Porcu Michele, Cocco Luigi, Cau Riccardo, Suri Jasjit S, Wintermark Max, Puig Josep, Qi Yang, Lanzino Giuseppe, Caulo Massimo, Saba Luca
Department of Radiology, AOU Cagliari, University of Cagliari, Cagliari, Italy.
Department of Medical Imaging, Azienda Ospedaliera Universitaria Di Cagliari, S.S: 554, km 4,500, Monserrato, CAP: 09042, Cagliari, Italy.
Brain Imaging Behav. 2022 Oct;16(5):2037-2048. doi: 10.1007/s11682-022-00674-1. Epub 2022 May 27.
This study aimed to evaluate the differences of brain connectivity between healthy subjects (HS) and patients with extracranial internal carotid artery (eICA) stenosis before and after carotid endarterectomy (CEA). An exploratory prospective study was designed. The study population consisted of a patient group (PG) of 20 patients with eICA stenosis eligible for CEA, and a control group (CG) of 20 HS, matched for age and sex. The subjects of the PG group underwent Magnetic Resonance Imaging (MRI) for resting-state functional connectivity MRI (rs-fc MRI) analysis within one week from the CEA (pre-CEA) and 12 months following CEA (post-CEA). The CG underwent a single MRI with the same protocol utilized for the PG. Three region-of-interest to region-of-interest (ROI-to-ROI) rs-fc MRI analyses were conducted: analysis 1 to compare pre-CEA PG and CG; analysis 2 to compare pre-CEA PG and post-CEA PG; analysis 3 to compare post-CEA PG and CG. The Functional Network Connectivity multivariate parametric technique was used for statistical analysis, adopting a p-uncorrected (p-unc) < 0.05 as connection threshold, and a cluster level False Discovery Rate corrected p (p-FDR) < 0.05 as cluster threshold. The clusters were defined by using a data-driven hierarchical clustering procedure. Analysis 1 revealed two clusters of reduced interhemispheric connectivity of pre-CEA PG when compared to CG. Analysis 2 and 3 showed no statistically significant differences. Our exploratory analysis suggests that patients with eICA stenosis have reduced interhemispheric connectivity when compared to a matched control group, and this difference was not evident anymore following endarterectomy.
本研究旨在评估健康受试者（HS）与颅外颈内动脉（eICA）狭窄患者在颈动脉内膜切除术（CEA）前后脑连接性的差异。设计了一项探索性前瞻性研究。研究人群包括20例符合CEA条件的eICA狭窄患者组成的患者组（PG）和20例年龄和性别匹配的HS组成的对照组（CG）。PG组的受试者在CEA前1周内（CEA前）和CEA后12个月（CEA后）接受磁共振成像（MRI）以进行静息态功能连接MRI（rs-fc MRI）分析。CG组按照与PG组相同的方案进行单次MRI检查。进行了三项感兴趣区域到感兴趣区域（ROI-to-ROI）的rs-fc MRI分析：分析1比较CEA前的PG组和CG组；分析2比较CEA前的PG组和CEA后的PG组；分析3比较CEA后的PG组和CG组。采用功能网络连接多变量参数技术进行统计分析，采用未校正的p值（p-unc）<0.05作为连接阈值，采用聚类水平错误发现率校正的p值（p-FDR）<0.05作为聚类阈值。通过数据驱动的层次聚类程序定义聚类。分析1显示，与CG组相比，CEA前的PG组半球间连接性降低的两个聚类。分析2和3显示无统计学显著差异。我们的探索性分析表明，与匹配的对照组相比，eICA狭窄患者的半球间连接性降低，而这种差异在动脉内膜切除术后不再明显。
