PMC6581709_01
Structural MRI lesion analysis for patients 1 and 2. The lesion of patient 1 (Top) covered parts of the hippocampus and amygdala, but most importantly, regions of the thalamus with projections to sensorimotor regions. The lesion of patient 2 (Bottom) covered great extent of the Brodmann areas 44 and 45, and parts of the primary (SI) and secondary somatosensory cortices (SII), thus strongly affecting the sense of touch. The lesion borders (red outlines) were drawn on the original 3D images, using MRIcron software.
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F1
Ischemic lesions were detected in the right inferior frontal gyrus (pars opercularis), insula, lateral parts of the pre- and post-central gyrus, superior temporal gyrus, supramaginal gyrus, and corona radiata (Figure 1).
PMC6581709_02
Structural MRI lesion analysis for patients 1 and 2. The lesion of patient 1 (Top) covered parts of the hippocampus and amygdala, but most importantly, regions of the thalamus with projections to sensorimotor regions. The lesion of patient 2 (Bottom) covered great extent of the Brodmann areas 44 and 45, and parts of the primary (SI) and secondary somatosensory cortices (SII), thus strongly affecting the sense of touch. The lesion borders (red outlines) were drawn on the original 3D images, using MRIcron software.
fneur-10-00593-g0001.jpg
PMC6581709_02_fneur-10-00593-g0001.jpg
F1
Ischemic lesions were detected in the right inferior frontal gyrus (pars opercularis), insula, lateral parts of the pre- and post-central gyrus, superior temporal gyrus, supramaginal gyrus, and corona radiata (Figure 1).
Test locations of the clinical and automated assessments, and localization confusion matrices of patients 1 and 2 (both with right hemispheric stroke) resulting from the automated assessment. The test locations of the manual clinical assessment are shown in the top left schematic hand, and the ones for of the automated assessment in the top right schematic hand (the colors yellow to blue indicate distal to proximal). The localization confusion matrices (Bottom) show the percentage of discretized reported location of perception based on the nearest stimulation location. Note that for correct interpretation of the matrix, the numbering of the test locations should be related to the specific locations on the hand (Top Right), instead of interpreting the distance of the gray pixels to the diagonal of the matrix, as neighboring numbers do not necessarily correspond to neighboring locations.
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F2
The following locations were tested: volar sides of distal phalanges of the 1st, 3rd, and 5th digit, distal volar side of the 2nd and 5th metacarpal, and center of the thenar eminence (Figure 2, top left). Each glove can apply well-controlled, reproducible vibrotactile stimuli on 24 locations distributed on the volar side of the hand (Figure 2, top right). Based on discretization of the reported perceived location to the nearest stimulation location a confusion matrix was calculated (Figure 2, bottom). Detailed outcome measures for the correct localization rate follow in Figure 2 (bottom), and Figure 3 shows a graphical illustration of the individual offset and spread metrics. For this, the distortion maps illustrating perceived locations using the outcome measures offset and spread (Figure 3, left) and the confusion matrices (Figure 2, bottom left) were computed as described by Rinderknecht et al.. The stimulus was erroneously perceived in two out of five trials on the intermediate phalanx of the ring finger, as shown in the confusion matrix (Figure 2, bottom left). These deficits are reflected in the confusion matrix for the left hand (Figure 2, bottom right), where most perceived locations are in the rightmost squares, representing the palm instead of having a more diagonal appearance.
Visualization of localization performance of patients 1 and 2 (both with right hemispheric stroke). The arrows originate from the stimulus location (thick black circles) and end at the center of the perceived locations. The length of the arrow corresponds to the offset metric (distortion of perception). The semitransparent circle around the arrow endpoint corresponds to the spread of the responses (uncertainty of perception). The colors yellow to blue indicate distal to proximal distribution of locations and is in accordance to Figure 2 (top right).
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F3
Detailed outcome measures for the correct localization rate follow in Figure 2 (bottom), and Figure 3 shows a graphical illustration of the individual offset and spread metrics. For this, the distortion maps illustrating perceived locations using the outcome measures offset and spread (Figure 3, left) and the confusion matrices (Figure 2, bottom left) were computed as described by Rinderknecht et al.. Figure 3 (left) shows a systematic shift from distal phalanges to intermediate phalanges in all five fingers of the left (contralesional) hand in patient 1. Patient 2 showed severe deficits in localization in all fingers from distal toward the center of the palm in the left (contralesional) hand, as visible in the distortion map (Figure 3, right).