Neuroimaging findings shed light on common mechanisms of poststroke delirium and spatial neglect

East Hanover, NJ. January 6, 2022.  – A team of stroke experts reported results of a neuroimaging study exploring the relationship between delirium and spatial neglect, serious complications that affect up to 50 percent of individuals with right hemispheric stroke. These disorders were linked to dysfunction of brain networks associated with arousal, attention, and spatial orientation, and with changes in right brain connectivity. These findings have implications for the development of diagnostic tools and novel behavioral therapies for these complications that hinder recovery after stroke.

The article,” Brain network dysfunction in poststroke delirium and spatial neglect: An fMRI study,” was published October 8, 2021, in Stroke (doi: 10.1161/STROKEAHA.121.035733). The authors are Olga Boukrina, PhD, Mateusz Kowalczyk, Yury Koush, PhD, Yekyung Kong, MD, and A.M. Barrett, MD. 

Link: https://www.ahajournals.org/doi/10.1161/STROKEAHA.121.035733

The team studied 29 participants with right-hemispheric stroke; 21 percent met the criteria for delirium, 45 percent for subsyndromal delirium, and 55 percent for spatial neglect. Using fMRI of the brain at rest, the study revealed that decreased connectivity within the brain’s arousal network was associated with more severe spatial neglect. Similarly, increased interconnectivity of the right dominant attention network with the unaffected left hemisphere regions was associated with more severe spatial neglect and delirium. This indicates that both delirium and spatial neglect may be linked with an imbalance of cortical-subcortical hemispheric connectivity.  

The findings have clinical significance, according to lead author Olga Boukrina, PhD, research scientist in the Center for Stroke Rehabilitation Research at Kessler Foundation. “Recognizing the overlap of these conditions will help raise awareness of the risks for delirium and spatial neglect after stroke,” said Dr. Boukrina. “We also found that the functional deficits that result from spatial neglect contributed to the risk for delirium, an acute and serious consequence of stroke that can lead to chronic cognitive decline. This interesting finding points to a potential pathway to new treatments and improved outcomes for stroke survivors.”  

Funding: American Heart Association (grant 17SDG33660442); National Institute on Aging (R24AG054259)

About Kessler Foundation:

Kessler Foundation, a major nonprofit organization in the field of disability, is a global leader in rehabilitation research that seeks to improve cognition, mobility, and long-term outcomes--including employment--for people with neurological disabilities caused by diseases and injuries of the brain and spinal cord. Kessler Foundation leads the nation in funding innovative programs that expand employment opportunities for people with disabilities.

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Image:

Title: Olga Boukrina, PhD, of Kessler Foundation

Caption: Dr. Boukrina is a research scientist in the Center for Stroke Rehabilitation Research at Kessler Foundation, and director of the Center’s Neurolinguistics and Brain Connectivity Laboratory.

Podcast:

Fast Take: Dr. Boukrina of Kessler Foundation discusses the clinical implications of her peer-reviewed article published in Stroke - Brain network dysfunction in poststroke delirium and spatial neglect: An fMRI study