Skip to main content
Erschienen in: Brain Topography 5/2016

20.07.2016 | Original Paper

Effective Connectivity of Cortical Sensorimotor Networks During Finger Movement Tasks: A Simultaneous fNIRS, fMRI, EEG Study

verfasst von: A. R. Anwar, M. Muthalib, S. Perrey, A. Galka, O. Granert, S. Wolff, U. Heute, G. Deuschl, J. Raethjen, Muthuraman Muthuraman

Erschienen in: Brain Topography | Ausgabe 5/2016

Einloggen, um Zugang zu erhalten

Abstract

Recently, interest has been growing to understand the underlying dynamic directional relationship between simultaneously activated regions of the brain during motor task performance. Such directionality analysis (or effective connectivity analysis), based on non-invasive electrophysiological (electroencephalography—EEG) and hemodynamic (functional near infrared spectroscopy—fNIRS; and functional magnetic resonance imaging—fMRI) neuroimaging modalities can provide an estimate of the motor task-related information flow from one brain region to another. Since EEG, fNIRS and fMRI modalities achieve different spatial and temporal resolutions of motor-task related activation in the brain, the aim of this study was to determine the effective connectivity of cortico-cortical sensorimotor networks during finger movement tasks measured by each neuroimaging modality. Nine healthy subjects performed right hand finger movement tasks of different complexity (simple finger tapping-FT, simple finger sequence-SFS, and complex finger sequence-CFS). We focused our observations on three cortical regions of interest (ROIs), namely the contralateral sensorimotor cortex (SMC), the contralateral premotor cortex (PMC) and the contralateral dorsolateral prefrontal cortex (DLPFC). We estimated the effective connectivity between these ROIs using conditional Granger causality (GC) analysis determined from the time series signals measured by fMRI (blood oxygenation level-dependent-BOLD), fNIRS (oxygenated-O2Hb and deoxygenated-HHb hemoglobin), and EEG (scalp and source level analysis) neuroimaging modalities. The effective connectivity analysis showed significant bi-directional information flow between the SMC, PMC, and DLPFC as determined by the EEG (scalp and source), fMRI (BOLD) and fNIRS (O2Hb and HHb) modalities for all three motor tasks. However the source level EEG GC values were significantly greater than the other modalities. In addition, only the source level EEG showed a significantly greater forward than backward information flow between the ROIs. This simultaneous fMRI, fNIRS and EEG study has shown through independent GC analysis of the respective time series that a bi-directional effective connectivity occurs within a cortico-cortical sensorimotor network (SMC, PMC and DLPFC) during finger movement tasks.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
Zurück zum Zitat Anwar AR et al (2012) Directionality analysis on functional magnetic resonance imaging during motor task using Granger Causality. In: Engineering in medicine and biology society (EMBC), 2012 Annual international conference of the IEEE, Aug. 28 2012–Sep 1 2012, pp 2287–2290. doi:10.1109/EMBC.2012.6346419 Anwar AR et al (2012) Directionality analysis on functional magnetic resonance imaging during motor task using Granger Causality. In: Engineering in medicine and biology society (EMBC), 2012 Annual international conference of the IEEE, Aug. 28 2012–Sep 1 2012, pp 2287–2290. doi:10.​1109/​EMBC.​2012.​6346419
Zurück zum Zitat Amjad AM, Halliday DM, Rosenberg JR, Conway BA (1997) An extended difference of coherence test for comparing and combining several independent coherence estimates: theory and application to the study of motor units and physiological tremor. J Neurosci Methods 73:69–79CrossRefPubMed Amjad AM, Halliday DM, Rosenberg JR, Conway BA (1997) An extended difference of coherence test for comparing and combining several independent coherence estimates: theory and application to the study of motor units and physiological tremor. J Neurosci Methods 73:69–79CrossRefPubMed
Zurück zum Zitat Andres FG, Gerloff C (1999) Coherence of sequential movements and motor learning. J Clin Neurophysiol 16:520–527CrossRefPubMed Andres FG, Gerloff C (1999) Coherence of sequential movements and motor learning. J Clin Neurophysiol 16:520–527CrossRefPubMed
