Lesion Network Mapping for Neurological Deficit in Acute Ischemic Stroke
Lingling Ding MD
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China
Search for more papers by this authorHao Liu PhD
Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
Search for more papers by this authorJing Jing MD
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China
Search for more papers by this authorYong Jiang PhD
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Search for more papers by this authorXia Meng MD
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Search for more papers by this authorYaojing Chen PhD
State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
Search for more papers by this authorXingquan Zhao MD
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China
Search for more papers by this authorHaijun Niu PhD
Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
Search for more papers by this authorCorresponding Author
Tao Liu PhD
Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
Address correspondence to Dr Li, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No 119 S 4th Ring West Road, Fengtai District, Beijing 100070, China. E-mail: [email protected]. Dr Yongjun Wang, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China. E-mail: [email protected]. Prof Tao Liu, School of Biological Science and Medical Engineering, Beihang University, IRC 300, Beihang University, Beijing, China. E-mail: [email protected]
Search for more papers by this authorCorresponding Author
Yongjun Wang MD
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China
Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China
Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
Clinical Center for Precision Medicine in Stroke, Capital Medical University, Beijing, China
Address correspondence to Dr Li, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No 119 S 4th Ring West Road, Fengtai District, Beijing 100070, China. E-mail: [email protected]. Dr Yongjun Wang, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China. E-mail: [email protected]. Prof Tao Liu, School of Biological Science and Medical Engineering, Beihang University, IRC 300, Beihang University, Beijing, China. E-mail: [email protected]
Search for more papers by this authorCorresponding Author
Zixiao Li MD
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China
Chinese Institute for Brain Research, Beijing, China
Beijing Engineering Research Center of Digital Healthcare for Neurological Diseases, Beijing, China
Address correspondence to Dr Li, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No 119 S 4th Ring West Road, Fengtai District, Beijing 100070, China. E-mail: [email protected]. Dr Yongjun Wang, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China. E-mail: [email protected]. Prof Tao Liu, School of Biological Science and Medical Engineering, Beihang University, IRC 300, Beihang University, Beijing, China. E-mail: [email protected]
Search for more papers by this authorLingling Ding MD
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China
Search for more papers by this authorHao Liu PhD
Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
Search for more papers by this authorJing Jing MD
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China
Search for more papers by this authorYong Jiang PhD
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Search for more papers by this authorXia Meng MD
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Search for more papers by this authorYaojing Chen PhD
State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
Search for more papers by this authorXingquan Zhao MD
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China
Search for more papers by this authorHaijun Niu PhD
Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
Search for more papers by this authorCorresponding Author
Tao Liu PhD
Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
Address correspondence to Dr Li, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No 119 S 4th Ring West Road, Fengtai District, Beijing 100070, China. E-mail: [email protected]. Dr Yongjun Wang, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China. E-mail: [email protected]. Prof Tao Liu, School of Biological Science and Medical Engineering, Beihang University, IRC 300, Beihang University, Beijing, China. E-mail: [email protected]
Search for more papers by this authorCorresponding Author
Yongjun Wang MD
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China
Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China
Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
Clinical Center for Precision Medicine in Stroke, Capital Medical University, Beijing, China
Address correspondence to Dr Li, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No 119 S 4th Ring West Road, Fengtai District, Beijing 100070, China. E-mail: [email protected]. Dr Yongjun Wang, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China. E-mail: [email protected]. Prof Tao Liu, School of Biological Science and Medical Engineering, Beihang University, IRC 300, Beihang University, Beijing, China. E-mail: [email protected]
Search for more papers by this authorCorresponding Author
Zixiao Li MD
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
China National Clinical Research Center for Neurological Diseases, Beijing, China
Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China
Chinese Institute for Brain Research, Beijing, China
Beijing Engineering Research Center of Digital Healthcare for Neurological Diseases, Beijing, China
Address correspondence to Dr Li, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No 119 S 4th Ring West Road, Fengtai District, Beijing 100070, China. E-mail: [email protected]. Dr Yongjun Wang, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China. E-mail: [email protected]. Prof Tao Liu, School of Biological Science and Medical Engineering, Beihang University, IRC 300, Beihang University, Beijing, China. E-mail: [email protected]
Search for more papers by this authorLingling Ding and Hao Liu contributed equally to this work.
Abstract
Objective
To create a comprehensive map of strategic lesion network localizations for neurological deficits, and identify prognostic neuroimaging biomarkers to facilitate the early detection of patients with a high risk of poor functional outcomes in acute ischemic stroke (AIS).
Methods
In a large-scale multicenter study of 7,807 patients with AIS, we performed voxel-based lesion-symptom mapping, functional disconnection mapping (FDC), and structural disconnection mapping (SDC) to identify distinct lesion and network localizations for National Institutes of Health Stroke Scale (NIHSS) score. Impact scores were calculated based on the odds ratios or t-values of voxels from voxel-based lesion-symptom mapping, FDC, and SDC results. Ordinal regression models were used to investigate the predictive value of the impact scores on functional outcome (defined as the modified Rankin score at 3 months).
Results
We constructed lesion, FDC, and SDC maps for each item of the NIHSS score, which provided insights into the neuroanatomical substrate and network localization of neurological function deficits after AIS. The lesion impact score of limb ataxia, the SDC impact score of limb deficit, and FDC impact score of sensation and dysarthria were significantly associated with modified Rankin Scale at 3 months. Adding the SDC impact score, FDC impact score, and lesion impact score to the NIHSS total score improved the performance in predicting functional outcomes, as compared with using the NIHSS score alone.
Interpretation
We constructed comprehensive maps of strategic lesion network localizations for neurological deficits that were predictive of functional outcomes in AIS. These results may provide specifically localized targets for future neuromodulation therapies. ANN NEUROL 2023;94:572–584
Potential Conflicts of Interest
Nothing to report.
Open Research
Data Availability Statement
The data that support the findings of this study are available from the corresponding author on reasonable request.
Supporting Information
| Filename | Description |
|---|---|
| ana26721-sup-0001-Supinfo.docxWord 2007 document , 11.8 MB | Data S1. Supplementary Methods. Figure S1. Flow chart. Figure S2. The schematic of the calculation process of the lesion impact score. Figure S3. Lesion network mapping of remaining deficit rate (RDR) for National Institutes of Health Stroke Scale items (1–4). Figure S4. Lesion network mapping of remaining deficit rate (RDR) for National Institutes of Health Stroke Scale items (5, 6). Figure S5. Lesion network mapping of remaining deficit rate (RDR) for National Institutes of Health Stroke Scale items (7–11). Figure S6. Comparison of linear transformation and linear + nonlinear transformation of lesions. Table S1. Overview of participant characteristics. Table S2. Lesion maps for National Institutes of Health Stroke Scale items. Table S3. Multivariate lesion locations for National Institutes of Health Stroke Scale items. Table S4. Structural disconnection (SDC) maps for National Institutes of Health Stroke Scale items. Table S5. Functional disconnection (FDC) maps for National Institutes of Health Stroke Scale items. Table S6. Lesion maps for remaining deficit rate (RDR). Table S7. Structural disconnection (SDC) maps for remaining deficit rate (RDR). Table S8. Functional disconnection (FDC) maps for remaining deficit rate (RDR). Table S9. Univariate ordinal regression models for the 3-month modified Rankin Score. Table S10. Multivariate ordinal regression models for the 3-month modified Rankin Score. Table S11. Tenfold cross-validation comparisons of different ordinal regressions in predicting the 3-month modified Rankin Score. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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