Geometric microstructural damage of white matter with functional compensation in post-stroke
Geometric microstructural damage of white matter with functional compensation in post-stroke
复制标题
中风后脑白质几何微观结构损伤及功能补偿
DOI：
10.1016/j.neuropsychologia.2021.107980
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发表时间：
2021
期刊：
影响因子：
2.6
通讯作者：
Zixiao Li
中科院分区：
文献类型：
--
作者：
Haichao Zhao;Jian Cheng;Jiyang Jiang;Lijun Zuo;Wanlin Zhu;Wei Wen;Perminder Sachdev;Yongjun Wang;Tao Liu;Zixiao Li
背景和目的皮质下缺血性卒中通常会导致梗死区周围白质纤维取向的几何微结构改变。本研究旨在观察伴有和不伴有认知障碍的卒中后患者脑白质纤维取向的微结构变化，并探讨梗死区周围白质损伤对其投射脑区形态和功能连通性的影响。方法应用一种新的数学框架--指向场分析(DFA)，研究了卒中后认知障碍患者(PSCI)、NPSCI患者(n=17)和认知正常患者(CN，n=29)脑白质纤维取向的微结构变化。结果PSCI患者大脑皮质、双侧内囊、外囊、外囊等部位的白质纤维取向广泛异常大钳、小钳和皮质脊髓束与NPSCI和CN的比较。与CN相比，NPSCI患者内囊白质纤维取向的弯曲和扭转也明显增加。基于SEED的功能连通性分析显示，梗死区周围白质缺失对与相关皮质区域的功能连通性有显著影响，提示卒中后损害与代偿共存。此外，这些梗死区周围脑白质损害和功能连接异常与认知评分显著相关。机器学习模型还表明，这些白质纤维取向和功能连通性的变化可以预测卒中后的认知状态。结论卒中后患者梗死区周围白质纤维取向存在病理性损害。梗死灶周围脑白质损害可进一步导致投射脑区功能连接异常。这些梗死区周围白质纤维的变性和相关的功能连接改变可能参与了卒中后的认知损害。
Background and purposeSubcortical ischemic stroke usually leads to the geometric microstructural changes in the orientation of peri-infarct white matter fiber. We conducted the study to determine the microstructural changes in the white matter fiber orientation in post stroke patients with and without cognitive impairment (PSCI, NPSCI), and to investigate the impact of peri-infarct white matter damage on the morphology and functional connectivity of their projective cerebral regions.MethodsA novel mathematical framework called Director Field Analysis (DFA) was applied to study the microstructural changes in the orientation of white matter fiber in PSCI (n = 23), NPSCI (n = 17), and cognitively normal (CN, n = 29) individuals.ResultsPSCI patients had extensive abnormalities in the orientation of white matter fiber in the corpus callosum, bilateral internal capsule, external capsule, forceps major, forceps minor, and corticospinal tract in comparison with NPSCI and CN. NPSCI patients also showed significant increases in bend and twist of white matter fiber orientation in the internal capsule in comparison with CN. Seed-based functional connectivity analysis showed that peri-infarct white matter deficits indicate a significant impact on functional connectivity with related cortical regions, suggesting the coexistence of impairment and compensation in post-stroke. In addition, these peri-infarct white matter damages and abnormal functional connectivity were significantly correlated with cognitive scores. Machine learning model also indicated that these changes in white matter fiber orientation and functional connectivity can predict the cognitive status in post-stroke.ConclusionsPost-stroke patients experienced pathological damage in the orientation of peri-infarct white matter fiber. The peri-infarct white matter damage may further induce the abnormal functional connectivity in projective cerebral regions. These degenerations of peri-infarct white matter fiber and associated functional connectivity changes may mediate the cognitive impairment in post-stroke.