Wang Jiyuan, Huang Jing, Kang Xiong, Dong Huiqing, Lu Jie
Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, 100037, People's Republic of China.
Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, 100053, People's Republic of China.
Eur J Med Res. 2025 May 20;30(1):399. doi: 10.1186/s40001-025-02668-3.
Neuromyelitis Optica Spectrum Disorder (NMOSD) affects the optic nerves and spinal cord, but its longitudinal effects on brain function remain unclear. This study aims to examine changes in brain functional connectivity over time in NMOSD patients and assess their correlation with clinical outcomes, and explore whether shifts in connectivity, especially within the default-mode hub Brodmann area 23 (BA23), are indicative of changes in clinical status.
Clinical assessments and resting-state fMRI data were analysed from 31 non-relapsing NMOSD patients at baseline and during one-year follow-up, and from 20 age- and gender-matched healthy controls (HCs) at baseline. We identified resting-state networks (RSNs) using independent component analysis (ICA). Functional connectivity (FC) was analyzed both within RSNs and between region-of-interest seeds and whole-brain voxels. Comparisons between groups (HCs vs. Baseline, HCs vs. Follow-up) and within the patient group (Baseline vs. Follow-up), as well as correlations with clinical evaluations, were conducted.
Significant FC changes were observed in NMOSD patients. At baseline, NMOSD patients exhibited significantly reduced FC in the lateral visual, sensorimotor, executive control, and left dorsal visual networks; however, these abnormalities showed partial recovery over time. Meanwhile, further decreases were noted in the medial visual and right dorsal visual networks at follow-up. Conversely, a significant increase in FC within the default mode network, particularly in the BA23 region, correlated with improvements in EDSS scores (r = 0.53, p < 0.01). Declines in connectivity between the BA23 region and both the lingual and fusiform gyri were associated with worsening Expanded Disability Status Scale (EDSS) scores (r = - 0.38, p < 0.05) and reduced visual acuity (r = - 0.45, p < 0.05).
NMOSD patients exhibit both compensatory and progressive changes in brain functional connectivity over time. Alterations in the BA23 region are closely associated with clinical outcomes, highlighting its potential as a functional biomarker. Highlights 1. Dynamic alterations in brain functional connectivity were observed in NMOSD patients during follow-up, reflecting both recovery and deterioration. 2. Increased connectivity within the default mode network, especially in the BA23 region, suggests compensatory neural adaptations. 3. Reduced connectivity between BA23 and visual processing regions (fusiform and lingual gyri) was linked to declines in visual acuity and neurological function.
视神经脊髓炎谱系障碍（NMOSD）会影响视神经和脊髓，但其对脑功能的长期影响尚不清楚。本研究旨在探讨NMOSD患者脑功能连接随时间的变化，并评估其与临床结局的相关性，同时探究连接性的变化，尤其是默认模式枢纽布罗德曼23区（BA23）内的变化，是否能指示临床状态的改变。
分析了31例非复发型NMOSD患者在基线期和一年随访期的临床评估及静息态功能磁共振成像（fMRI）数据，以及20名年龄和性别匹配的健康对照者（HCs）在基线期的数据。我们使用独立成分分析（ICA）识别静息态网络（RSNs）。在RSNs内部以及感兴趣区域种子与全脑体素之间分析功能连接（FC）。进行了组间比较（HCs与基线期、HCs与随访期）以及患者组内比较（基线期与随访期），并分析了与临床评估的相关性。
在NMOSD患者中观察到显著的FC变化。在基线期，NMOSD患者在外侧视觉、感觉运动、执行控制和左侧背侧视觉网络中表现出显著降低的FC；然而，这些异常随时间呈现部分恢复。同时，在随访期内侧视觉和右侧背侧视觉网络中FC进一步降低。相反，默认模式网络内，特别是BA23区域的FC显著增加，与扩展残疾状态量表（EDSS）评分的改善相关（r = 0. 53，p < 0.01）。BA23区域与舌回和梭状回之间连接性的下降与扩展残疾状态量表（EDSS）评分恶化（r = -0.38，p < 0.05）和视力下降（r = -0.45，p < 0.05）相关。
随着时间推移，NMOSD患者脑功能连接呈现代偿性和进行性变化。BA23区域的改变与临床结局密切相关，凸显了其作为功能生物标志物的潜力。要点：1. 在随访期间，NMOSD患者脑功能连接出现动态变化，反映了恢复和恶化情况。2. 默认模式网络内连接性增加，尤其是在BA23区域，提示神经的代偿性适应。3. BA23与视觉处理区域（梭状回和舌回）之间连接性降低与视力和神经功能下降有关。
