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Brain disconnectivity mapping of post-stroke fatigue

Kristine M. Ulrichsen, Knut K. Kolskår, View ORCID ProfileGeneviève Richard, View ORCID ProfileDag Alnæs, Erlend S. Dørum, Anne-Marthe Sanders, Sveinung Tornås, Jennifer Monereo Sánchez, Andreas Engvig, Hege Ihle Hansen, View ORCID ProfileMichel Thiebaut de Schotten, Jan E. Nordvik, View ORCID ProfileLars T. Westlye
doi: https://doi.org/10.1101/2020.11.13.380972
Kristine M. Ulrichsen
1NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Norway
2Department of Psychology, University of Oslo, Norway
3Sunnaas Rehabilitation Hospital HT, Nesodden, Norway
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  • For correspondence: k.m.ulrichsen@psykologi.uio.no l.t.westlye@psykologi.uio.no
Knut K. Kolskår
1NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Norway
2Department of Psychology, University of Oslo, Norway
3Sunnaas Rehabilitation Hospital HT, Nesodden, Norway
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Geneviève Richard
1NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Norway
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  • ORCID record for Geneviève Richard
Dag Alnæs
1NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Norway
4Bjørknes College, Oslo, Norway
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Erlend S. Dørum
1NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Norway
2Department of Psychology, University of Oslo, Norway
3Sunnaas Rehabilitation Hospital HT, Nesodden, Norway
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Anne-Marthe Sanders
1NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Norway
2Department of Psychology, University of Oslo, Norway
3Sunnaas Rehabilitation Hospital HT, Nesodden, Norway
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Sveinung Tornås
3Sunnaas Rehabilitation Hospital HT, Nesodden, Norway
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Jennifer Monereo Sánchez
9Faculty of Health, Medicine and Life Sciences, Maastricht University, Netherlands
10Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Netherlands
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Andreas Engvig
11Department of Nephrology, Oslo University Hospital, Ullevål, Norway
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Hege Ihle Hansen
5Department of Neurology, Oslo University Hospital, Norway
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Michel Thiebaut de Schotten
6Brain Connectivity and Behaviour Laboratory, Sorbonne Universities, Paris, France
7Groupe d’Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives-UMR 5293, CNRS, CEA University of Bordeaux, Bordeaux, France
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Jan E. Nordvik
8CatoSenteret Rehabilitation Center, Son, Norway
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Lars T. Westlye
1NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Norway
2Department of Psychology, University of Oslo, Norway
12KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Norway
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  • For correspondence: k.m.ulrichsen@psykologi.uio.no l.t.westlye@psykologi.uio.no
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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 remain 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 disconnectivity approach with regards to the brain correlates of PSF. To this end, we estimated individual 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 are not simply explained by lesion characteristics or brain disconnectome measures in stroke patients in a chronic phase, and are discussed in light of methodological considerations.

Competing Interest Statement

The authors have declared no competing interest.

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The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC 4.0 International license.
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Posted November 15, 2020.
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Brain disconnectivity mapping of post-stroke fatigue
Kristine M. Ulrichsen, Knut K. Kolskår, Geneviève Richard, Dag Alnæs, Erlend S. Dørum, Anne-Marthe Sanders, Sveinung Tornås, Jennifer Monereo Sánchez, Andreas Engvig, Hege Ihle Hansen, Michel Thiebaut de Schotten, Jan E. Nordvik, Lars T. Westlye
bioRxiv 2020.11.13.380972; doi: https://doi.org/10.1101/2020.11.13.380972
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Brain disconnectivity mapping of post-stroke fatigue
Kristine M. Ulrichsen, Knut K. Kolskår, Geneviève Richard, Dag Alnæs, Erlend S. Dørum, Anne-Marthe Sanders, Sveinung Tornås, Jennifer Monereo Sánchez, Andreas Engvig, Hege Ihle Hansen, Michel Thiebaut de Schotten, Jan E. Nordvik, Lars T. Westlye
bioRxiv 2020.11.13.380972; doi: https://doi.org/10.1101/2020.11.13.380972

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