Ai Yinan, Zhang Yu, Zheng Fang, Hu Haojie, Yin Mingyu, Ye Ziying, Zheng Haiqing, Zhang Liying, Hu Xiquan
The Third Affiliated Hospital, Sun Yat-sen University, Department of Rehabilitation Medicine, Guangzhou, China.
New York University, Department of Psychology, College of Arts and Sciences, New York, New York, United States.
Neurophotonics. 2025 Jan;12(1):015008. doi: 10.1117/1.NPh.12.1.015008. Epub 2025 Feb 17.
The current neuromodulation treatment for post-stroke cognitive impairment (PSCI) is formulated based on interhemispheric inhibition, which is particularly relevant in the context of motor disorders after stroke. However, the pathological mechanism of PSCI remains unclear, which is completely different from motor disorders. Therefore, exploring the pathological brain characteristics of PSCI can provide a reliable theoretical basis for effective neuromodulation treatment for it.
We explored different functional connectivity (FC) manifestations of PSCI with or without aphasia via functional near-infrared spectroscopy (fNIRS) to provide a pathological basis for the neuromodulation strategy.
We collected cognitive performance and fNIRS data from patients with PSCI without aphasia (PSCI group, ) and patients with post-stroke aphasia (PSA group, ), using normal cognition stroke patients (SC group, ) and healthy subjects (HC group, ) as controls. Differences in FC among different types of stroke-related cognitive impairment were analyzed.
The overall FC in the PSCI group was lower than that in the SC or HC group, and the FCs of the right hemisphere, the right default mode network (DMN), and the right central executive network (CEN) of PSCI patients were significantly lower than those of the left ones. In the PSA group, the FCs of the DMN and CEN were not lower than those in the SC and HC groups, and the FC of the left hemisphere was significantly greater than that of the right hemisphere. In addition, the FC of PSCI patients with right lesions was weaker than that of left lesions, which was closely correlated with the cognitive scale.
Unlike the left hemisphere activation strategy commonly used previously, our results suggest that the important role of the right hemisphere may be overlooked in PSCI patients with or without aphasia. Future treatment options and studies could consider focusing on the right hemisphere or bilateral hemispheres.
目前用于治疗中风后认知障碍（PSCI）的神经调节疗法是基于半球间抑制制定的，这在中风后的运动障碍背景下尤为相关。然而，PSCI的病理机制仍不清楚，这与运动障碍完全不同。因此，探索PSCI的病理性脑特征可为其有效的神经调节治疗提供可靠的理论基础。
我们通过功能近红外光谱（fNIRS）探索有无失语症的PSCI患者不同的功能连接（FC）表现，为神经调节策略提供病理基础。
我们收集了无失语症的PSCI患者（PSCI组， ）和中风后失语症患者（PSA组， ）的认知表现和fNIRS数据，以正常认知的中风患者（SC组， ）和健康受试者（HC组， ）作为对照。分析了不同类型中风相关认知障碍之间FC的差异。
PSCI组的整体FC低于SC组或HC组，PSCI患者右半球、右侧默认模式网络（DMN）和右侧中央执行网络（CEN）的FC显著低于左侧。在PSA组中.DMN和CEN的FC不低于SC组和HC组，且左半球的FC显著大于右半球。此外，右侧病变的PSCI患者的FC比左侧病变的患者弱，这与认知量表密切相关。
与先前常用的左半球激活策略不同，我们的结果表明，在有或无失语症的PSCI患者中，右半球的重要作用可能被忽视。未来的治疗选择和研究可考虑关注右半球或双侧半球。
