCA scores were significantly lower for patients than controls (median [interquartile range] = 26.0 [4] versus 29.5 [3], P = 0.005), and patient reaction times were increased. The amplitude of activation was significantly lower after infarct and demonstrated a pattern of temporal dispersion independent of stroke location. Differences were prominent in the fusiform gyrus and lateral temporal lobe. The pattern suggests that distributed network dysfunction may be responsible. Additionally, controls were able to modulate their cerebral activity based on task difficulty. In contrast, stroke patients exhibited the same low-amplitude response to all stimuli. Group differences remained, to a lesser degree, 6 mo later; while MoCA scores and reaction times improved for patients. This study suggests that function is a globally distributed property beyond area-specific functionality and illustrates the need for longer-term follow-up studies to determine whether abnormal activation patterns ultimately resolve or another mechanism underlies continued recovery. National Academy of Sciences 2020-12-29 2020-12-14 /pmc/articles/PMC7776947/ /pubmed/33318200 http://dx.doi.org/10.1073/pnas.2013231117 Text en Copyright © 2020 the Author(s). Published by PNAS. https://creativecommons.org/licenses/by-nc-nd/4.0/ https://creativecommons.org/licenses/by-nc-nd/4.0/This open access article is distributed under Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Biological Sciences
Marsh, Elisabeth B.
Brodbeck, Christian
Llinas, Rafael H.
Mallick, Dania
Kulasingham, Joshua P.
Simon, Jonathan Z.
Llinás, Rodolfo R.
Poststroke acute dysexecutive syndrome, a disorder resulting from minor stroke due to disruption of network dynamics
title Poststroke acute dysexecutive syndrome, a disorder resulting from minor stroke due to disruption of network dynamics
title_full Poststroke acute dysexecutive syndrome, a disorder resulting from minor stroke due to disruption of network dynamics
title_fullStr Poststroke acute dysexecutive syndrome, a disorder resulting from minor stroke due to disruption of network dynamics
title_full_unstemmed Poststroke acute dysexecutive syndrome, a disorder resulting from minor stroke due to disruption of network dynamics
title_short Poststroke acute dysexecutive syndrome, a disorder resulting from minor stroke due to disruption of network dynamics
title_sort poststroke acute dysexecutive syndrome, a disorder resulting from minor stroke due to disruption of network dynamics
topic Biological Sciences
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7776947/
https://www.ncbi.nlm.nih.gov/pubmed/33318200
http://dx.doi.org/10.1073/pnas.2013231117
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