Zhang Zheng
Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT, 06520, USA.
Brain Topogr. 2025 Jan 4;38(2):19. doi: 10.1007/s10548-024-01096-6.
Aberrant large-scale resting-state functional connectivity (rsFC) has been frequently documented in ischemic stroke. However, it remains unclear about the altered patterns of within- and across-network connectivity. The purpose of this meta-analysis was to identify the altered rsFC in patients with ischemic stroke relative to healthy controls, as well as to reveal longitudinal changes of network dysfunctions across acute, subacute, and chronic phases. A total of 24 studies were identified as eligible for inclusion in the present meta-analysis. These studies included 269 foci observed in 58 contrasts (558 patients with ischemic stroke; 526 healthy controls; 38.84% female). The results showed: (1) within-network hypoconnectivity in the sensorimotor network (SMN), default mode network (DMN), frontoparietal network (FPN), and salience network (SN), respectively; (2) across-network hypoconnectivity between the SMN and both of the SN and visual network, and between the FPN and both of the SN and DMN; and (3) across-network hyperconnectivity between the SMN and both of the DMN and FPN, and between the SN and both of the DMN and FPN. Meta-regression showed that hypoconnectivity between the DMN and the FPN became less pronounced as the ischemic stroke phase progressed from the acute to the subacute and chronic phases. This study provides the first meta-analytic evidence of large-scale rsFC dysfunction in ischemic stroke. These dysfunctional biomarkers could help identify patients with ischemic stroke at risk for cognitive, sensory, motor, and emotional impairments and further provide potential insight into developing diagnostic models and therapeutic interventions for rehabilitation and recovery.
缺血性卒中患者中常出现异常的大规模静息态功能连接(rsFC)。然而,网络内和网络间连接的改变模式仍不清楚。本荟萃分析的目的是确定缺血性卒中患者相对于健康对照的rsFC改变,以及揭示急性、亚急性和慢性期网络功能障碍的纵向变化。共有24项研究被确定符合纳入本荟萃分析的条件。这些研究包括在58个对比中观察到的269个病灶(558例缺血性卒中患者;526例健康对照;女性占38.84%)。结果显示:(1)感觉运动网络(SMN)、默认模式网络(DMN)、额顶叶网络(FPN)和突显网络(SN)内的网络连接减弱;(2)SMN与SN和视觉网络之间以及FPN与SN和DMN之间的网络间连接减弱;(3)SMN与DMN和FPN之间以及SN与DMN和FPN之间的网络间连接增强。荟萃回归显示,随着缺血性卒中从急性期进展到亚急性期和慢性期,DMN与FPN之间的连接减弱变得不那么明显。本研究提供了缺血性卒中大规模rsFC功能障碍的首个荟萃分析证据。这些功能障碍生物标志物有助于识别有认知、感觉、运动和情感障碍风险的缺血性卒中患者,并进一步为开发康复和恢复的诊断模型及治疗干预提供潜在见解。