Ubuchopho Babantu Abasinde Ekushayweni Kohlangothi Buvuka Kabusha Ukuze Banxephezele Ukulimala

Isifinyezo: Ocwaningweni olukhulu lwamazwe ngamazwe, abacwaningi bathole iphethini emangazayo ye-neuroplasticity kwabasinde unhlangothi. Besebenzisa ukufunda okujulile ukuze bahlaziye izikena zobuchopho ezivela kwabasindile abangaphezu kuka-500 emazweni ayisishiyagalombili, abacwaningi bathola ukuthi nakuba isifo sohlangothi sisheshisa ukuguga endaweni eyonakele, uhlangothi olungalimele lobuchopho empeleni luqala ukubukeka “luluncane” ekwakhekeni kwalo.

Lokhu kuvuselelwa kwesifunda—ikakhulukazi ezindaweni ezinesibopho sokuhlela nokunaka kwezimoto—kubonakala kuyindlela yobuchopho “yokulungisa kabusha” amanethiwekhi anempilo ukuze kunxeshezelwe ukukhubazeka okukhulu ngokomzimba.

Amaqiniso Abalulekile

• Umaka we-Brain-PAD: Abacwaningi basebenzisa i-AI ukubala “Umehluko Weminyaka Ebikezelwe Ubuchopho” (ubuchopho-PAD). Iminyaka yobuchopho “encane” ezifundeni ezingalimele isebenze njengomaka obucayi wokuhlelwa kabusha kwemizwa.
• I-Contralesional Shift: Abasindile abanezingqinamba ezinzima kakhulu zokunyakaza babonise amaphethini esakhiwo “amasha” kakhulu endaweni ebhekene nokulimala kwabo, ikakhulukazi ngaphakathi inethiwekhi ye-frontoparietal.
• Ukusebenzisana Kwembulunga yonke: Ucwaningo lwaluyingxenye ye Iqembu Lokusebenza Lokubuyisela I-Stroke ENIGMAivumelanisa idatha evela kumasayithi ocwaningo angu-34 ukuze kwakhiwe idathasethi enkulu kunazo zonke emhlabeni yohlobo lwayo.
• I-Paradoxical Adaptation: Lokhu kushintsha kwentsha akusho ukuthi umnyakazo usululeme ngokugcwele; kunalokho, kukhombisa ubuchopho obuzivumelanisa nezimo futhi “buvuselela” izicubu ezinempilo ukuze zicoshe ukuxega kwesistimu yemoto eyonakele.

Umthombo: USC

Ocwaningweni olusha olushicilelwe ku I-Lancet Digital Healthososayensi base-USC Mark noMary Stevens Neuroimaging and Informatics Institute (Stevens INI) baye bathola ukuthi ubuchopho babantu ababhekana nokukhubazeka okukhulu ngokomzimba ngemva kokushaywa yisifo sohlangothi kungase kuhlelwe kabusha ngezindlela ezingalindelekile, kubonisa izimpawu zesakhiwo sobuchopho “abancane” ezindaweni ezingalimele njengoba zivumelanisa nokulimala.

Umzamo wocwaningo wamazwe ngamazwe uyingxenye ye-Enhacing NeuroImaging Genetics through Meta-Analysis (ENIGMA) Stroke Recovery Working Group, ehlaziye izikena zobuchopho ezivela kwabasinde abangaphezu kuka-500 ababulawa isifo sohlangothi kuzo zonke izizinda zocwaningo ezingama-34 emazweni ayisishiyagalombili.

Besebenzisa amamodeli okufunda ajulile aqeqeshwe emashumini ezinkulungwane ze-MRI scan, abacwaningi balinganisela “iminyaka yobuchopho” yezifunda ezihlukahlukene ku-hemisphere ngayinye ukuze babone ukuthi ukulimala kwe-stroke kuthinta kanjani ukwakheka kobuchopho nokululama.

“Sithole ukuthi imivimbo emikhulu isheshisa ukuguga endaweni eyonakele kodwa ngokuxakayo yenza uhlangothi oluphambene lobuchopho lubonakale luncane,” kusho u-Hosung Kim, PhD, uprofesa ohlangene wocwaningo lwe-neurology e-Keck School of Medicine yase-USC kanye nomlobi ophezulu wocwaningo.

