单侧脑卒中患者对侧海马亚区体积的改变及其与认知功能的关系。

Alterations of contralesional hippocampal subfield volumes and relations to cognitive functions in patients with unilateral stroke.

机构信息

School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China.

Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.

出版信息

Brain Behav. 2024 Aug;14(8):e3645. doi: 10.1002/brb3.3645.

DOI:10.1002/brb3.3645

PMID:39135280

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11319231/

Abstract

BACKGROUND

The volumes of the hippocampal subfields are related to poststroke cognitive dysfunctions. However, it remains unclear whether contralesional hippocampal subfield volume contributes to cognitive impairment. This study aimed to investigate the volumetric differences in the contralesional hippocampal subfields between patients with left and right hemisphere strokes (LHS/RHS). Additionally, correlations between contralesional hippocampal subfield volumes and clinical outcomes were explored.

METHODS

Fourteen LHS (13 males, 52.57 ± 7.10 years), 13 RHS (11 males, 51.23 ± 15.23 years), and 18 healthy controls (11 males, 46.94 ± 12.74 years) were enrolled. Contralesional global and regional hippocampal volumes were obtained with T1-weighted images. Correlations between contralesional hippocampal subfield volumes and clinical outcomes, including the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE), were analyzed. Bonferroni correction was applied for multiple comparisons.

RESULTS

Significant reductions were found in contralesional hippocampal as a whole (adjusted p = .011) and its subfield volumes, including the hippocampal tail (adjusted p = .005), cornu ammonis 1 (CA1) (adjusted p = .002), molecular layer (ML) (adjusted p = .004), granule cell and ML of the dentate gyrus (GC-ML-DG) (adjusted p = .015), CA3 (adjusted p = .009), and CA4 (adjusted p = .014) in the RHS group compared to the LHS group. MoCA and MMSE had positive correlations with volumes of contralesional hippocampal tail (p = .015, r = .771; p = .017, r = .763) and fimbria (p = .020, r = .750; p = .019, r = .753) in the LHS group, and CA3 (p = .007, r = .857; p = .009, r = .838) in the RHS group, respectively.

CONCLUSION

Unilateral stroke caused volumetric differences in different hippocampal subfields contralesionally, which correlated to cognitive impairment. RHS leads to greater volumetric reduction in the whole contralesional hippocampus and specific subfields (hippocampal tail, CA1, ML, GC-ML-DG, CA3, and CA4) compared to LHS. These changes are correlated with cognitive impairments, potentially due to disrupted neural pathways and interhemispheric communication.

摘要

背景

海马亚区体积与卒中后认知功能障碍有关。然而，对侧海马亚区体积是否与认知损害有关仍不清楚。本研究旨在探讨左、右侧半球卒中（LHS/RHS）患者对侧海马亚区体积的差异。此外，还探讨了对侧海马亚区体积与临床结局之间的相关性。

方法

纳入 14 例左侧半球卒中患者（13 名男性，52.57±7.10 岁）、13 例右侧半球卒中患者（11 名男性，51.23±15.23 岁）和 18 名健康对照者（11 名男性，46.94±12.74 岁）。采用 T1 加权图像获取对侧海马整体和区域体积。分析对侧海马亚区体积与临床结局（蒙特利尔认知评估量表（MoCA）和简易精神状态检查量表（MMSE））之间的相关性。采用 Bonferroni 校正进行多重比较。

结果

右侧半球卒中组对侧海马整体（调整后 p=0.011）及其亚区体积，包括海马尾部（调整后 p=0.005）、CA1（调整后 p=0.002）、分子层（ML）（调整后 p=0.004）、齿状回颗粒细胞和 ML（GC-ML-DG）（调整后 p=0.015）、CA3（调整后 p=0.009）和 CA4（调整后 p=0.014）体积均显著降低。左侧半球卒中组 MoCA 和 MMSE 与对侧海马尾部（p=0.015，r=0.771；p=0.017，r=0.763）和穹窿（p=0.020，r=0.750；p=0.019，r=0.753）体积呈正相关，右侧半球卒中组 CA3（p=0.007，r=0.857；p=0.009，r=0.838）体积也呈正相关。