Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, China.
Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, China.
Mult Scler Relat Disord. 2022 Dec;68:104113. doi: 10.1016/j.msard.2022.104113. Epub 2022 Aug 13.
Cognitive impairment is one of the common symptoms in patients with neuromyelitis optica spectrum disorder (NMOSD). However, the underlying mechanism remains unclear. Resting-state functional magnetic resonance imaging (rs-fMRI) offers the opportunity to reveal the patterns of brain activity in patients with different cognitive states. Accordingly, this study investigated functional connectivity (FC) abnormalities within and between the main cognitive networks in cognitively impaired (CI) patients with NMOSD and their correlations with cognitive performance.
Thirty-four patients with NMOSD and 39 healthy controls (HC) were included. Neuropsychological evaluations and rs-fMRI scanning were performed. Patients were classified as CI (n = 16) or cognitively preserved (CP; n = 18) according to neuropsychological evaluations. Seven components representing six main cognitive networks were selected by group independent component analysis. The differences in inter- and intranetwork FC among CI, CP, and HC groups were assessed. The correlation between FC values and neuropsychological data in NMOSD was calculated.
The CI group showed decreased intranetwork connectivity in the posterior default mode network (pDMN) compared with the HC group (P < 0.05, GRF corrected), and decreased internetwork connectivity between the salience network (SN) and pDMN, and between the SN and right frontoparietal network (rFPN) compared with CP and HC groups. The altered FC values were significantly correlated with cognitive performance in the whole NMOSD group.
The disconnection within the pDMN and between the SN and pDMN or rFPN might suggest the neural substrates underlying cognitive impairment in NMOSD.
认知障碍是视神经脊髓炎谱系疾病（NMOSD）患者的常见症状之一。然而，其潜在机制尚不清楚。静息态功能磁共振成像（rs-fMRI）为揭示不同认知状态患者的大脑活动模式提供了机会。因此，本研究旨在探讨认知障碍（CI）NMOSD 患者主要认知网络内和网络间功能连接（FC）的异常及其与认知表现的相关性。
共纳入 34 例 NMOSD 患者和 39 名健康对照者（HC）。进行神经心理学评估和 rs-fMRI 扫描。根据神经心理学评估，患者分为认知障碍（CI；n=16）和认知正常（CP；n=18）。采用组独立成分分析（group independent component analysis）选取 7 个代表 6 个主要认知网络的成分。评估 CI、CP 和 HC 组间的网络间和网络内 FC 的差异。计算 NMOSD 患者 FC 值与神经心理学数据之间的相关性。
与 HC 组相比，CI 组后默认模式网络（pDMN）内网络连接减少（P<0.05，GRF 校正），突显网络（SN）与 pDMN 之间以及 SN 与右侧额顶网络（rFPN）之间的网络间连接减少，与 CP 和 HC 组相比（P<0.05，GRF 校正）。改变的 FC 值与整个 NMOSD 组的认知表现显著相关。
pDMN 内以及 SN 与 pDMN 或 rFPN 之间的连接中断可能提示 NMOSD 认知障碍的神经基础。