“Le phethini iphakamisa ukuthi ubuchopho bungase buzihlele kabusha, empeleni buvuselele amanethiwekhi angonakalisiwe ukuze kunxeshezelwe umsebenzi olahlekile.”

Ithimba labacwaningi lisebenzise uhlobo oluthuthukisiwe lobuhlakani bokwenziwa olwaziwa njengenethiwekhi yokuguqulwa kwegrafu ukubikezela iminyaka yebhayoloji yezifunda zobuchopho eziyi-18 kusuka kudatha ye-MRI. Umehluko phakathi kweminyaka yobuchopho ebikezelwe yomuntu kanye neminyaka yabo yangempela yokulandelana kwezikhathi, eyaziwa ngokuthi umehluko weminyaka ebikezelwe ubuchopho (ubuchopho-PAD), usebenze njengomaka obucayi wempilo yemizwa.

Lapho ithimba lihlobanisa lezi zilinganiso namaphuzu okusebenza kwemoto, lithole iphethini ephawulekayo: abasinde ekushayweni kohlangothi abanesileleka esikhulu sokunyakaza, ngisho nangemva kwezinyanga ezingaphezu kwezingu-6 zokuvuselelwa, babonise iminyaka yobuchopho obuncane kunobekulindelekile ezifundeni eziphambene nesilonda, ikakhulukazi ngaphakathi kwenethiwekhi yangaphambili, isistimu eyinhloko ehilelekile ekuhlelweni kwemoto, ukunaka, nokuxhumana.

“Lokhu okutholakele kusikisela ukuthi lapho ukulimala kwe-stroke kuholela ekulahlekelweni okukhulu kokunyakaza, izifunda ezingalimele ngakolunye uhlangothi lobuchopho zingase zivumelane nokusiza ukunxephezela,” kuchaza uKim.

“Sikubonile lokhu kunethiwekhi ye-contralesional frontoparietal, ebonisa iphethini 'eyintsha' kakhudlwana futhi eyaziwa ngokusekela ukuhlelwa kwemoto, ukunaka, nokuxhumana. Kunokuba ibonise ukululama okuphelele kokunyakaza, le phethini ingase ibonise umzamo wobuchopho wokulungisa lapho isimiso sezithuthuthu esilimele singasakwazi ukusebenza ngendlela evamile. Lokhu kusinika indlela entsha yokubona i-neuroplasticity leyo imaging yendabuko eyayingakwazi ukuthwebula.”

Ucwaningo lwenziwe nge-ENIGMA, umfelandawonye womhlaba wonke ohlanganisa idatha evela emazweni angaphezu kuka-50 ukuze uqonde kangcono ubuchopho kuzo zonke izifo. Abacwaningi bavumelanise idatha ye-MRI nezindlela zomtholampilo kuwo wonke amaqoqo ukuze bakhe idathasethi yedatha ye-stroke enkulu kunazo zonke emhlabeni yohlobo lwayo.

“Ngokuhlanganisa idatha evela kumakhulu abasindile sohlangothi emhlabeni wonke nokusebenzisa i-AI esezingeni eliphezulu, singathola amaphethini acashile okuhlelwa kabusha kobuchopho obekungeke kubonakale ezifundweni ezincane. Lokhu okutholwe kokuguga kobuchopho obuhlukene ngokwesifunda ku-stroke okungamahlalakhona kungagcina kuqondise amasu okubuyisela umuntu uqobo,” kusho u-Arthur W. Toga, PhD, umqondisi weStevens INI kanye neProfessor USCvo.

Ithimba lihlela ukwandisa umsebenzi walo ukuze lifake izifundo ze-longitudinal zokulandelela iziguli kusukela ezigabeni ezibucayi kuya ezingapheli zokululama isifo sohlangothi. Ngokubheka ukuthi amaphethini okuguga kobuchopho nokuhlelwa kabusha athuthuka kanjani ngokuhamba kwesikhathi, odokotela bangase bakwazi ukwenza ngokwezifiso ukungenelela ngokusekelwe kunqubo eyingqayizivele yesiguli ngasinye yokujwayela imizwa, ekugcineni kuthuthukiswe imiphumela yokululama kanye nekhwalithi yokuphila esikhathini esizayo esiseduze.

