Cognitive Reserve Modifies the Relationship Between Neural Function,Neural Injury and Upper-Limb Recovery After Stroke |
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| Institution: | 1. Innovation, IMPlementation and Clinical Translation (IIMPACT) in Health, Allied Health and Human Performance, University of South Australia, Adelaide, Australia;2. Royal Adelaide Hospital, Central Adelaide Local Health Network, SA Health, Adelaide, Australia;1. Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, No.119, the South Fourth Ring West Road, Fengtai district, Beijing 100070, China;2. Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Beijing 100070, China;3. The George Institute for Global Health at Peking University Health Science Center, Beijing, China;4. Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia;5. Department of Ultrasound, Huaian Hospital of Huaian City, Huaian, Jiangsu, China;1. Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA;2. School of Medicine, Stony Brook University, Stony Brook, NY, USA;1. Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand;2. Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand;1. Department of Radiology, Mayo Clinic;2. Department of Quantitative Health Sciences, Mayo Clinic;3. Department of Neurology, Mayo Clinic;4. Department of Quantitative Health Sciences, Mayo Clinic;1. Boston Medical Center, Boston University School of Medicine, Boston, MA USA;2. University of Pennsylvania, Philadelphia, USA;3. Cooper Neurological Institute, Cooper University Hospital, Camden, NJ USA |
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| Abstract: | ObjectiveTo investigate whether cognitive reserve modifies the relationship between functional connectivity, lesion volume, stroke severity and upper-limb motor impairment and recovery in stroke survivors.MethodsTen patients with first-ever ischemic middle cerebral artery stroke completed the Cognitive Reserve Index Questionnaire at baseline. Upper-limb motor impairment and functional connectivity were assessed using the Fugl-Meyer Assessment and electroencephalography respectively at baseline and 3-months post-stroke. A debiased weighted phase lag index was computed to estimate functional connectivity between electrodes. Partial least squares (PLS) regression identified a connectivity model that maximally predicted variance in the degree of upper-limb impairment. Regression models were generated to determine whether cognitive reserve modified the relationship between neural function (functional connectivity), neural injury (lesion volume), stroke severity (National Institutes of Health Stroke Scale) and upper-limb motor impairment at baseline and recovery at 3-months (Fugl-Meyer Assessment).ResultsThe addition of cognitive reserve to a regression model with a dependent variable of upper-limb motor recovery and independent variables of functional connectivity between the ipsilesional motor cortex and parietal cortex, stroke severity and lesion volume improved model efficiency (?BIC=-7.07) despite not reaching statistical significance (R2=0.90, p=0.07). Cognitive reserve did not appear to improve regression models examining motor impairment at baseline.ConclusionsPreliminary observations suggest cognitive reserve might modify the relationship between neural function, neural injury, stroke severity and upper-limb motor recovery. Further investigation of cognitive reserve in motor recovery post-stroke appears warranted. |
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