Ruan Zhao, Zhou Xiaoli, Rao Bo, Li Yidan, Sun Wenbo, Li Tianliang, Gao Lei, Xu Haibo
Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang, Wuhan, Hubei, 430071, China.
Brain Imaging Behav. 2025 Apr;19(2):346-356. doi: 10.1007/s11682-025-00972-4. Epub 2025 Jan 29.
This study investigates post-stroke cognitive impairment (PSCI) by utilizing spectral dynamic causal modeling (spDCM) to examine changes in effective connectivity (EC) within the default mode, executive control, dorsal attention, and salience networks. Forty-one PSCI patients and 41 demographically matched healthy controls underwent 3D-T1WI and resting-state functional magnetic resonance imaging on a 3.0T MRI. The study compared EC among eight representative regions of interest using spDCM and analyzed the correlation between altered EC and cognitive test scores. Subgroup analysis was conducted based on lesion location. The study found a significant increase in EC in the PSCI group, specifically from the posterior cingulate cortex (PCC) to the left and right dorsolateral prefrontal cortex (L_DLPFC and R_DLPFC, respectively), and from the right insula to R_DLPFC (p < 0.05). These changes were significantly negatively correlated with cognitive scores. Subgroup analysis showed increased executive control in PSCI patients with left anterior circulation lesions. Validation through low-order functional connectivity analysis indicated abnormalities dominated by large-scale intra- and inter-network functional connectivity increases in patients with PSCI. The study suggests an increase in effective connectivity between networks, particularly within the triple network model. The findings implicate the PCC and R_DLPFC in the pathophysiology of PSCI, shedding light on its cognitive implications. This study emphasizes the importance of understanding network changes in PSCI from various perspectives, enhancing our understanding of the neural mechanisms underlying PSCI, and establishing a foundation for future research.
本研究通过利用频谱动态因果模型（spDCM）来研究中风后认知障碍（PSCI），以检查默认模式、执行控制、背侧注意和突显网络内有效连接（EC）的变化。41例PSCI患者和41例人口统计学匹配的健康对照在3.0T磁共振成像（MRI）上接受了三维T1加权成像（3D-T1WI）和静息态功能磁共振成像。该研究使用spDCM比较了八个代表性感兴趣区域之间的有效连接，并分析了改变的有效连接与认知测试分数之间的相关性。基于病变位置进行了亚组分析。研究发现，PSCI组的有效连接显著增加，特别是从后扣带回皮质（PCC）到左右背外侧前额叶皮质（分别为左背外侧前额叶皮质和右背外侧前额叶皮质），以及从右侧脑岛到右背外侧前额叶皮质（p < 0.05）。这些变化与认知分数显著负相关。亚组分析显示，左前循环病变的PSCI患者执行控制增加。通过低阶功能连接分析进行的验证表明，PSCI患者中以大规模网络内和网络间功能连接增加为主的异常情况。该研究表明网络之间，特别是在三重网络模型内，有效连接增加。这些发现表明PCC和右背外侧前额叶皮质在PSCI的病理生理学中起作用，揭示了其认知意义。本研究强调了从多个角度理解PSCI中网络变化的重要性，增进了我们对PSCI潜在神经机制的理解，并为未来研究奠定了基础。