Imibuzo Ebalulekile Iyaphendulwa:

Amanothi Omhleli:

• Lesi sihloko sihlelwe umhleli weNeuroscience News.
• Iphepha lejenali libuyekezwe ngokugcwele.
• Ingqikithi eyengeziwe yengezwe abasebenzi bethu.

Mayelana nalezi zindaba ze-neurology kanye ne-stroke

Umbhali: Laura LeBlanc
Umthombo: USC
Othintana naye: Laura LeBlanc – USC
Isithombe: Isithombe sifakwe ku-Neuroscience News

Ucwaningo lwangempela: Ukufinyelela okuvaliwe.
“Ukuhlangana phakathi kwe-neuroplasticity ye-contralesional kanye nokukhubazeka kwezimoto ngokusebenzisa iminyaka yobuchopho yesifunda ye-MRI ejulile yokufunda-etholakala ku-stroke engapheli (ENIGMA): i-multicohort, i-retrospective, isifundo sokubheka” ngu-Gilsoon Park, uMahir H. Khan, u-Justin W. Andrushko, u-Nerisa Banaj, u-Michael R. Borich, u-Lara Broman A. Boyd R. U-Buetefisch, Adriana B. Conforto, Steven C. Cramer, Michael Dimyan, Martin Domin, Miranda R. Donnelly, Natalia Egorova-Brumley, Elsa R. Ermer, Wuwei Feng, Fatemeh Geranmayeh, Colleen A. Hanlon, Brenton Hordacre, Neda Jahanshautz Martin, Mohamed Salad, Steven Jie Lotze, Bradley J. MacIntosh, Feroze B. Mohamed, Jan E. Nordvik, Fabrizio Piras, Kate P. Revill, Andrew D. Robertson, Christian Schranz, Nicolas Schweighofer, Na Jin Seo, Surjo R. Soekadar, Shraddha Srivastava, Bethany P. Gregory Tmory Tveulos. Daniela Vecchio, Emilio Werden, Lars T. Westlye, Carolee J. Winstein, George F. Wittenberg, Jennifer K. Ferris, Chunshui Yu, Paul M. Thompson, Sook-Lei Liew, noHosung Kim. I-Lancet Digital Health
I-DOI:10.1016/j.landig.2025.100942

Abstract

Ukuhlangana phakathi kwe-contralesional neuroplasticity kanye nokukhubazeka kwezimoto ngokusebenzisa iminyaka yobuchopho besifunda ye-MRI etholakala ekufundeni okujulile ku-stroke engapheli (ENIGMA): i-multicohort, i-retrospective, isifundo sokubheka

Ingemuva

Ukushaywa unhlangothi kuholela ekushintsheni okuyinkimbinkimbi kwesakhiwo nokusebenza kwengqondo okuthinta ngokuqondile imiphumela yemoto. Umehluko wobudala obubikezelwe ubuchopho (PAD) uvele njenge-biomarker ebucayi yakho kokubili inzwa kanye nokusebenza kwengqondo ngemva kokushaywa unhlangothi. Ucwaningo lwethu lwangaphambilini lubonise i-PAD yobuchopho ephakeme yomhlaba wonke ehlotshaniswa nomsebenzi ompofu wemoto ngemva kokushaywa unhlangothi.

Kodwa-ke, ukuhlobana phakathi komthwalo wendawo we-stroke, iminyaka yobuchopho besifunda, nokukhubazeka kwemoto akucaci. Lolu cwaningo luhlose ukuphenya izinhlangano phakathi kokulimala kwe-focal lesion, i-PAD yobuchopho besifunda kuwo womabili ama-hemispheres, kanye nemiphumela yemoto ekushayweni okungapheli, nokukhomba izibikezelo ezibalulekile zokukhubazeka kwemoto.

Izindlela

Kulolu cwaningo lwe-multicohort, olwedlule, olwedlule, oluhlolisisayo, sifake abantu abanesifo sohlangothi esingamahlalakhona (>izinsuku ezingu-180 ngemva kokushaywa unhlangothi) kusukela kudathasethi yeqembu le-ENIGMA Stroke Recovery Working futhi sasebenzisa abantu abavela eqenjini lase-UK Biobank ukuqeqesha imodeli yesifunda yokubikezela iminyaka yobuchopho. Izikena ze-MRI ezinesisindo se-T1 zasetshenziswa ukulinganisa i-PAD yobuchopho besifunda ezindaweni ezingaphansi eziyi-18 ezichazwe ngaphambilini nge-algorithm yenethiwekhi yegrafu.