Zurück zum Zitat Astolfi L, Babiloni F (2007) Estimation of cortical connectivity in humans: advanced signal processing techniques. Estimation of cortical connectivity in humans: advanced signal processing techniques. Morgan & Claypool, San Rafael. doi:10.2200/S00094ED1V01Y200708BME013 Astolfi L, Babiloni F (2007) Estimation of cortical connectivity in humans: advanced signal processing techniques. Estimation of cortical connectivity in humans: advanced signal processing techniques. Morgan & Claypool, San Rafael. doi:10.​2200/​S00094ED1V01Y200​708BME013
Zurück zum Zitat Astolfi L, Cichocki A, Babiloni F (2009) NeuroMath: advanced methods for the estimation of human brain activity and connectivity. Comput Intell Neurosci. doi:10.1155/2009/275638 Astolfi L, Cichocki A, Babiloni F (2009) NeuroMath: advanced methods for the estimation of human brain activity and connectivity. Comput Intell Neurosci. doi:10.​1155/​2009/​275638
Zurück zum Zitat Baccalá LA, Sameshima K, Takahashi DY (2007) Generalized partial directed coherence. In: 2007 15th International conference on digital signal processing, 1–4 July 2007, pp 163–166. doi:10.1109/ICDSP.2007.4288544 Baccalá LA, Sameshima K, Takahashi DY (2007) Generalized partial directed coherence. In: 2007 15th International conference on digital signal processing, 1–4 July 2007, pp 163–166. doi:10.​1109/​ICDSP.​2007.​4288544
Zurück zum Zitat Biswal B, Yetkin FZ, Haughton VM, Hyde JS (1995) Functional connectivity in the motor cortex of resting human brain using echo-planar MRI. Magn Reson Med 34:537–541CrossRefPubMed Biswal B, Yetkin FZ, Haughton VM, Hyde JS (1995) Functional connectivity in the motor cortex of resting human brain using echo-planar MRI. Magn Reson Med 34:537–541CrossRefPubMed
Zurück zum Zitat Blinowska KJ, Malinowski M (1991) Non-linear and linear forecasting of the EEG time series. Biol Cybern 66:159–165CrossRefPubMed Blinowska KJ, Malinowski M (1991) Non-linear and linear forecasting of the EEG time series. Biol Cybern 66:159–165CrossRefPubMed
Zurück zum Zitat Cohen D (1968) Magnetoencephalography: evidence of magnetic fields produced by alpha-rhythm currents. Science (New York, NY) 161:784–786CrossRef Cohen D (1968) Magnetoencephalography: evidence of magnetic fields produced by alpha-rhythm currents. Science (New York, NY) 161:784–786CrossRef
Zurück zum Zitat Engel AK, Fries P, Singer W (2001) Dynamic predictions: oscillations and synchrony in top-down processing. Nat Rev Neurosci 2:704–716CrossRefPubMed Engel AK, Fries P, Singer W (2001) Dynamic predictions: oscillations and synchrony in top-down processing. Nat Rev Neurosci 2:704–716CrossRefPubMed
Zurück zum Zitat Ferrari M, Quaresima V (2012) A brief review on the history of human functional near-infrared spectroscopy (fNIRS) development and fields of application. Neuroimage 63:921–935CrossRefPubMed Ferrari M, Quaresima V (2012) A brief review on the history of human functional near-infrared spectroscopy (fNIRS) development and fields of application. Neuroimage 63:921–935CrossRefPubMed
Zurück zum Zitat Florin E, Gross J, Pfeifer J, Fink GR, Timmermann L (2010) The effect of filtering on Granger causality based multivariate causality measures. NeuroImage 50:577–588CrossRefPubMed Florin E, Gross J, Pfeifer J, Fink GR, Timmermann L (2010) The effect of filtering on Granger causality based multivariate causality measures. NeuroImage 50:577–588CrossRefPubMed
Zurück zum Zitat Fuchs M, Kastner J, Wagner M, Hawes S, Ebersole JS (2002) A standardized boundary element method volume conductor model. Clin Neurophysiol 113:702–712CrossRefPubMed Fuchs M, Kastner J, Wagner M, Hawes S, Ebersole JS (2002) A standardized boundary element method volume conductor model. Clin Neurophysiol 113:702–712CrossRefPubMed
Zurück zum Zitat Govindan RB, Raethjen J, Kopper F, Claussen JC, Deuschl G (2005) Estimation of time delay by coherence analysis. Phys A 350:277–295CrossRef Govindan RB, Raethjen J, Kopper F, Claussen JC, Deuschl G (2005) Estimation of time delay by coherence analysis. Phys A 350:277–295CrossRef
