Li Lei, Liu Jiayu, Liang Fenxiong, Chen Haidong, Zhan Rungen, Zhao Shengli, Li Tiao, Peng Yongjun
Department of Nuclear Medicine, Zhuhai People's Hospital (Zhuhai Hospital Affiliated With Jinan University), Zhuhai, China.
Department of Neurosurgery, Peking University People's Hospital, Beijing, China.
Front Neurol. 2022 Jul 14;13:782732. doi: 10.3389/fneur.2022.782732. eCollection 2022.
Dysphagia after cerebral infarction (DYS) has been detected in several brain regions through resting-state functional magnetic resonance imaging (rs-fMRI). In this study, we used two rs-fMRI measures to investigate the changes in brain function activity in DYS and their correlations with dysphagia severity.
In this study, a total of 22 patients with DYS were compared with 30 patients without dysphagia (non-DYS) and matched for baseline characteristics. Then, rs-fMRI scans were performed in both groups, and regional homogeneity (ReHo) and fractional amplitude of low-frequency fluctuation (fALFF) values were calculated in both groups. The two-sample -test was used to compare ReHo and fALFF between the groups. Pearson's correlation analysis was used to determine the correlations between the ReHo and fALFF of the abnormal brain regions and the scores of the Functional Oral Intake Scale (FOIS), the Standardized Bedside Swallowing Assessment (SSA), the Videofluoroscopic Swallowing Study (VFSS), and the Penetration-Aspiration Scale (PAS).
Compared with the non-DYS group, the DYS group showed decreased ReHo values in the left thalamus, the left parietal lobe, and the right temporal lobe and significantly decreased fALFF values in the right middle temporal gyrus and the inferior parietal lobule. In the DYS group, the ReHo of the right temporal lobe was positively correlated with the SSA score and the PAS score ( = 0.704, < 0.001 and = 0.707, < 0.001, respectively) but negatively correlated with the VFSS score ( = -0.741, < 0.001). The ReHo of the left parietal lobe was positively correlated with SSA and PAS ( = 0.621, = 0.002 and = 0.682, < 0.001, respectively) but negatively correlated with VFSS ( = -0.679, = 0.001).
The changes in the brain function activity of these regions are related to dysphagia severity. The DYS group with high ReHo values in the right temporal and left parietal lobes had severe dysphagia.
通过静息态功能磁共振成像（rs-fMRI）已在多个脑区检测到脑梗死后吞咽困难（DYS）。在本研究中，我们使用两种rs-fMRI测量方法来研究DYS患者脑功能活动的变化及其与吞咽困难严重程度的相关性。
在本研究中，将总共22例DYS患者与30例无吞咽困难的患者（非DYS）进行比较，并匹配基线特征。然后，对两组患者进行rs-fMRI扫描，并计算两组的局部一致性（ReHo）和低频振幅分数（fALFF）值。采用两样本t检验比较两组之间的ReHo和fALFF。使用Pearson相关分析确定异常脑区的ReHo和fALFF与功能性经口摄食量表（FOIS）、标准化床边吞咽评估（SSA）、电视荧光吞咽造影研究（VFSS）和渗透-误吸量表（PAS）评分之间的相关性。
与非DYS组相比，DYS组左侧丘脑、左侧顶叶和右侧颞叶的ReHo值降低，右侧颞中回和顶下小叶的fALFF值显著降低。在DYS组中，右侧颞叶的ReHo与SSA评分和PAS评分呈正相关（分别为r = 0.704，P < 0.001和r = 0.707，P < 0.001），但与VFSS评分呈负相关（r = -0.741，P < 0.001）。左侧顶叶的ReHo与SSA和PAS呈正相关（分别为r = 0.621，P = 0.002和r = 0.682，P < 0.001），但与VFSS呈负相关（r = -0.679，P = 0.001）。
这些区域的脑功能活动变化与吞咽困难严重程度相关。右侧颞叶和左侧顶叶ReHo值高的DYS组吞咽困难严重。
