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Behavioural clusters and predictors of performance during recovery from stroke

Nature Human Behaviour volume 1, Article number: 0038 (2017) Cite this article

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Abstract

We examined the patterns and variability of post-stroke recovery in multiple behavioural domains. A large cohort of first-time stroke patients with heterogeneous lesions was studied prospectively and longitudinally at one to two weeks, three months and one year after the stroke using structural magnetic resonance imaging to measure lesion anatomy and 44 neuropsychological tests to assess behavioural outcomes. Impairment was described at all time points by a few clusters of correlated deficits. The time course and magnitude of recovery was similar across behavioural domains, with change scores largely proportional to the initial deficit and most recovery occurring within the first three months. Damage to specific white matter tracts produced poorer recovery for several domains: attention (superior longitudinal fasciculus II/III), language (posterior arcuate fasciculus) and motor (corticospinal tract). Finally, after accounting for the severity of the initial deficit, language and visual memory recovery was worse for those with lower levels of education, while the occurrence of multiple deficits negatively impacted attention recovery.

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Figure 1: Lesion anatomy.
Figure 2: Behavioural clusters.
Figure 3: Magnitude of recovery.
Figure 4: Time course of recovery.
Figure 5: Behaviour prediction on the basis of lesion topography.

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Acknowledgements

The authors received funding from the following grants: R01 HD061117-05 and R01 NS095741 (M.C.). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information

Authors and Affiliations

  1. Department of Physical Therapy, Carroll University, Waukesha, Wisconsin 53186, USA

    L. E. Ramsey

  2. Department of Neurology, Washington University School of Medicine, St Louis, Missouri 63110, USA

    J. S. Siegel, C. E. Lang, G. L. Shulman & M. Corbetta

  3. Program in Physical Therapy, Washington University School of Medicine, St Louis, Missouri 63110, USA

    C. E. Lang

  4. Program in Occupational Therapy, Washington University School of Medicine, St Louis, Missouri 63110, USA

    C. E. Lang

  5. Department of Psychology, Washington University, St Louis, Missouri 63110, USA

    M. Strube

  6. Department of Radiology, Washington University School of Medicine, St Louis, Missouri 63110, USA

    M. Corbetta

  7. Department of Neuroscience, Washington University School of Medicine, St Louis, Missouri 63110, USA

    M. Corbetta

  8. Department of Biomedical Engineering, Washington University, St Louis, Missouri 63110, USA

    M. Corbetta

  9. Department of Neuroscience, University of Padua, Padua 35122, Italy

    M. Corbetta

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  1. L. E. Ramsey
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  5. G. L. Shulman
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Contributions

Study concept and design by M.C., G.L.S., L.E.R. and C.E.L. Data acquisition was done by L.E.R and J.S.S. Analysis was done by L.E.R., J.S.S. and M.S. The manuscript was written by L.E.R., M.C. and G.L.S.

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Correspondence to L. E. Ramsey.

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The authors declare no competing interests.

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Ramsey, L., Siegel, J., Lang, C. et al. Behavioural clusters and predictors of performance during recovery from stroke. Nat Hum Behav 1, 0038 (2017). https://doi.org/10.1038/s41562-016-0038

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