Li Qiong-Ge, Zhao Cheng, Shan Yi, Yin Ya-Yan, Rong Dong-Dong, Zhang Miao, Ma Qing-Feng, Lu Jie
Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China.
Front Neurosci. 2020 Sep 18;14:526645. doi: 10.3389/fnins.2020.526645. eCollection 2020.
This study intends to track whole-brain functional connectivity strength (FCS) changes and the lateralization index (LI) in left basal ganglia (BG) ischemic stroke patients.
Twenty-five patients ( = 25; aged 52.73 ± 10.51 years) with five visits at <7, 14, 30, 90, and 180 days and 26 healthy controls (HCs; = 26; 51.84 ± 8.06 years) were examined with resting-state functional magnetic resonance imaging (rs-fMRI) and motor function testing. FCS and LI were calculated through constructing the voxel-based brain functional network. One-way analysis of covariance (ANOVA) was first performed to obtain longitudinal FCS and LI changes in patients among the five visits (Bonferroni corrected, < 0.05). Then, pairwise comparisons of FCS and LI were obtained during the five visits, and the two-sample test was used to examine between-group differences in FCS [family-wise error (FWE) corrected, < 0.05] and LI. Correlations between connectivity metrics (FCS and LI) and motor function were further assessed.
Compared to HCs, decreased FCS in the patients localized in the calcarine and inferior occipital gyrus (IOG), while increased FCS gathered in the middle prefrontal cortex (MPFC), middle frontal gyrus, and insula ( < 0.05). The LI and FCS of patients first decreased and then increased, which showed significant differences compared with HCs ( < 0.05) and demonstrated a transition at the 30-day visit. Additionally, LI at the third visit was significantly different from those at the other visits ( < 0.05). No significant longitudinal correlations were observed between motor function and FCS or LI ( > 0.05).
Focal ischemic stroke in the left BG leads to extensive alterations in the FCS. Strong plasticity in the functional networks could be reorganized in different temporal dynamics to facilitate motor recovery after BG stroke, contribute to diagnosing the disease course, and estimate the intervention treatment.
本研究旨在追踪左侧基底节区(BG)缺血性脑卒中患者的全脑功能连接强度(FCS)变化及偏侧化指数(LI)。
对25例患者(n = 25;年龄52.73±10.51岁)在第7、14、30、90和180天进行5次随访,并对26例健康对照者(HCs;n = 26;51.84±8.06岁)进行静息态功能磁共振成像(rs-fMRI)和运动功能测试。通过构建基于体素的脑功能网络来计算FCS和LI。首先进行单因素协方差分析(ANOVA)以获得患者在5次随访中的纵向FCS和LI变化(经Bonferroni校正,P < 0.05)。然后,获得5次随访期间FCS和LI的两两比较结果,并使用两样本t检验来检验FCS组间差异[经家族性错误率(FWE)校正,P < 0.05]和LI。进一步评估连接性指标(FCS和LI)与运动功能之间的相关性。
与HCs相比,患者FCS降低的区域位于距状回和枕下回(IOG),而FCS升高的区域集中在额中回、额中回和岛叶(P < 0.05)。患者的LI和FCS先降低后升高,与HCs相比有显著差异(P < 0.05),并在第30天随访时出现转变。此外,第3次随访时的LI与其他随访时的LI有显著差异(P < 0.05)。未观察到运动功能与FCS或LI之间存在显著的纵向相关性(P > 0.05)。
左侧BG局灶性缺血性脑卒中导致FCS广泛改变。功能网络中的强大可塑性可在不同的时间动态中重新组织,以促进BG脑卒中后的运动恢复,有助于诊断病程,并评估干预治疗。