Huang Hui-Wei, Liu Rong-Hua, Zeng Jing-Yi, Li Dan, Li Jian-Qi, Chen Hua-Jun
Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, 350001, China.
Department of Gastroenterology Nursing, Fujian Medical University Union Hospital, Fuzhou, 350001, China.
Neuroradiology. 2025 Feb;67(2):371-381. doi: 10.1007/s00234-024-03470-4. Epub 2024 Oct 1.
To investigate dynamical degree centrality (dDC) alteration and its association with metabolic disturbance and cognitive impairment in minimal hepatic encephalopathy (MHE).
Fifty-eight cirrhotic patients (22 with MHE, 36 without MHE [NHE]) and 25 healthy controls underwent resting-state functional magnetic resonance imaging, H-magnetic resonance spectroscopy, and neurocognitive examination based on the Psychometric Hepatic Encephalopathy Score (PHES). We obtained metabolite ratios in the bilateral posterior cingulate cortex and precuneus, including glutamate and glutamine (Glx)/total creatine (tCr), myo-inositol (mI)/tCr, total choline/tCr, and N-acetyl aspartate/tCr. For each voxel, degree centrality was calculated as the sum of its functional connectivity with other voxels in the brain; and sliding-window correlation was used to calculate dDC per voxel.
We observed a stepwise increase in Glx/tCr and a decrease in mI/tCr from NHE to MHE. The intergroup dDC differences were observed in the bilateral posterior cingulate cortex and precuneus (region of interest [ROI1]), bilateral superior-medial frontal gyrus and anterior cingulate cortex (ROI2), and left caudate head. The dDC in ROI2 (r = 0.450, P < 0.001) and mI/tCr (r = 0.297, P = 0.024) was correlated with PHES. Significant correlations were found between dDC in ROI1 and Glx/tCr (r = - 0.413, P = 0.001) and mI/tCr (r = 0.554, P < 0.001). The dDC in ROI2, Glx/tCr, and mI/tCr showed potential for distinguishing NHE from MHE (areas under the curve = 0.859, 0.655, and 0.672, respectively).
Our findings suggested dynamic brain network disorganization in MHE, which was associated with metabolic derangement and neurocognitive impairment.
研究最小肝性脑病（MHE）中动态度中心性（dDC）的改变及其与代谢紊乱和认知障碍的关系。
58例肝硬化患者（22例MHE患者，36例无MHE [NHE]患者）和25名健康对照者接受静息态功能磁共振成像、H磁共振波谱分析以及基于心理测量肝性脑病评分（PHES）的神经认知检查。我们获取了双侧后扣带回皮质和楔前叶的代谢物比率，包括谷氨酸和谷氨酰胺（Glx）/总肌酸（tCr）、肌醇（mI）/tCr、总胆碱/tCr以及N-乙酰天门冬氨酸/tCr。对于每个体素，度中心性计算为其与大脑中其他体素的功能连接总和；并使用滑动窗口相关性来计算每个体素的dDC。
我们观察到从NHE到MHE，Glx/tCr呈逐步增加，mI/tCr呈下降趋势。在双侧后扣带回皮质和楔前叶（感兴趣区域[ROI1]）、双侧额上内侧回和前扣带回皮质（ROI2）以及左侧尾状核头部观察到组间dDC差异。ROI2中的dDC（r = 0.450，P < 0.001）和mI/tCr（r = 0.297，P = 0.024）与PHES相关。在ROI1中的dDC与Glx/tCr（r = - 0.413，P = 0.001）和mI/tCr（r = 0.554，P < 0.001）之间发现显著相关性。ROI2中的dDC、Glx/tCr和mI/tCr显示出区分NHE和MHE的潜力（曲线下面积分别为0.859、0.655和0.672）。
我们的研究结果表明MHE中存在动态脑网络紊乱，这与代谢紊乱和神经认知障碍有关。
