Jia Weili, Zhou Yijun, Zuo Lijun, Liu Tao, Li Zixiao
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China.
Brain Res. 2024 Jan 1;1822:148635. doi: 10.1016/j.brainres.2023.148635. Epub 2023 Oct 16.
Brain atrophy and disrupted functional connectivity are often present in patients with poststroke cognitive impairment (PSCI). This study aimed to explore the relationship between remote brain atrophy, connectional diaschisis and cognitive impairment in ischemic stroke patients to provide valuable information about the mechanisms underlying cognitive function recovery.
Forty first-time stroke patients with basal ganglia infarcts and twenty-nine age-matched healthy people were enrolled. All participants underwent T1-weighted and functional MRI scans, comprehensive cognitive function assessments at baseline, and 3-month follow-up. Brain volumes were calculated, and the atrophic regions were regarded as regions of interest in seed-based functional connectivity analyses. Pearson correlation analysis was used to explore the relationships among cognitive performance, brain atrophy, and functional connectivity alterations.
Compared with healthy participants, stroke patients had worse cognitive performance at baseline and the 3-month follow-up. Worse cognitive performance was associated with smaller bilateral thalamus, left hippocampus, and left amygdala volumes, as well as lower functional connectivity between the left thalamus and the left medial superior frontal gyrus, between the right thalamus and the left median cingulate and paracingulate gyri, between the right hippocampus and the left medial superior frontal gyrus, and between the left amygdala and the right dorsolateral superior frontal gyrus.
In patients with basal ganglia infarction, connectional diaschisis between remote brain atrophy and the prefrontal lobe plays a significant role in PSCI. This finding provides new scientific evidence for understanding the mechanisms of PSCI and indicates that the prefrontal lobe may be a target to improve cognitive function after stroke.
脑萎缩和功能连接中断在卒中后认知障碍（PSCI）患者中常存在。本研究旨在探讨缺血性卒中患者中远程脑萎缩、关联性失联络与认知障碍之间的关系，以提供有关认知功能恢复潜在机制的有价值信息。
纳入40例首次发生基底节梗死的卒中患者和29例年龄匹配的健康人。所有参与者均接受T1加权和功能磁共振成像扫描，在基线及3个月随访时进行全面的认知功能评估。计算脑容量，并将萎缩区域视为基于种子点的功能连接分析中的感兴趣区域。采用Pearson相关分析探讨认知表现、脑萎缩和功能连接改变之间的关系。
与健康参与者相比，卒中患者在基线和3个月随访时的认知表现更差。较差的认知表现与双侧丘脑、左侧海马体和左侧杏仁核体积较小，以及左侧丘脑与左侧额上回内侧、右侧丘脑与左侧扣带前回及旁扣带前回、右侧海马体与左侧额上回内侧、左侧杏仁核与右侧额上回背外侧之间的功能连接较低有关。
在基底节梗死患者中，远程脑萎缩与前额叶之间的关联性失联络在PSCI中起重要作用。这一发现为理解PSCI的机制提供了新的科学证据，并表明前额叶可能是改善卒中后认知功能的一个靶点。