Zurück zum Zitat Gratton G, Coles MGH, Donchin E (1983) A new method for off-line removal of ocular artifact. Electroencephalogr Clin Neurophysiol 55:468–484CrossRefPubMed Gratton G, Coles MGH, Donchin E (1983) A new method for off-line removal of ocular artifact. Electroencephalogr Clin Neurophysiol 55:468–484CrossRefPubMed
Zurück zum Zitat Gross J, Kujala J, Hamalainen M, Timmermann L, Schnitzler A, Salmelin R (2001) Dynamic imaging of coherent sources: Studying neural interactions in the human brain. Proc Natl Acad Sci USA 98:694–699CrossRefPubMedPubMedCentral Gross J, Kujala J, Hamalainen M, Timmermann L, Schnitzler A, Salmelin R (2001) Dynamic imaging of coherent sources: Studying neural interactions in the human brain. Proc Natl Acad Sci USA 98:694–699CrossRefPubMedPubMedCentral
Zurück zum Zitat Halliday DM, Rosenberg JR, Amjad AM, Breeze P, Conway BA, Farmer SF (1995) A framework for the analysis of mixed time series/point process data–theory and application to the study of physiological tremor, single motor unit discharges and electromyograms. Prog Biophys Mol Biol 64:237–278CrossRefPubMed Halliday DM, Rosenberg JR, Amjad AM, Breeze P, Conway BA, Farmer SF (1995) A framework for the analysis of mixed time series/point process data–theory and application to the study of physiological tremor, single motor unit discharges and electromyograms. Prog Biophys Mol Biol 64:237–278CrossRefPubMed
Zurück zum Zitat Hasan A, Galea JM, Casula EP, Falkai P, Bestmann S, Rothwell JC (2013) Muscle and timing-specific functional connectivity between the dorsolateral prefrontal cortex and the primary motor cortex. J Cogn Neurosci 25:558–570. doi:10.1162/jocn_a_00338 CrossRefPubMed Hasan A, Galea JM, Casula EP, Falkai P, Bestmann S, Rothwell JC (2013) Muscle and timing-specific functional connectivity between the dorsolateral prefrontal cortex and the primary motor cortex. J Cogn Neurosci 25:558–570. doi:10.​1162/​jocn_​a_​00338 CrossRefPubMed
Zurück zum Zitat Im C-H, Jung Y-J, Lee S, Koh D, Kim D-W, Kim B-M (2010) Estimation of directional coupling between cortical areas using Near-Infrared Spectroscopy (NIRS). Opt Express 18:5730–5739CrossRefPubMed Im C-H, Jung Y-J, Lee S, Koh D, Kim D-W, Kim B-M (2010) Estimation of directional coupling between cortical areas using Near-Infrared Spectroscopy (NIRS). Opt Express 18:5730–5739CrossRefPubMed
Zurück zum Zitat Journee HL (2007) Demodulation of amplitude modulated noise: a mathematical evaluation of a demodulator for pathological tremor. In: EMG’s IEEE transactions on biomedical engineering, pp 304–308 Journee HL (2007) Demodulation of amplitude modulated noise: a mathematical evaluation of a demodulator for pathological tremor. In: EMG’s IEEE transactions on biomedical engineering, pp 304–308
Zurück zum Zitat Kai L, Karsten S, Jon Shah N, Lutz J (2000) Tapping movements according to regular and irregular visual timing signals investigated with fMRI. Neuro Rep 11:1301–1306 Kai L, Karsten S, Jon Shah N, Lutz J (2000) Tapping movements according to regular and irregular visual timing signals investigated with fMRI. Neuro Rep 11:1301–1306
Zurück zum Zitat Kaminski MJ, Blinowska KJ (1991) A new method of the description of the information flow in the brain structures. Biol Cybern 65:203–210CrossRefPubMed Kaminski MJ, Blinowska KJ (1991) A new method of the description of the information flow in the brain structures. Biol Cybern 65:203–210CrossRefPubMed
Zurück zum Zitat Kamiński M, Ding M, Truccolo WA, Bressler SL (2001) Evaluating causal relations in neural systems: Granger causality, directed transfer function and statistical assessment of significance. Biol Cybern 85:145–157. doi:10.1007/s004220000235 CrossRefPubMed Kamiński M, Ding M, Truccolo WA, Bressler SL (2001) Evaluating causal relations in neural systems: Granger causality, directed transfer function and statistical assessment of significance. Biol Cybern 85:145–157. doi:10.​1007/​s004220000235 CrossRefPubMed
Zurück zum Zitat Kinoshita M et al (2010) How does voluntary movement stop resting tremor? Clin Neurophysiol 121:983–985CrossRefPubMed Kinoshita M et al (2010) How does voluntary movement stop resting tremor? Clin Neurophysiol 121:983–985CrossRefPubMed
