Inflammation Disrupts the Brain Network of Executive Function after Cardiac Surgery.
Inflammation Disrupts the Brain Network of Executive Function after Cardiac Surgery.
复制标题
心脏手术后炎症扰乱大脑执行功能网络
DOI：
10.1097/sla.0000000000005041
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发表时间：
2023-03-01
影响因子：
9
通讯作者：
中科院分区：
文献类型：
--
作者：
目的：研究受损认知领域的术后功能连接（FC）改变及其与全身炎症的因果关系。背景资料：术后认知功能障碍通常发生在心脏手术后，全身和神经炎症都可能引发其发展。心脏手术后特定认知领域缺陷的FC改变是否受炎症影响仍不清楚。研究方法：17名接受心脏瓣膜置换术的患者在术前和术后第7天和第30天完成了神经心理学测试和脑MRI扫描，并与年龄匹配的健康对照组进行了比较。采集血液样品用于肿瘤坏死因子-a和白细胞介素-6测量。检查左侧背外侧前额叶皮层（DLPFC）的种子到体素FC。使用二元相关和线性回归模型来确定认知功能、FC改变和细胞因子之间的关系。结果：心脏手术后执行功能明显受损。在第7天随访时，与对照组相比，手术患者表现出上级顶叶的DLPFC FC显著降低，默认模式网络中的负连接减弱，包括角回和后扣带回皮质。左侧DLPFC增强了右侧DLPFC和后扣带回皮质的连通性，所有这些都与心脏手术后7天肿瘤坏死因子-a增加和执行功能下降有关。结论：心脏手术后执行控制网络的FC降低及其与默认模式网络的相关性可能是心脏手术后执行功能障碍的原因之一。全身性炎症可能触发这些短暂的FC变化和执行功能障碍。
Objective: To investigate postoperative functional connectivity (FC) alterations across impaired cognitive domains and their causal relationships with systemic inflammation. Background: Postoperative cognitive dysfunction commonly occurs after cardiac surgery, and both systemic and neuroinflammation may trigger its development. Whether FC alterations underlying deficits in specific cognitive domains after cardiac surgery are affected by inflammation remains unclear. Methods: Seventeen patients, who underwent cardiac valve replacement, completed a neuropsychological test battery and brain MRI scan before surgery and on days 7 and 30 after surgery compared to age-matched healthy controls. Blood samples were taken for tumor necrosis factor-a and interleukin-6 measurements. Seed-to-voxel FC of the left dorsolateral prefrontal cortex (DLPFC) was examined. Bivariate correlation and linear regression models were used to determine the relationships among cognitive function, FC alterations, and cytokines. Results: Executive function was significantly impaired after cardiac surgery. At day 7 follow-up, the surgical patients, compared to the controls, demonstrated significantly decreased DLPFC FC with the superior parietal lobe and attenuated negative connectivity in the default mode network, including the angular gyrus and posterior cingulate cortex. The left DLPFC enhanced the connectivity in the right DLPFC and posterior cingulate cortex, all of which were related to the increased tumor necrosis factor-a and decreased executive function up to day 7 after cardiac surgery. Conclusions: The decreased FC of executive control network and its anticorrelation with the default mode network may contribute to executive function deficits after cardiac surgery. Systemic inflammation may trigger these transient FC changes and executive function impairments.
影响因子：
3.2
作者：
Barber AD;Caffo BS;Pekar JJ;Mostofsky SH
通讯作者：
Mostofsky SH