Common behavioral clusters and subcortical anatomy in stroke.

A long-held view is that stroke causes many distinct neurological syndromes due to damage of specialized cortical and subcortical centers. However, it is unknown if a syndrome-based description is helpful in characterizing behavioral deficits across a large number of patients. We studied a large prospective sample of first-time stroke patients with heterogeneous lesions at 1–2 weeks post-stroke. We measured behavior over multiple domains and lesion anatomy with structural MRI and a probabilistic atlas of white matter pathways. Multivariate methods estimated the percentage of behavioral variance explained by structural damage. A few clusters of behavioral deficits spanning multiple functions explained neurological impairment. Stroke topography was predominantly subcortical, and disconnection of white matter tracts critically contributed to behavioral deficits and their correlation. The locus of damage explained more variance for motor and language than memory or attention deficits. Our findings highlight the need for better models of white matter damage on cognition.

一种长期存在的观点认为，由于特定的皮质和皮质下中枢受损，中风会导致许多不同的神经综合征。然而，基于综合征的描述是否有助于描述大量患者的行为缺陷尚不明确。我们对一大组首次中风且在中风后1 - 2周存在不同病灶的前瞻性样本进行了研究。我们通过结构磁共振成像以及白质通路概率图谱测量了多个领域的行为以及病灶解剖结构。多变量方法估算了由结构损伤所解释的行为差异的百分比。 少数跨越多种功能的行为缺陷群解释了神经损伤。中风病灶主要位于皮质下，白质束的断开对行为缺陷及其相关性起关键作用。损伤部位对运动和语言缺陷的解释力比对记忆或注意力缺陷的解释力更强。我们的研究结果强调需要更好的白质损伤对认知影响的模型。