一项关于中风后心肺功能下降的静息态功能磁共振成像横断面研究。

A resting-state fMRI cross-sectional study of cardiorespiratory fitness decline after stroke.

作者信息

Qu Qingming, Zhang Kexu, Wang Hewei, Zhu Jie, Lin Yingnan, Jia Jie

机构信息

Department of Rehabilitation Medicine, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China.

School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.

出版信息

Front Neurol. 2025 Jan 28;16:1465467. doi: 10.3389/fneur.2025.1465467. eCollection 2025.

DOI:10.3389/fneur.2025.1465467

PMID:40040907

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11877007/

Abstract

OBJECTIVE

The present study aimed to investigate alterations in neural activity and reorganization of functional networks within critical brain regions associated with reduced cardiorespiratory fitness (CRF) in stroke patients. By employing resting-state functional magnetic resonance imaging (fMRI), we sought to identify specific brain areas that may be implicated in CRF decline among this patient population.

METHODS

A total of 22 patients with stroke and 15 healthy subjects matched for age, gender, and body mass index were recruited. Rehabilitation assessments included peak oxygen uptake (VOpeak), peak work-rate, 10-meter walk test (10mWT), five times sit-to-stand test (FTSST), and 6-min walking distance (6MWD). Resting-state fMRI data were collected for the two groups, and correlation between changes in the amplitude of low-frequency fluctuations (ALFF) and CRF was analyzed to detect brain regions related to CRF and local neural activity in patients with stroke. On the basis of ALFF analysis, brain network analysis was performed, and the CRF-related brain regions in patients with stroke were selected as seed points. Functional connectivity (FC) analysis was the used to identify brain regions and networks potentially associated with CRF in patients with stroke.

RESULTS

Patients with stroke exhibited significantly lower VOpeak, peak work-rate, 10mWT, and 6MWD compared to healthy controls ( < 0.001). FTSST was significantly higher in patients with stroke than healthy controls ( < 0.001). ALFF analysis identified CRF-related brain regions in patients with stroke, including the ipsilesional superior temporal gyrus ( = 0.56947, = 0.00036), middle frontal gyrus ( = 0.62446, = 0.00006), and precentral gyrus ( = 0.56866, = 0.00036). FC analysis revealed that the functional connectivity of brain regions related to CRF in patients with stroke involved the ipsilesional M1 to ipsilesional precentral gyrus and contralesional postcentral gyrus, and the correlation coefficients were = 0.54802 ( = 0.00065) and = 0.49511 ( = 0.0025), respectively. The correlation coefficients of ipsilesional middle frontal gyrus to contralesional middle frontal gyrus, angular gyrus and ipsilesional superior frontal gyrus were = 0.58617 ( = 0.00022), = 0.57735 ( = 0.00028), and = -0.65229 ( = 0.00002), respectively.

CONCLUSION

This study observed that CRF levels were lower in stroke patients compared to those in healthy individuals. Resting fMRI analysis was applied to identify CRF-related brain regions (ipsilesional superior temporal, middle frontal, precentral gyri) and networks in patients with stroke.

CLINICAL TRIAL REGISTRATION

https://www.chictr.org.cn/showproj.html?proj=151095.

摘要

目的

本研究旨在调查中风患者中与心肺适能（CRF）降低相关的关键脑区神经活动变化和功能网络重组。通过采用静息态功能磁共振成像（fMRI），我们试图确定在该患者群体中可能与CRF下降有关的特定脑区。

方法

共招募了22名中风患者和15名年龄、性别及体重指数相匹配的健康受试者。康复评估包括峰值摄氧量（VOpeak）、峰值工作率、10米步行试验（10mWT）、五次坐立试验（FTSST）和6分钟步行距离（6MWD）。收集两组的静息态fMRI数据，分析低频波动幅度（ALFF）变化与CRF之间的相关性，以检测中风患者中与CRF及局部神经活动相关的脑区。基于ALFF分析进行脑网络分析，并将中风患者中与CRF相关的脑区选为种子点。采用功能连接（FC）分析来识别中风患者中可能与CRF相关的脑区和网络。

结果

与健康对照组相比，中风患者的VOpeak、峰值工作率、10mWT和6MWD显著更低（<0.001）。中风患者的FTSST显著高于健康对照组（<0.001）。ALFF分析确定了中风患者中与CRF相关的脑区，包括患侧颞上回（=0.56947，=0.00036）、额中回（=0.62446，=0.00006）和中央前回（=0.56866，=0.00036）。FC分析显示，中风患者中与CRF相关的脑区功能连接涉及患侧M1至患侧中央前回和对侧中央后回，相关系数分别为=0.54802（=0.00065）和=0.49511（=0.0025）。患侧额中回与对侧额中回、角回和患侧额上回的相关系数分别为=0.58617（=0.00022）、=0.57735（=0.00028）和=-0.65229（=0.00002）。