Impact of Anesthesia on Brain Functional Networks in Moyamoya Disease and Spinal Lesions

IF 5 1区医学 Q1 NEUROSCIENCES

CNS Neuroscience & Therapeutics Pub Date : 2025-04-21 DOI:10.1111/cns.70358

Xuanling Chen, Xuewei Qin, Zhengqian Li, Shengpei Wang, Zhenhu Liang, Hua Zhang, Lan Yao, Xiaoli Li, Ran Duan, Rong Wang, Xiangyang Guo

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Abstract

Aims

To analyze the effects of intravenous propofol combined with remifentanil on whole-brain functional networks in patients with ischemic moyamoya disease (IMMD) and intraspinal space-occupying lesions (SOLs) using resting-state functional magnetic resonance imaging (rs-fMRI).

Methods

Ten patients with IMMD and 10 sex- and age-matched patients with lumbar SOL (normal cerebrovascular findings on preoperative MRI) were recruited. General anesthesia was administered using propofol and remifentanil. rs-fMRI imaging was performed in both awake and anesthetized states. Whole-brain functional network in different states was constructed based on graph theory tools.

Results

In awake patients with IMMD, significant reductions in nodal strength (NS) were observed in the default mode network (DMN), sensorimotor network, and frontoparietal control network (FPN), compared to patients with SOL. Nodal efficiency (NE) showed further significant network declines. Under anesthesia, patients with IMMD: (1) exhibited disease-specific decreases in NS and NE across several networks, potentially reflecting underlying cerebral pathology. (2) Propofol's effects also contributed to significant NS and NE reductions in several brain regions. Changes before and after anesthesia in patients with IMMD were significantly decreased in specific regions (discussed in detail) per analysis of NS versus NE. DMN connectivity correlated moderately with Montreal Cognitive Assessment scores.

Conclusions

Reduced whole-brain functional connectivity in patients with IMMD before anesthesia was similar to the alterations caused by systemic intravenous drugs administered after anesthesia.

Trial Registration

ChiCTR2300075268

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麻醉对烟雾病和脊柱病变患者脑功能网络的影响

目的应用静息状态功能磁共振成像（rs-fMRI）分析静脉注射异丙酚联合瑞芬太尼对缺血性烟雾病（imd）和椎管内占位性病变（SOLs）患者全脑功能网络的影响。方法选取10例imd患者和10例性别、年龄相匹配的腰椎SOL患者（术前MRI显示脑血管正常）。全身麻醉使用异丙酚和瑞芬太尼。在清醒和麻醉状态下均进行rs-fMRI成像。基于图论工具构建了不同状态下的全脑功能网络。结果在清醒的imd患者中，与SOL患者相比，默认模式网络（DMN）、感觉运动网络和额顶叶控制网络（FPN）的节点强度（NS）显著降低，节点效率（NE）进一步显著下降。在麻醉下，imd患者：(1)在多个网络中表现出疾病特异性的NS和NE减少，可能反映了潜在的大脑病理。(2)异丙酚的作用也导致了几个脑区NS和NE的显著减少。根据NS和NE的分析，imd患者麻醉前后特定区域的变化显著降低（详细讨论）。DMN连通性与蒙特利尔认知评估得分中度相关。结论麻醉前imd患者全脑功能连通性降低与麻醉后全身静脉给药引起的改变相似。试验注册ChiCTR2300075268

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CNS Neuroscience & Therapeutics 医学-神经科学

CiteScore

7.30

自引率

12.70%

发文量

240

审稿时长

2 months

期刊介绍： CNS Neuroscience & Therapeutics provides a medium for rapid publication of original clinical, experimental, and translational research papers, timely reviews and reports of novel findings of therapeutic relevance to the central nervous system, as well as papers related to clinical pharmacology, drug development and novel methodologies for drug evaluation. The journal focuses on neurological and psychiatric diseases such as stroke, Parkinson’s disease, Alzheimer’s disease, depression, schizophrenia, epilepsy, and drug abuse.