Deans' stroke musings: Structural brain disconnectivity mapping of post-stroke fatigue

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Friday, March 26, 2021

Structural brain disconnectivity mapping of post-stroke fatigue

Nothing here solves the problem of post stroke fatigue. The whole fucking point of stroke research is to solve stroke, not just describe some piece of it. Useless

Knut K.Kolskår^a^b^c GenevièveRichard^a DagAlnæs^a^d Erlend S.Dørum^a^b^c Anne-MartheSanders^a^b^c SveinungTornås^c Jennifer MonereoSánchezⁱ^j AndreasEngvig^k Hege IhleHansen^e Michel Thiebautde Schotten^f^g Jan E.Nordvik^h Lars T.Westlye^a^b^l

https://doi.org/10.1016/j.nicl.2021.102635 Get rights and content

Under a Creative Commons license

open access

Highlights

•: We tested for associations between post stroke fatigue (PSF) and both lesion characteristics and brain structural disconnectome in 84 stroke patients.
•: Results provided no evidence supporting a simple association between PSF severity and lesion characteristics or disconnectivity.
•: PSF was strongly correlated with depression.
•: Further studies including patients with more severe symptoms are needed to generalize the findings across a wider clinical spectrum.(Since you are not solving fatigue these further studies would be a waste of time.)

Abstract

Stroke patients commonly suffer from post stroke fatigue (PSF). Despite a general consensus that brain perturbations constitute a precipitating event in the multifactorial etiology of PSF, the specific predictive value of conventional lesion characteristics such as size and localization remains unclear. The current study represents a novel approach to assess the neural correlates of PSF in chronic stroke patients. While previous research has focused primarily on lesion location or size, with mixed or inconclusive results, we targeted the extended structural network implicated by the lesion, and evaluated the added explanatory value of a structural disconnectivity approach with regards to the brain correlates of PSF. To this end, we estimated individual structural brain disconnectome maps in 84 stroke survivors in the chronic phase (≥ 3 months post stroke) using information about lesion location and normative white matter pathways obtained from 170 healthy individuals. PSF was measured by the Fatigue Severity Scale (FSS). Voxel wise analyses using non-parametric permutation-based inference were conducted on disconnectome maps to estimate regional effects of disconnectivity. Associations between PSF and global disconnectivity and clinical lesion characteristics were tested by linear models, and we estimated Bayes factor to quantify the evidence for the null and alternative hypotheses, respectively. The results revealed no significant associations between PSF and disconnectome measures or lesion characteristics, with moderate evidence in favor of the null hypothesis. These results suggest that symptoms of post-stroke fatigue among chronic stroke patients are not simply explained by lesion characteristics or the extent and distribution of structural brain disconnectome, and are discussed in light of methodological considerations.