Miao Guofu, Rao Bo, Wang Sirui, Fang Pinyan, Chen Zhuo, Chen Linglong, Zhang Xin, Zheng Jun, Xu Haibo, Liao Weijing
Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.
Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
Front Neurosci. 2022 Feb 16;15:796530. doi: 10.3389/fnins.2021.796530. eCollection 2021.
Stroke is an important cause of cognitive impairment. Rich club organization, a highly interconnected network brain core region, is closely related to cognition. We hypothesized that the disturbance of rich club organization exists in patients with post-stroke cognitive impairment (PSCI).
We collected data on resting-state functional magnetic resonance imaging (rs-fMRI) with 21 healthy controls (HC), 16 hemorrhagic stroke (hPSCI), and 21 infarct stroke (iPSCI). 3D shape features and first-order statistics of stroke lesions were extracted using 3D slicer software. Additionally, we assessed cognitive function using the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE).
Normalized rich club coefficients were higher in hPSCI and iPSCI than HC at low-degree -levels ( = 1-8 in iPSCI, = 2-8 in hPSCI). Feeder and local connections were significantly decreased in PSCI patients versus HC, mainly distributed in salience network (SN), default-mode network (DMN), cerebellum network (CN), and orbitofrontal cortex (ORB), especially involving the right and left caudate with changed nodal efficiency. The feeder and local connections of significantly between-group difference were positively related to MMSE and MoCA scores, primarily distributed in the sensorimotor network (SMN) and visual network (VN) in hPSCI, SN, and DMN in iPSCI. Additionally, decreased local connections and low-degree ϕ(k) were correlated to 3D shape features and first-order statistics of stroke lesions.
This study reveals the disrupted low-degree level rich club organization and relatively preserved functional core network in PSCI patients. Decreased feeder and local connections in cognition-related networks (DMN, SN, CN, and ORB), particularly involving the caudate nucleus, may offer insight into pathological mechanism of PSCI patients. The shape and signal features of stroke lesions may provide an essential clue for the damage of functional connectivity and the whole brain networks.
中风是认知障碍的重要原因。富集俱乐部组织是大脑中一个高度互联的核心区域网络，与认知密切相关。我们假设中风后认知障碍（PSCI）患者存在富集俱乐部组织紊乱。
我们收集了21名健康对照者（HC）、16名出血性中风患者（hPSCI）和21名梗死性中风患者（iPSCI）的静息态功能磁共振成像（rs-fMRI）数据。使用3D Slicer软件提取中风病灶的三维形状特征和一阶统计量。此外，我们使用蒙特利尔认知评估量表（MoCA）和简易精神状态检查表（MMSE）评估认知功能。
在低度水平（iPSCI中k = 1 - 8，hPSCI中k = 2 - 8），hPSCI和iPSCI的标准化富集俱乐部系数高于HC。与HC相比，PSCI患者的前馈连接和局部连接显著减少，主要分布在突显网络（SN）、默认模式网络（DMN）、小脑网络（CN）和眶额皮质（ORB），尤其涉及左右尾状核，节点效率发生改变。组间差异显著的前馈连接和局部连接与MMSE和MoCA评分呈正相关，主要分布在hPSCI的感觉运动网络（SMN）和视觉网络（VN）、iPSCI的SN和DMN。此外，局部连接减少和低度ϕ(k)与中风病灶的三维形状特征和一阶统计量相关。
本研究揭示了PSCI患者低度水平的富集俱乐部组织紊乱以及功能核心网络相对保留。认知相关网络（DMN、SN、CN和ORB）中前馈连接和局部连接减少，尤其是涉及尾状核，可能有助于深入了解PSCI患者的病理机制。中风病灶的形状和信号特征可能为功能连接和全脑网络损伤提供重要线索。
