Huang Xiaoyuan, Jin Lu, Chang Tengwu, Liu Jian, Qu Yuan, Li Jinyong, Bai Wenju, Li Chuzhong, Wang Jichao
Graduate School, Xinjiang Medical University, Ürümqi, China.
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Front Neurol. 2024 Aug 14;15:1438149. doi: 10.3389/fneur.2024.1438149. eCollection 2024.
Cognitive impairment is a frequent clinical symptom of non-communicating hydrocephalus (NCH) involving multiple domains, including executive function, working memory, visual-spatial function, language, and attention. Functional magnetic resonance imaging (fMRI) can be used to obtain information on functional activity in local brain areas and functional connectivity (FC) across multiple brain regions. However, studies on the associated cognitive impairment are limited; further, the pathophysiological mechanisms of NCH with cognitive impairment remain unclear. Here, we aimed to explore alterations in regional neural activity and FC, as well as the mechanisms of cognitive impairment, in patients with NCH.
Overall, 16 patients with NCH and 25 demographically matched healthy controls (HCs) were assessed using the Mini-Mental State Examination (MMSE) and fMRI. Changes in regional homogeneity (ReHo), degree centrality (DC), and region of interest-based FC were analyzed in both groups. The relationship between fMRI metrics (ReHo, DC, and FC) and MMSE scores in patients with NCH was also investigated.
Compared with the HC group, the NCH group exhibited significantly lower ReHo values in the left precentral and postcentral gyri, and significantly higher ReHo values in the left medial prefrontal cortex (MPFC). The NCH group also showed significantly higher DC values in the bilateral MPFC compared with the HC group. Regarding seed-based FC, the MPFC showed reduced FC values in the right superior parietal and postcentral gyrus in the NCH group compared with those in the HC group. Moreover, within the NCH group, MMSE scores were significantly negatively correlated with the ReHo value in the left MPFC and the DC value in the bilateral MPFC, whereas MMSE scores were significantly positively correlated with FC values. To conclude, regional neural activity and FC are altered in patients with NCH and are correlated with cognitive impairment. These results advance our understanding of the pathophysiological mechanisms underlying the association between NCH and cognitive impairment.
认知障碍是交通性脑积水（NCH）常见的临床症状，涉及多个领域，包括执行功能、工作记忆、视觉空间功能、语言和注意力。功能磁共振成像（fMRI）可用于获取局部脑区功能活动以及多个脑区之间功能连接（FC）的信息。然而，关于相关认知障碍的研究有限；此外，伴有认知障碍的NCH的病理生理机制仍不清楚。在此，我们旨在探讨NCH患者局部神经活动和FC的改变以及认知障碍的机制。
总体而言，使用简易精神状态检查表（MMSE）和fMRI对16例NCH患者和25例人口统计学匹配的健康对照者（HC）进行评估。分析两组的局部一致性（ReHo）、中心度（DC）以及基于感兴趣区的FC的变化。还研究了NCH患者fMRI指标（ReHo、DC和FC）与MMSE评分之间的关系。
与HC组相比，NCH组在左侧中央前回和中央后回的ReHo值显著降低，而在左侧内侧前额叶皮质（MPFC）的ReHo值显著升高。与HC组相比，NCH组在双侧MPFC的DC值也显著更高。关于基于种子的FC，与HC组相比，NCH组中MPFC在右侧顶上小叶和中央后回的FC值降低。此外，在NCH组内，MMSE评分与左侧MPFC的ReHo值以及双侧MPFC的DC值显著负相关，而MMSE评分与FC值显著正相关。总之，NCH患者的局部神经活动和FC发生改变，且与认知障碍相关。这些结果推进了我们对NCH与认知障碍之间关联的病理生理机制的理解。
