Differential Reorganization of SMA Subregions After Stroke: A Subregional Level Resting-State Functional Connectivity Study
Differential Reorganization of SMA Subregions After Stroke: A Subregional Level Resting-State Functional Connectivity Study
复制标题
中风后 SMA 亚区域的差异重组：亚区域水平静息态功能连接研究
DOI：
10.3389/fnhum.2019.00468
复制
发表时间：
2020-02-28
影响因子：
2.9
通讯作者：
Qin, Wen
中科院分区：
文献类型：
--
作者：
Liu, Huaigui;Cai, Wangli;Qin, Wen
背景和目的：人类辅助运动区（SMA）包含SMA固有和前SMA两个功能亚区;然而，中风后这两个SMA亚区的重组模式仍不确定。同时，局灶性皮质下病变可能会影响大脑网络的整体功能重组。我们试图通过静息态功能连接（rsFC）分析来确定皮质下卒中后SMA亚区的差异性重组。方法：对25例表现出良好恢复的整体运动功能（Fugl-Meyer评分>90）的慢性包膜卒中患者进行静息态功能MRI检查。结果：脑卒中患者和正常对照者的SMA各亚区的rsFC均与额岛皮质（FIC）存在共同的rsFC，但SMA proper和preSMA主要分别与感觉运动区和认知相关区相关。在脑卒中患者中，SMA固有区和preSMA表现出完全不同的功能重组模式：前者表现出运动执行网络的初级感觉运动区和尾侧扣带运动区（CMA）的rsFC增加，而后者表现出运动控制网络的喙侧CMA的rsFC增加。两个SMA亚区均显示卒中患者FIC的rsFC降低;前SMA还显示前额叶皮质（PFC）的rsFC降低。虽然两个SMA亚区都表现出与认知相关区域的功能断开，但SMA本身与运动执行网络内的功能重组有关，而preSMA参与中风患者运动控制网络内的功能重组。
Background and Purpose: The human supplementary motor area (SMA) contains two functional subregions of the SMA proper and preSMA; however, the reorganization patterns of the two SMA subregions after stroke remain uncertain. Meanwhile, a focal subcortical lesion may affect the overall functional reorganization of brain networks. We sought to identify the differential reorganization of the SMA subregions after subcortical stroke using the resting-state functional connectivity (rsFC) analysis.Methods: Resting-state functional MRI was conducted in 25 patients with chronic capsular stroke exhibiting well-recovered global motor function (Fugl-Meyer score >90). The SMA proper and preSMA were identified by the rsFC-based parcellation, and the rsFCs of each SMA subregion were compared between stroke patients and healthy controls.Results: Despite common rsFC with the fronto-insular cortex (FIC), the SMA proper and preSMA were mainly correlated with the sensorimotor areas and cognitive-related regions, respectively. In stroke patients, the SMA proper and preSMA exhibited completely different functional reorganization patterns: the former showed increased rsFCs with the primary sensorimotor area and caudal cingulate motor area (CMA) of the motor execution network, whereas the latter showed increased rsFC with the rostral CMA of the motor control network. Both of the two SMA subregions showed decreased rsFC with the FIC in stroke patients; the preSMA additionally showed decreased rsFC with the prefrontal cortex (PFC).Conclusion: Although both SMA subregions exhibit functional disconnection with the cognitive-related areas, the SMA proper is implicated in the functional reorganization within the motor execution network, whereas the preSMA is involved in the functional reorganization within the motor control network in stroke patients.