Xu Jiaona, Chen Weiwei, Niu Guozhong, Meng Yuting, Qiu Kefan, Li Tongyue, Wang Luoyu, Zhang Liqing, Lv Yating, Ding Zhongxiang
Department of Rehabilitation, Affiliated Hangzhou First People's Hospital, Westlake University School of Medicine, Hangzhou, China.
Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.
Ann Clin Transl Neurol. 2024 Dec;11(12):3152-3162. doi: 10.1002/acn3.52221. Epub 2024 Oct 4.
Granger causal analysis (GCA) and amplitude of low-frequency fluctuation (ALFF) are commonly used to evaluate functional alterations in brain disorders. By combining the GCA and ALFF, this study aimed to investigate the effective connectivity (EC) changes in patients with acute ischemic stroke (AIS) and anterior circulation occlusion after mechanical thrombectomy (MT).
Resting-state functional magnetic resonance imaging (rs-fMRI) data were collected from 43 AIS patients with anterior circulation occlusion within 1 week post-MT and 37 healthy controls. ALFF and GCA were calculated for each participant. Patients were further divided into groups based on prognosis and perfusion levels. The differences in ALFF and EC were compared between AIS patients and healthy controls and between subgroups of patients. Pearson correlations between EC, ALFF values, and clinical characteristics of patients were calculated.
Compared to healthy controls, post-MT, AIS patients exhibited significant ALFF increases in the left precuneus and decreases in the left fusiform gyrus and right caudate. Increased EC from the contralesional lingual gyrus, contralesional putamen, ipsilesional thalamus, and contralesional thalamus to the contralesional caudate was obsrved, while decrease in EC were found for contralesional caudate to the ipsilesional thalamus and medial superior frontal gyrus. EC differences were particularly notable between perfusion groups, with significantly lower EC in the poorly perfused group. EC values were also positively correlated with National Institutes of Health Stroke Scale (NIHSS) scores pre-MT.
In AIS patients, the caudate nucleus was central to the observed EC changes post-MT, characterized by decreased outputs and increased inputs. These changes indicate functional remodeling within the cortico-basal ganglia-thalamic-cortical pathway.
格兰杰因果分析（GCA）和低频振幅（ALFF）常用于评估脑部疾病中的功能改变。本研究通过结合GCA和ALFF，旨在探讨急性缺血性卒中（AIS）患者及机械取栓（MT）后前循环闭塞患者的有效连接（EC）变化。
收集了43例MT后1周内前循环闭塞的AIS患者和37名健康对照的静息态功能磁共振成像（rs-fMRI）数据。计算了每位参与者的ALFF和GCA。患者根据预后和灌注水平进一步分组。比较了AIS患者与健康对照之间以及患者亚组之间ALFF和EC的差异。计算了EC、ALFF值与患者临床特征之间的Pearson相关性。
与健康对照相比，MT后AIS患者左侧楔前叶的ALFF显著增加，左侧梭状回和右侧尾状核的ALFF降低。观察到从对侧舌回、对侧壳核、同侧丘脑和对侧丘脑到对侧尾状核的EC增加，而从对侧尾状核到同侧丘脑和额上回中部的EC降低。灌注组之间的EC差异尤为显著，灌注不良组的EC显著更低。EC值也与MT前的美国国立卫生研究院卒中量表（NIHSS）评分呈正相关。
在AIS患者中，尾状核是MT后观察到的EC变化的核心，其特征是输出减少和输入增加。这些变化表明皮质-基底神经节-丘脑-皮质通路内的功能重塑。
