Background / Purpose: The purpose of this study was 1) to identify changes in structural connectivity after stroke and 2) to relate changes in indirect connectivity to post-stroke impairment.
METHODS
A novel measure of indirect connectivity was implemented to assess the impact of stroke on brain connectivity. Probabilistic tractography was performed on 13 chronic stroke and 16 control participants to estimate connectivity between gray matter regions. The Fugl-Meyer assessment of motor impairment was measured for stroke participants. Network measures of direct and indirect connectivity were calculated, and these measures were linearly combined with measures of white matter integrity to predict motor impairment.
RESULTS
We found significantly reduced indirect connectivity in the frontal and parietal lobes, ipsilesional subcortical regions and bilateral cerebellum after stroke. When added to the regression analysis, the volume of gray matter with reduced indirect connectivity significantly improved the correlation between image parameters and upper extremity motor impairment (R2=0.71, p<0.05).
CONCLUSION
This study provides evidence of changes in indirect connectivity in regions remote from the lesion, particularly in the cerebellum and regions in the fronto-parietal cortices, and these changes correlate with upper extremity motor impairment. These results highlight the value of using measures of indirect connectivity to identify the effect of stroke on brain networks.