基于功能连接分析对基底节区卒中患者的偏侧化研究

Study of lateralization changes in the basal ganglia stroke patients based on functional connectivity analysis

目的 探究左侧基底节区卒中患者(left-sided basal ganglia stroke,L-BGS)与右侧基底节区卒中患者(right-sided basal ganglia stroke,R-BGS)大脑静态和动态功能连接的改变,进一步探索卒中偏侧化机制。材料与方法 选取23名L-BGS患者、18名R-BGS患者和20名健康对照(healthy controls,HCs),分别对三组受试者进行静息态功能MRI (resting-state functional MRI,rs-fMRI)扫描。基于rs-fMRI和滑动窗口技术分别对两组患者和HCs进行静态功能连接分析和动态功能连接分析。结果 在静态脑网络连接分析中,同HCs组相比,L-BGS组患者表现为更广泛的网络内连通性增加及减弱(P<0.001,团块水平FWE校正);R-BGS组患者则有着更为广泛的网络间连接受损(P<0.016 7,FDR校正)。在动态连接分析中,相较于HCs组,L-BGS组患者表现出更积极的网络连接重组(P<0.05,FDR校正)。结论 本研究证实在基底节区卒中发生的1个月内,L-BGS患者表现出更积极的静态与动态脑网络连接的代偿性改变。

Objective:To explore the altered static and dynamic functional connectivity of the brain in patients with left-sided basal ganglia stroke(L-BGS)versus right-sided basal ganglia stroke(R-BGS)and to further explore the mechanisms of stroke lateralisation.Materials and Methods:Twenty-three L-BGS patients,18 R-BGS patients and 20 healthy controls(HCs)were analysed,and resting-state functional MRI(rs-fMRI)was performed on each of the three groups of subjects.Based on rs-fMRI and sliding window techniques,static functional connectivity analysis and dynamic functional connectivity analysis were performed on the two groups of patients and HCs,respectively.Results:In static brain network connectivity analysis,L-BGS patients had more extensive increased and decreased intra-network connectivity compared to HCs(P<0.001,cluster level FWE correction);R-BGS patients had more extensive impaired inter-network connectivity compared to HCs(P<0.0167,FDR correction).In dynamic connectivity analyses,L-BGS showed more positive reorganisation of network connectivity compared to HCs(P<0.05,FDR corrected).Conclusions:The present study confirms that within 1 month of basal ganglia stroke onset,L-BGS patients show more positive compensatory changes in static and dynamic brain network connectivity.