意识障碍的功能性脑网络差异：脑连通性分析

IF 3.1 4区医学 Q2 CLINICAL NEUROLOGY

Journal of Neurorestoratology Pub Date : 2025-04-30 DOI:10.1016/j.jnrt.2025.100208

Xuewei Qin , Xuanling Chen , Xin Zhao , Lan Yao , Zongsheng Xu , Hongchuan Niu , Fengqiao Sun , Kai Li , Changyu Lu , Yuanli Zhao , Shengpei Wang , Xiangyang Guo , Xiaoli Li

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引用次数: 0

摘要

背景：睡眠状态功能磁共振成像提供了对意识障碍患者脑功能的深入了解。我们研究了不同病因的意识障碍中功能性脑网络的变异性，并确定了与康复的潜在相关性。方法在这项单中心前瞻性观察研究中，我们纳入了7例外伤性脑损伤患者，7例脑血管意外患者，以及8例椎管内占位性病变的健康对照组。所有参与者接受静息状态功能磁共振成像，并使用昏迷恢复量表进行评估。区域均匀性值在各组间进行比较，以评估脑功能活动的差异。结果外伤性脑损伤患者右侧梭状回、左侧中扣带和右侧额下回的区域均匀性值升高，左侧颞中回、右侧边缘上回、右侧辅助运动区、右侧中央前回和额下回的区域均匀性值降低。与健康对照组相比，两组均表现出更高的皮质下核区域均匀性值。与脑血管意外患者相比，外伤性脑损伤患者在中央旁小叶和额叶、颞叶和边缘上区域的区域均匀性降低。术前昏迷恢复量表-修订评分与海马区域均匀性呈正相关，与颞中线区域均匀性负相关。3个月后，两组患者的意识均有所改善。结论区域均匀性分析可以识别与意识恢复相关的脑功能活动的改变，为意识障碍的临床评估和预后提供潜在的神经影像学生物标志物。

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Functional brain network discrepancies in disorders of consciousness: A brain connectivity analysis

Background

Resting-state functional magnetic resonance imaging provides insight into brain function in patients with consciousness disorders. We investigated the variability in functional brain networks in consciousness disorders with different etiologies and identified potential correlations with recovery.

Methods

In this single-center prospective observational study, we included seven patients with traumatic brain injury, seven with cerebrovascular accidents, and a healthy control group of eight participants with intraspinal space-occupying lesions. All participants underwent resting-state functional magnetic resonance imaging and were assessed using the Coma Recovery Scale-Revised. Regional homogeneity values were compared across groups to evaluate differences in functional brain activity.

Results

Patients with traumatic brain injury demonstrated increased regional homogeneity values in the right fusiform gyrus, left middle cingulum, and right inferior frontal gyrus and reduced values in the left middle temporal gyrus, right supramarginal gyrus, right supplementary motor area, right precentral gyrus, and inferior frontal gyrus. Both groups exhibited higher regional homogeneity values in subcortical nuclei compared with the healthy control group. Patients with traumatic brain injury had reduced regional homogeneity in the paracentral lobule and frontal, temporal, and supramarginal regions compared with patients with cerebrovascular accidents. Preoperative Coma Recovery Scale-Revised scores were positively correlated with regional homogeneity in the hippocampus and negatively correlated with regional homogeneity in the midline temporal region. For 3 months, both groups showed improved consciousness.

Conclusions

Regional homogeneity analysis can identify alterations in functional brain activity associated with recovery of consciousness, offering potential neuroimaging biomarkers for clinical assessment and prognosis for consciousness disorders.

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来源期刊

Journal of Neurorestoratology CLINICAL NEUROLOGY-

CiteScore

2.10

自引率

18.20%

发文量

审稿时长

12 weeks