Department of Neurosurgery, Chinese PLA General Hospital, Haidian District, Beijing, PR China.
Department of Respiratory Medicine, Anhui Provincial Children's Hospital, Hefei, Anhui, PR China.
Transl Psychiatry. 2023 Oct 5;13(1):308. doi: 10.1038/s41398-023-02615-y.
Cushing's disease is a rare neuroendocrine disorder with excessive endogenous cortisol, impaired cognition, and psychiatric symptoms. Evidence from resting-state fMRI revealed the abnormalities of static brain connectivity in patients with Cushing's disease (CD patients). However, it is unknown whether the CD patients' dynamic functional connectivity would be abnormal and whether the dynamic features are associated with deficits in cognition and psychopathological symptoms. Here, we evaluated 50 patients with Cushing's disease and 57 healthy participants by using resting-state fMRI and dynamic functional connectivity (dFNC) approach. We focused on the dynamic features of default mode network (DMN), salience network (SN), and central executive network (CEN) because these are binding sites for the cognitive-affective process, as well as vital in understanding the pathophysiology of psychiatric disorders. The dFNC was further clustered into four states by k-mean clustering. CD patients showed more dwell time in State 1 but less time in State 4. Intriguingly, group differences in dwell time in these two states can explain the cognitive deficits of CD patients. Moreover, the inter-network connections between DMN and SN and the engagement time in State 4 negatively correlated with anxiety and depression but positively correlated with cognitive performance. Finally, the classifier trained by the dynamic features of these networks successfully classified CD patients from healthy participants. Together, our study revealed the dynamic features of CD patients' brains and found their associations with impaired cognition and emotional symptoms, which may open new avenues for understanding the cognitive and affective deficits induced by Cushing's disease.
库欣病是一种罕见的神经内分泌疾病，其特征是内源性皮质醇过多、认知障碍和精神症状。静息态 fMRI 的证据显示库欣病（CD 患者）患者存在静息态脑连接异常。然而，目前尚不清楚 CD 患者的动态功能连接是否异常，以及动态特征是否与认知和精神病理症状的缺陷有关。在这里，我们通过静息态 fMRI 和动态功能连接（dFNC）方法评估了 50 名库欣病患者和 57 名健康参与者。我们关注默认模式网络（DMN）、突显网络（SN）和中央执行网络（CEN）的动态特征，因为这些网络是认知-情感过程的结合部位，对于理解精神疾病的病理生理学也很重要。dFNC 进一步通过 k-均值聚类分为四个状态。CD 患者在状态 1 停留的时间更多，但在状态 4 停留的时间更少。有趣的是，这两种状态下的组间停留时间差异可以解释 CD 患者的认知缺陷。此外，DMN 和 SN 之间的网络连接以及状态 4 的参与时间与焦虑和抑郁呈负相关，与认知表现呈正相关。最后，由这些网络的动态特征训练的分类器成功地将 CD 患者与健康参与者区分开来。总之，我们的研究揭示了 CD 患者大脑的动态特征，并发现它们与认知障碍和情绪症状有关，这可能为理解库欣病引起的认知和情感缺陷开辟新的途径。