Zurück zum Zitat Korzeniewska A, Manczak M, Kaminski M, Blinowska KJ, Kasicki S (2003) Determination of information flow direction among brain structures by a modified directed transfer function (dDTF) method. J Neurosci Methods 125:195–207CrossRefPubMed Korzeniewska A, Manczak M, Kaminski M, Blinowska KJ, Kasicki S (2003) Determination of information flow direction among brain structures by a modified directed transfer function (dDTF) method. J Neurosci Methods 125:195–207CrossRefPubMed
Zurück zum Zitat Leff DR, Orihuela-Espina F, Elwell CE, Athanasiou T, Delpy DT, Darzi AW, Yang GZ (2011) Assessment of the cerebral cortex during motor task behaviours in adults: a systematic review of functional near infrared spectroscopy (fNIRS) studies. Neuroimage 54:2922–2936CrossRefPubMed Leff DR, Orihuela-Espina F, Elwell CE, Athanasiou T, Delpy DT, Darzi AW, Yang GZ (2011) Assessment of the cerebral cortex during motor task behaviours in adults: a systematic review of functional near infrared spectroscopy (fNIRS) studies. Neuroimage 54:2922–2936CrossRefPubMed
Zurück zum Zitat Leuchter AF, Newton TF, Cook IA, Walter DO, Rosenberg-Thompson S, Lachenbruch PA (1992) Changes in brain functional connectivity in Alzheimer-type and multi-infarct dementia. Brain 115(Pt 5):1543–1561CrossRefPubMed Leuchter AF, Newton TF, Cook IA, Walter DO, Rosenberg-Thompson S, Lachenbruch PA (1992) Changes in brain functional connectivity in Alzheimer-type and multi-infarct dementia. Brain 115(Pt 5):1543–1561CrossRefPubMed
Zurück zum Zitat Matsumoto R, Nair DR, LaPresto E, Bingaman W, Shibasaki H, Luders HO (2007) Functional connectivity in human cortical motor system: a cortico-cortical evoked potential study. Brain 130:181–197. doi:10.1093/brain/awl257 CrossRefPubMed Matsumoto R, Nair DR, LaPresto E, Bingaman W, Shibasaki H, Luders HO (2007) Functional connectivity in human cortical motor system: a cortico-cortical evoked potential study. Brain 130:181–197. doi:10.​1093/​brain/​awl257 CrossRefPubMed
Zurück zum Zitat Muthuraman M, Heute U, Arning K, Anwar AR, Elble R, Deuschl G, Raethjen J (2012) Oscillating central motor networks in pathological tremors and voluntary movements. What makes the difference? NeuroImage 60:1331–1339CrossRefPubMed Muthuraman M, Heute U, Arning K, Anwar AR, Elble R, Deuschl G, Raethjen J (2012) Oscillating central motor networks in pathological tremors and voluntary movements. What makes the difference? NeuroImage 60:1331–1339CrossRefPubMed
Zurück zum Zitat Nedelko V et al (2010) Age-independent activation in areas of the mirror neuron system during action observation and action imagery. A fMRI study. Restor Neurol Neurosci 28:737–747PubMed Nedelko V et al (2010) Age-independent activation in areas of the mirror neuron system during action observation and action imagery. A fMRI study. Restor Neurol Neurosci 28:737–747PubMed
Zurück zum Zitat Niedermeyer E, da Silva FHL (2005) Electroencephalography: basic principles, clinical applications, and related fields. Lippincott Williams & Wilkins, Philadelphia Niedermeyer E, da Silva FHL (2005) Electroencephalography: basic principles, clinical applications, and related fields. Lippincott Williams & Wilkins, Philadelphia
Zurück zum Zitat Nikouline VV, Linkenkaer-Hansen K, Huttunen J, Ilmoniemi RJ (2001) Interhemispheric phase synchrony and amplitude correlation of spontaneous beta oscillations in human subjects: a magnetoencephalographic study. NeuroReport 12:2487–2491CrossRefPubMed Nikouline VV, Linkenkaer-Hansen K, Huttunen J, Ilmoniemi RJ (2001) Interhemispheric phase synchrony and amplitude correlation of spontaneous beta oscillations in human subjects: a magnetoencephalographic study. NeuroReport 12:2487–2491CrossRefPubMed
Zurück zum Zitat Oldfield RC (1971) The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia 9:97–113CrossRefPubMed Oldfield RC (1971) The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia 9:97–113CrossRefPubMed
Zurück zum Zitat Oostenveld R, Fries P, Maris E, Schoffelen J-M (2010) FieldTrip: open source software for advanced analysis of MEG, EEG, and invasive electrophysiological data. Comput Intell Neurosci. doi:10.1155/2011/156869 Oostenveld R, Fries P, Maris E, Schoffelen J-M (2010) FieldTrip: open source software for advanced analysis of MEG, EEG, and invasive electrophysiological data. Comput Intell Neurosci. doi:10.​1155/​2011/​156869
