Li Yongxin, Yu Zeyun, Zhou Xuan, Wu Ping, Chen Jiaxu
School of Traditional Chinese Medicine, Formula-Pattern Research Center, Jinan University, Guangzhou, China.
Acupuncture and Tuina School/Tird Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Front Neurol. 2022 Oct 4;13:996621. doi: 10.3389/fneur.2022.996621. eCollection 2022.
The purpose of the present study was to explore the longitudinal changes in functional homotopy in the default mode network (DMN) and motor network and its relationships with clinical characteristics in patients with stroke.
Resting-state functional magnetic resonance imaging was performed in stroke patients with subcortical ischemic lesions and healthy controls. The voxel-mirrored homotopic connectivity (VMHC) method was used to examine the differences in functional homotopy in patients with stroke between the two time points. Support vector machine (SVM) and correlation analyses were also applied to investigate whether the detected significant changes in VMHC were the specific feature in patients with stroke.
The patients with stroke had significantly lower VMHC in the DMN and motor-related regions than the controls, including in the precuneus, parahippocampus, precentral gyrus, supplementary motor area, and middle frontal gyrus. Longitudinal analysis revealed that the impaired VMHC of the superior precuneus showed a significant increase at the second time point, which was no longer significantly different from the controls. Between the two time points, the changes in VMHC in the superior precuneus were significantly correlated with the changes in clinical scores. SVM analysis revealed that the VMHC of the superior precuneus could be used to correctly identify the patients with stroke from the controls with a statistically significant accuracy of 81.25% ( ≤ 0.003).
Our findings indicated that the increased VMHC in the superior precuneus could be regarded as the neuroimaging manifestation of functional recovery. The significant correlation and the discriminative power in classification results might provide novel evidence to understand the neural mechanisms responsible for brain reorganization after stroke.
本研究旨在探讨中风患者默认模式网络（DMN）和运动网络中功能同伦的纵向变化及其与临床特征的关系。
对患有皮质下缺血性病变的中风患者和健康对照者进行静息态功能磁共振成像。采用体素镜像同伦连接（VMHC）方法检查中风患者在两个时间点之间功能同伦的差异。还应用支持向量机（SVM）和相关性分析来研究检测到的VMHC显著变化是否为中风患者的特定特征。
中风患者在DMN和运动相关区域的VMHC显著低于对照组，包括楔前叶、海马旁回、中央前回、辅助运动区和额中回。纵向分析显示，楔前叶上部受损的VMHC在第二个时间点显著增加，与对照组不再有显著差异。在两个时间点之间，楔前叶上部VMHC的变化与临床评分的变化显著相关。SVM分析显示，楔前叶上部的VMHC可用于从对照组中正确识别中风患者，统计显著准确率为81.25%（≤0.003）。
我们的研究结果表明，楔前叶上部VMHC的增加可被视为功能恢复的神经影像学表现。分类结果中的显著相关性和判别能力可能为理解中风后脑重组的神经机制提供新的证据。
