Qin Yin, Liu Xiaoying, Guo Xiaoping, Liu Minhua, Li Hui, Xu Shangwen
Department of Rehabilitation Medicine, The 900th Hospital of Joint Logistic Support Force, PLA, Fuzhou, China.
Department of Rehabilitation Medicine, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China.
Front Neurol. 2021 Dec 7;12:771034. doi: 10.3389/fneur.2021.771034. eCollection 2021.
Strokes consistently result in brain network dysfunction. Previous studies have focused on the resting-state characteristics over the study period, while dynamic recombination remains largely unknown. Thus, we explored differences in dynamics between brain networks in patients who experienced subcortical stroke and the effects of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) on dynamic functional connectivity (dFC). A total of 41 patients with subcortical stroke were randomly divided into the LF-rTMS ( = 23) and the sham stimulation groups ( = 18). Resting-state functional MRI data were collected before (1 month after stroke) and after (3 months after stroke) treatment; a total of 20 age- and sex-matched healthy controls were also included. An independent component analysis, sliding window approach, and k-means clustering were used to identify different functional networks, estimate dFC matrices, and analyze dFC states before treatment. We further assessed the effect of LF-rTMS on dFCs in patients with subcortical stroke. Compared to healthy controls, patients with stroke spent significantly more time in state I [ = 0.043, effect size (ES) = 0.64] and exhibited shortened stay in state II ( = 0.015, ES = 0.78); the dwell time gradually returned to normal after LF-rTMS treatment ( = 0.015, ES = 0.55). Changes in dwell time before and after LF-rTMS treatment were positively correlated with changes in the Fugl-Meyer Assessment for Upper Extremity (pr = 0.48, = 0.028). Moreover, patients with stroke had decreased dFCs between the sensorimotor and cognitive control domains, yet connectivity within the cognitive control network increased. These abnormalities were partially improved after LF-rTMS treatment. Abnormal changes were noted in temporal and spatial characteristics of sensorimotor domains and cognitive control domains of patients who experience subcortical stroke; LF-rTMS can promote the partial recovery of dFC. These findings offer new insight into the dynamic neural mechanisms underlying effect of functional recombination and rTMS in subcortical stroke. http://www.chictr.org.cn/index.aspx, Unique.identifier: ChiCTR1800019452.
中风持续导致脑网络功能障碍。以往研究主要关注研究期间的静息态特征，而动态重组情况仍 largely 未知。因此，我们探讨了皮质下中风患者脑网络动态的差异以及低频重复经颅磁刺激（LF-rTMS）对动态功能连接（dFC）的影响。41 例皮质下中风患者被随机分为 LF-rTMS 组（n = 23）和假刺激组（n = 18）。在治疗前（中风后 1 个月）和治疗后（中风后 3 个月）收集静息态功能磁共振成像数据；还纳入了 20 名年龄和性别匹配的健康对照。采用独立成分分析、滑动窗口方法和 k 均值聚类来识别不同功能网络、估计 dFC 矩阵并分析治疗前的 dFC 状态。我们进一步评估了 LF-rTMS 对皮质下中风患者 dFC 的影响。与健康对照相比，中风患者在状态 I 的停留时间显著更长（P = 0.043，效应量（ES）= 0.64），在状态 II 的停留时间缩短（P = 0.015，ES = 0.78）；LF-rTMS 治疗后停留时间逐渐恢复正常（P = 0.015，ES = 0.55）。LF-rTMS 治疗前后停留时间的变化与上肢 Fugl-Meyer 评估的变化呈正相关（pr = 0.48，P = 0.028）。此外，中风患者感觉运动和认知控制域之间的 dFC 降低，但认知控制网络内的连接性增加。LF-rTMS 治疗后这些异常情况部分得到改善。皮质下中风患者的感觉运动域和认知控制域在时间和空间特征上出现异常变化；LF-rTMS 可促进 dFC 的部分恢复。这些发现为皮质下中风中功能重组和 rTMS 作用的动态神经机制提供了新见解。http://www.chictr.org.cn/index.aspx，唯一标识符：ChiCTR1800019452 。