Zurück zum Zitat Pollok B, Gross J, Dirks M, Timmermann L, Schnitzler A (2004) The cerebral oscillatory network of voluntary tremor. J Physiol 554:871–878CrossRefPubMed Pollok B, Gross J, Dirks M, Timmermann L, Schnitzler A (2004) The cerebral oscillatory network of voluntary tremor. J Physiol 554:871–878CrossRefPubMed
Zurück zum Zitat Rosenberg JR, Amjad AM, Breeze P, Brillinger DR, Halliday DM (1989) The Fourier approach to the identification of functional coupling between neuronal spike trains. Prog Biophys Mol Biol 53:1–31CrossRefPubMed Rosenberg JR, Amjad AM, Breeze P, Brillinger DR, Halliday DM (1989) The Fourier approach to the identification of functional coupling between neuronal spike trains. Prog Biophys Mol Biol 53:1–31CrossRefPubMed
Zurück zum Zitat Sekihara K, Scholz B (1996) Generalized Wiener estimation of three-dimensional current distribution from biomagnetic measurements. IEEE Trans Biomed Eng 43:281–291CrossRefPubMed Sekihara K, Scholz B (1996) Generalized Wiener estimation of three-dimensional current distribution from biomagnetic measurements. IEEE Trans Biomed Eng 43:281–291CrossRefPubMed
Zurück zum Zitat Shibasaki H (2008) Human brain mapping: hemodynamic response and electrophysiology. Clin Neurophysiol 119:731–743CrossRefPubMed Shibasaki H (2008) Human brain mapping: hemodynamic response and electrophysiology. Clin Neurophysiol 119:731–743CrossRefPubMed
Zurück zum Zitat Shirer WR, Ryali S, Rykhlevskaia E, Menon V, Greicius MD (2012) Decoding subject-driven cognitive states with whole-brain connectivity patterns. Cerebral cortex (New York, NY) 22:158–165. doi:10.1093/cercor/bhr099 Shirer WR, Ryali S, Rykhlevskaia E, Menon V, Greicius MD (2012) Decoding subject-driven cognitive states with whole-brain connectivity patterns. Cerebral cortex (New York, NY) 22:158–165. doi:10.​1093/​cercor/​bhr099
Zurück zum Zitat Stephan KE, Friston KJ (2010) Analyzing effective connectivity with functional magnetic resonance imaging. Wiley Interdiscip Rev 1:446–459. doi:10.1002/wcs.58 CrossRef Stephan KE, Friston KJ (2010) Analyzing effective connectivity with functional magnetic resonance imaging. Wiley Interdiscip Rev 1:446–459. doi:10.​1002/​wcs.​58 CrossRef
Zurück zum Zitat Van Veen BD, Van Drongelen W, Yuchtman M, Suzuki A (2002) Localization of brain electrical activity via linearly constrained minimum variance spatial filtering. IEEE Trans Biomed Eng 44:867–880CrossRef Van Veen BD, Van Drongelen W, Yuchtman M, Suzuki A (2002) Localization of brain electrical activity via linearly constrained minimum variance spatial filtering. IEEE Trans Biomed Eng 44:867–880CrossRef
Zurück zum Zitat Witt ST, Laird AR, Meyerand ME (2008) Functional neuroimaging correlates of finger-tapping task variations: an ALE meta-analysis. Neuroimage 42:343–356CrossRefPubMedPubMedCentral Witt ST, Laird AR, Meyerand ME (2008) Functional neuroimaging correlates of finger-tapping task variations: an ALE meta-analysis. Neuroimage 42:343–356CrossRefPubMedPubMedCentral
Zurück zum Zitat Xiong J, Parsons LM, Gao JH, Fox PT (1999) Interregional connectivity to primary motor cortex revealed using MRI resting state images. Hum Brain Mapp 8:151–156CrossRefPubMed Xiong J, Parsons LM, Gao JH, Fox PT (1999) Interregional connectivity to primary motor cortex revealed using MRI resting state images. Hum Brain Mapp 8:151–156CrossRefPubMed
Zurück zum Zitat Zhang L, Zhong G, Wu Y, Vangel M, Jiang B, Kong J (2010) Using granger-geweke causality model to evaluate the effective connecitivty of primary motor cortex, supplementary motor area and cerebellum. J Biomed Sci Eng 3:848–860CrossRefPubMedPubMedCentral Zhang L, Zhong G, Wu Y, Vangel M, Jiang B, Kong J (2010) Using granger-geweke causality model to evaluate the effective connecitivty of primary motor cortex, supplementary motor area and cerebellum. J Biomed Sci Eng 3:848–860CrossRefPubMedPubMedCentral
Metadaten
Titel
Effective Connectivity of Cortical Sensorimotor Networks During Finger Movement Tasks: A Simultaneous fNIRS, fMRI, EEG Study
verfasst von
A. R. Anwar
M. Muthalib
S. Perrey
A. Galka
O. Granert
S. Wolff
U. Heute
G. Deuschl
J. Raethjen
Muthuraman Muthuraman
Publikationsdatum
20.07.2016
Verlag
Springer US
Erschienen in
Brain Topography / Ausgabe 5/2016
Print ISSN: 0896-0267
Elektronische ISSN: 1573-6792
DOI
https://doi.org/10.1007/s10548-016-0507-1