Umthamo wesilonda wesifunda ngasinye ubalwe ngesisekelo sokugqagqana kwesilonda. Amamodeli emiphumela exubile eqondile ahlole ukuhlobana phakathi kosayizi wesilonda, umthwalo wendawo wesilonda, kanye ne-PAD yobuchopho besifunda. Izihlukanisi zokufunda ngomshini zibikezele imiphumela yezimoto zisebenzisa imithwalo yezilonda nama-PAD obuchopho besifunda. Ukumodela kwe-structural equation kuhlole ubudlelwano obuqondisayo phakathi komthwalo wezilonda ze-corticospinal tract, ipsilesional brain PAD, imiphumela yemoto, kanye ne-contralesional brain PAD.

Okutholakele

Sifake abantu abangu-501 abavela kudathasethi yeQembu Lokusebenza Lokubuyisela I-ENIGMA Stroke (amaqembu angu-34 emazweni ayisishiyagalombili) kanye nabantu abangu-17 791 abavela kudathasethi yase-UK Biobank. Usayizi omkhulu we-lesion omkhulu uhlotshaniswe kahle nama-PADs aphezulu e-IPsilesional brain brain (iminyaka yobudala yobuchopho) kuzo zonke izifunda eziningi (β=0 · 5420 kuya ku-0 · 9458 kuzo zonke izifunda ezihlobene kakhulu, izinga lokutholwa okungamanga. [FDR]-ilungiswe p<0 · 05), kanye ne-PAD yobuchopho obuphansi ekunakeni kwe-ventral ye-contralesional kanye nesifunda senethiwekhi yolimi (β=–0 · 3747, 95% CI -0 · 6961 kuya -0 · 0534, FDR-ilungiswe p<0 · 05).

Imithwalo yezilonda yendawo ephakeme ibonise amaphethini afanayo. Ngokukhethekile, umthwalo wezilonda kunethiwekhi ye-salience ube nomthelela omkhulu kuma-PAD obuchopho besifunda kuwo womabili ama-hemispheres. Amamodeli okufunda omshini ahlonze umthwalo wezilonda ze-corticospinal tract (umehluko olungisiwe wesilinganiso -0 · 0905, 95% CI -0 · 1221 kuya ku-0 · 0589, p<0 · 0001), umthwalo we-salience network lesion load (–0 · 0632, -0 · 0906 kuya ku-0 · 0358, p<0·000 yenethiwekhi ye-contrarie D1), inethiwekhi ye-contrarie ye-contrarie0 (0 · 9939, 0 · 4929 kuya ku-1 · 4950, p=0 · 0001) njengezibikezelo ezintathu eziphezulu zemiphumela yemoto.

Imodeli ye-equation yesakhiwo yembula ukuthi umthwalo ophezulu we-corticospinal tract lesion uhlotshaniswa nemiphumela yemoto empofu (β=–0 ·355, 95% CI -0 · 446 kuya -0 · 267, p<0 · 0001), okuphinde kwaxhunyaniswa neminyaka yobudala yobuchopho be-contralesional (0 · 204, 0 · 0 · 1, 0 · 0, 0, 0, 0, 0, 1, 0, 0, 1, 0, 0, 1, 0, 1, 0, 1, 0, 1, 1, 1, 1, 1 na 1, 0. ukukhubazeka okukhulu kwemoto kuxhunyaniswa nokuncipha okuyisinxephezelo kuminyaka yobuchopho ephikisanayo.

Ukuhunyushwa

Okutholakele kwethu kwembula ukuthi izilonda ezinkulu ze-stroke zihlotshaniswa nokuguga okusheshayo ku-ipsilesional hemisphere kanye nokuguga kobuchopho ngokwehla ngendlela exakayo ku-contralesional hemisphere, okuphakamisa izindlela ze-neural eziyisinxephezelo. Ukuhlola iminyaka yobuchopho besifunda kungase kusebenze njenge-biomarker ye-neuroplasticity futhi kwazise ukungenelela okuhlosiwe ukuze kuthuthukiswe ukululama kwemoto ngemva kokushaywa unhlangothi.

Uxhaso

I-US National Institutes of Health.