Browsing by Author "Chilvers, Matthew J"

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    Grey and White Matter Correlates Underlying Proprioceptive Impairments After Stroke
    (2023-01-25) Chilvers, Matthew J; Dukelow, Sean P; Cluff, Tyler; Kirton, Adam
    Proprioception is our sense of limb position and movement and is an important sense for the accurate control of movement. Proprioception is commonly affected post-stroke, with impairments demonstrated in ~50% of individuals. Despite high prevalence rates, the understanding of the neural correlates of these impairments, at both the grey and white matter level, is incomplete. In Chapter Two, a selective lesion analysis was performed to identify other temporoparietal structures that, when lesioned, resulted in impairments on an arm position matching (APM) and kinaesthesia task, even in the absence of lesions to sensory cortex. Participants with lesions to right temporoparietal regions performed worse on both tasks than their left hemisphere counterparts. In Chapter Three, lesions to, and diffusion properties of, the Superior Longitudinal Fasciculus (SLF), Arcuate Fasciculus (AF) and Middle Longitudinal Fasciculus (MdLF) were assessed in relation to performance on an APM task post-stroke (n=26). Lesions to each tract was associated with worse APM performance, while lower fractional anisotropy of the SLF III and AF was also associated with worse performance. In Chapter Four, the association between tract damage and APM performance was assessed, in addition to differences in the disconnectome between participants with and without APM task impairments. The extent of damage to a perisylvian network of white matter was associated with APM performance. Along with a perisylvian network, disconnection of the medial lemniscus, corpus callosum, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus and optic radiations was also associated with impairments on the APM task. In Chapter Five, the ability of clinical, robotic and neuroimaging data, collected in the subacute stage post-stroke (n=133), was assessed for its utility in predicting chronic proprioceptive impairments. Models which combined variables across modalities (clinical, robotic and neuroimaging) were often the highest performing and could accurately predict impairments at six-months post-stroke. Overall, this thesis advances our understanding of the grey and white matter correlates of proprioceptive impairment post-stroke, something which has been under-investigated to date. Developing a better understanding of the neuroanatomy important for proprioception, and identifying participants at risk of long-term proprioceptive impairments, is key to developing better treatments for proprioception post-stroke.