Elsevier

Neuropsychologia

Volume 115, 1 July 2018, Pages 88-100
Neuropsychologia

Lesion mapping in acute stroke aphasia and its implications for recovery

https://doi.org/10.1016/j.neuropsychologia.2018.03.036Get rights and content
Under a Creative Commons license
open access

Highlights

  • Lesion mapping methods determine different lesion extents and associated outcomes.

  • Voxel-based methods are sensitive to lesions associated with aphasia recovery.

  • Diffusion data can reveal anatomical predictors of recovery beyond the lesion.

Abstract

Patients with stroke offer a unique window into understanding human brain function. Mapping stroke lesions poses several challenges due to the complexity of the lesion anatomy and the mechanisms causing local and remote disruption on brain networks. In this prospective longitudinal study, we compare standard and advanced approaches to white matter lesion mapping applied to acute stroke patients with aphasia. Eighteen patients with acute left hemisphere stroke were recruited and scanned within two weeks from symptom onset. Aphasia assessment was performed at baseline and six-month follow-up. Structural and diffusion MRI contrasts indicated an area of maximum overlap in the anterior external/extreme capsule with diffusion images showing a larger overlap extending into posterior perisylvian regions. Anatomical predictors of recovery included damage to ipsilesional tracts (as shown by both structural and diffusion images) and contralesional tracts (as shown by diffusion images only). These findings indicate converging results from structural and diffusion lesion mapping methods but also clear differences between the two approaches in their ability to identify predictors of recovery outside the lesioned regions.

Keywords

Lesion mapping
VLSM
White matter atlas
Tractography
Acute stroke
Aphasia recovery

Cited by (0)