Song Jiarui, Lei Ting, Li Yajun, Zhou Lijing, Yan Wei, Li Haiqing, Chen Li
Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Department of Nuclear Medicine, Chongqing Liangjiang New District people's Hospital, Chongqing, China.
Front Mol Neurosci. 2023 Sep 22;16:1200756. doi: 10.3389/fnmol.2023.1200756. eCollection 2023.
Previous studies have focused on the changes of dynamic and static functional connections in cerebral small vessel disease (CSVD). However, the dynamic characteristics of local brain activity are poorly understood. The purpose of this study was to investigate the dynamic cerebral activity changes in patients with CSVD using the dynamic amplitude of low-frequency fluctuation (d-ALFF).
A total of 104 CSVD patients with cognitive impairment (CSVD-CI, = 52) or normal cognition (CSVD-NC, = 52) and 63 matched healthy controls (HCs) were included in this study. Every participant underwent magnetic resonance imaging scans and a battery of neuropsychological examinations. The dynamics of spontaneous brain activity were assessed using dynamic changes in the amplitude of low-frequency fluctuation (ALFF) with the sliding-window method. We used voxel-wise one-way analysis of variance (ANOVA) to compare dynamic ALFF variability among the three groups. Post-hoc -tests were used to evaluate differences between each group pair. Finally, the brain regions with d-ALF values with differences between CSVD subgroups were taken as regions of interest (ROI), and the d-ALFF values corresponding to the ROI were extracted for partial correlation analysis with memory.
(1) There was no significant difference in age ( = 0.120), sex ( = 0.673) and education ( = 0.067) among CSVD-CI, CSVD-NC and HC groups, but there were significant differences Prevalence of hypertension and diabetes mellitus among the three groups ( < 10). There were significant differences in scores of several neuropsychological scales among the three groups ( < 10). (2) ANOVA and post-hoc test showed that there were dynamic abnormalities of spontaneous activity in several brain regions in three groups, mainly located in bilateral parahippocampal gyrus and bilateral hippocampus, bilateral insular and frontal lobes, and the static activity abnormalities in bilateral parahippocampal gyrus and bilateral hippocampal regions were observed at the same time, suggesting that bilateral parahippocampal gyrus and bilateral hippocampus may be the key brain regions for cognitive impairment caused by CSVD. (3) The correlation showed that d-ALFF in the bilateral insular was slightly correlated with the Mini-Mental State Examination (MMSE) score and disease progression rate. The d-ALFF value of the left postcentral gyrus was negatively correlated with the Clock Drawing Test (CDT) score ( = -0.416, = 0.004), and the d-ALFF value of the right postcentral gyrus was negatively correlated with the Rey's Auditory Verbal Learning Test (RAVLT) word recognition ( = -0.320, = 0.028).
There is a wide range of dynamic abnormalities of spontaneous brain activity in patients with CSVD, in which the abnormalities of this activity in specific brain regions are related to memory and execution or emotion.
以往研究主要聚焦于脑小血管病（CSVD）中动态和静态功能连接的变化。然而，局部脑活动的动态特征却鲜为人知。本研究旨在利用低频波动动态幅度（d-ALFF）来探究CSVD患者的动态脑活动变化。
本研究纳入了104例有认知障碍的CSVD患者（CSVD-CI，n = 52）或认知正常的CSVD患者（CSVD-NC，n = 52）以及63例匹配的健康对照（HCs）。每位参与者均接受了磁共振成像扫描和一系列神经心理学检查。采用滑动窗口法，通过低频波动幅度（ALFF）的动态变化来评估自发脑活动的动态变化。我们使用体素水平的单因素方差分析（ANOVA）来比较三组之间的动态ALFF变异性。事后检验用于评估每组之间的差异。最后，将CSVD亚组间d-ALF值存在差异的脑区作为感兴趣区域（ROI），提取ROI对应的d-ALFF值与记忆进行偏相关分析。
（1）CSVD-CI组、CSVD-NC组和HC组在年龄（P = 0.120）、性别（P = 0.673）和教育程度（P = 0.067）方面无显著差异，但三组间高血压和糖尿病的患病率存在显著差异（P < 0.01）。三组在几个神经心理学量表得分上存在显著差异（P < 0.01）。（2）ANOVA和事后检验表明，三组多个脑区存在自发活动的动态异常，主要位于双侧海马旁回和双侧海马、双侧岛叶和额叶，同时观察到双侧海马旁回和双侧海马区域存在静态活动异常，提示双侧海马旁回和双侧海马可能是CSVD导致认知障碍的关键脑区。（3）相关性分析表明，双侧岛叶的d-ALFF与简易精神状态检查表（MMSE）得分和疾病进展率呈轻度相关。左侧中央后回的d-ALFF值与画钟试验（CDT）得分呈负相关（r = -0.416，P = 0.004），右侧中央后回的d-ALFF值与雷伊听觉词语学习测验（RAVLT）单词识别呈负相关（r = -0.320，P = 0.028）。
CSVD患者存在广泛的自发脑活动动态异常，其中特定脑区的这种活动异常与记忆、执行或情感相关。
