Departments of Radiology, Tianjin Key Laboratory of Functional Imaging & Tianjin Institute of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China.
Departments of Radiology, Tianjin Key Laboratory of Functional Imaging & Tianjin Institute of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China; Department of MRI, The First Affiliated Hospital of Zhengzhou University, Henan 450052, China.
Neuroimage Clin. 2024;42:103612. doi: 10.1016/j.nicl.2024.103612. Epub 2024 Apr 27.
Subcortical stroke may significantly alter the cerebral cortical structure and affect attention function, but the details of this process remain unclear. The study aimed to investigate the neural substrates underlying attention impairment in patients with subcortical stroke.
In this prospective observational study, two distinct datasets were acquired to identify imaging biomarkers underlying attention deficit. The first dataset consisted of 86 patients with subcortical stroke, providing a cross-sectional perspective, whereas the second comprised 108 patients with stroke, offering longitudinal insights. All statistical analyses were subjected to false discovery rate correction upon P < 0.05.
In the chronic-stage data, the stroke group exhibited significantly poorer attention function compared with that of the control group. The cortical structure analysis showed that patients with stroke exhibited decreased cortical thickness of the precentral gyrus and surface area of the cuneus, along with an increase in various frontal, occipital, and parietal cortices regions. The declined attention function positively correlated with the superior frontal gyrus cortical thickness and supramarginal gyrus surface area. In the longitudinal dataset, patients with stroke showed gradually increasing cortical thickness and surface area within regions of obvious structural reorganization. Furthermore, deficient attention positively correlated with supramarginal gyrus surface area both at the subacute and chronic stages post-stroke.
Subcortical stroke can elicit dynamic reorganization of cortical areas associated with attention impairment. Moreover, the altered surface area of the supramarginal gyrus is a potential neuroimaging biomarker for attention deficits.
皮质下卒中可能会显著改变大脑皮质结构,并影响注意力功能,但这一过程的细节尚不清楚。本研究旨在探讨皮质下卒中患者注意力损伤的神经基础。
在这项前瞻性观察研究中,我们使用了两个不同的数据集来确定注意力缺陷的影像学生物标志物。第一个数据集包括 86 例皮质下卒中患者,提供了一个横断面的视角;第二个数据集包括 108 例卒中患者,提供了纵向的见解。所有的统计分析都在 P<0.05 时进行了假发现率校正。
在慢性期数据中,卒中组的注意力功能明显比对照组差。皮质结构分析显示,卒中患者的中央前回皮质厚度和楔前回表面积减少,同时额叶、顶叶和顶叶等多个皮质区域的面积增加。注意力功能下降与额上回皮质厚度和缘上回表面积呈正相关。在纵向数据集,卒中患者表现出明显结构重排区域的皮质厚度和表面积逐渐增加。此外,在亚急性期和慢性期,注意力缺陷与缘上回表面积均呈正相关。
皮质下卒中可引起与注意力损伤相关的皮质区域的动态重组。此外,缘上回表面积的改变可能是注意力缺陷的潜在神经影像学生物标志物。