White matter lesional predictors of chronic visual neglect: A longitudinal study
Brain. 2015-01-19; 138(3): 746-760
DOI: 10.1093/brain/awu389
Lire sur PubMed
1. Brain. 2015 Mar;138(Pt 3):746-60. doi: 10.1093/brain/awu389. Epub 2015 Jan 21.
White matter lesional predictors of chronic visual neglect: a longitudinal study.
Lunven M(1), Thiebaut De Schotten M(2), Bourlon C(3), Duret C(3), Migliaccio
R(4), Rode G(5), Bartolomeo P(6).
Author information:
(1)1 INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, and Université Pierre et
Marie Curie-Paris 6, UMR S 1127, Institut du Cerveau et de la Moelle épinière
(ICM), F-75013 Paris, France 2 Service de Médecine Physique et Réadaptation,
Unité de Rééducation Neurologique CRF ‘Les Trois Soleils’ Boissise le Roi, France
3 Inserm UMR_S 1028, CNRS UMR 5292, ImpAct, centre des neurosciences de Lyon,
université Lyon-1, 16, avenue Lépine 69676 Bron, France.
(2)1 INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, and Université Pierre et
Marie Curie-Paris 6, UMR S 1127, Institut du Cerveau et de la Moelle épinière
(ICM), F-75013 Paris, France 4 Natbrainlab, Department of Forensic and
Neurodevelopmental Sciences, Institute of Psychiatry, King’s College London, UK.
(3)2 Service de Médecine Physique et Réadaptation, Unité de Rééducation
Neurologique CRF ‘Les Trois Soleils’ Boissise le Roi, France.
(4)1 INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, and Université Pierre et
Marie Curie-Paris 6, UMR S 1127, Institut du Cerveau et de la Moelle épinière
(ICM), F-75013 Paris, France 5 AP-HP, Department of Neurology, IFR 70,
Salpêtrière Hospital, Paris, France.
(5)3 Inserm UMR_S 1028, CNRS UMR 5292, ImpAct, centre des neurosciences de Lyon,
université Lyon-1, 16, avenue Lépine 69676 Bron, France 6 Service de médecine
physique et réadaptation neurologique, hospital Henry-Gabrielle, hospice civils
de Lyon, 20, route de Vourles, Saint-Genis-Laval, France.
(6)1 INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, and Université Pierre et
Marie Curie-Paris 6, UMR S 1127, Institut du Cerveau et de la Moelle épinière
(ICM), F-75013 Paris, France 5 AP-HP, Department of Neurology, IFR 70,
Salpêtrière Hospital, Paris, France 7 Department of Psychology, Catholic
University, Milan, Italy .
Chronic visual neglect prevents brain-damaged patients from returning to an
independent and active life. Detecting predictors of persistent neglect as early
as possible after the stroke is therefore crucial to plan the relevant
interventions. Neglect signs do not only depend on focal brain lesions, but also
on dysfunction of large-scale brain networks connected by white matter bundles.
We explored the relationship between markers of axonal degeneration occurring
after the stroke and visual neglect chronicity. A group of 45 patients with
unilateral strokes in the right hemisphere underwent cognitive testing for
neglect twice, first at the subacute phase (1 year). For each patient, magnetic resonance imaging
including diffusion sequences was performed at least 4 months after the stroke.
After masking each patient’s lesion, we used tract-based spatial statistics to
obtain a voxel-wise statistical analysis of the fractional anisotropy data.
Twenty-seven patients had signs of visual neglect at initial testing. Only 10 of
these patients had recovered from neglect at follow-up. When compared with
patients without neglect, the group including all subacute neglect patients had
decreased fractional anisotropy in the second (II) and third (III) branches of
the right superior longitudinal fasciculus, as well as in the splenium of the
corpus callosum. The subgroup of chronic patients showed reduced fractional
anisotropy in a portion the splenium, the forceps major, which provides
interhemispheric communication between regions of the occipital lobe and of the
superior parietal lobules. The severity of neglect correlated with fractional
anisotropy values in superior longitudinal fasciculus II/III for subacute
patients and in its caudal portion for chronic patients. Our results confirm a
key role of fronto-parietal disconnection in the emergence and chronic
persistence of neglect, and demonstrate an implication of caudal interhemispheric
disconnection in chronic neglect. Splenial disconnection may prevent
fronto-parietal networks in the left hemisphere from resolving the activity
imbalance with their right hemisphere counterparts, thus leading to persistent
neglect.
© The Author (2015). Published by Oxford University Press on behalf of the
Guarantors of Brain. All rights reserved. For Permissions, please email:
.
DOI: 10.1093/brain/awu389
PMCID: PMC4339774
PMID: 25609686 [Indexed for MEDLINE]