Weitere Artikel der Ausgabe 5/2016

Brain Topography 5/2016 Zur Ausgabe

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Sozialer Aufstieg verringert Demenzgefahr

24.05.2024 Demenz Nachrichten

Ein hohes soziales Niveau ist mit die beste Versicherung gegen eine Demenz. Noch geringer ist das Demenzrisiko für Menschen, die sozial aufsteigen: Sie gewinnen fast zwei demenzfreie Lebensjahre. Umgekehrt steigt die Demenzgefahr beim sozialen Abstieg.

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Was nützt die Kraniektomie bei schwerer tiefer Hirnblutung?

17.05.2024 Hirnblutung Nachrichten

Eine Studie zum Nutzen der druckentlastenden Kraniektomie nach schwerer tiefer supratentorieller Hirnblutung deutet einen Nutzen der Operation an. Für überlebende Patienten ist das dennoch nur eine bedingt gute Nachricht.

Thrombektomie auch bei großen Infarkten von Vorteil

16.05.2024 Ischämischer Schlaganfall Nachrichten

Auch ein sehr ausgedehnter ischämischer Schlaganfall scheint an sich kein Grund zu sein, von einer mechanischen Thrombektomie abzusehen. Dafür spricht die LASTE-Studie, an der Patienten und Patientinnen mit einem ASPECTS von maximal 5 beteiligt waren.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.