目的 探讨脑功能网络拓扑属性在评价经颅直流电刺激(transcranial direct current stimulation,tDCS)改善缺血性脑卒中(ischemic stroke,IS)后认知障碍中的应用价值.材料与方法 前瞻性纳入51例轻度及以上认知功能障碍的IS患者,随机分配到电刺激组(26例)与对照组(25例)进行15天的常规康复治疗,以及tDCS治疗或假刺激.收集两组受试者治疗前后的认知量表评分以及静息态功能磁共振(resting-state functional magnetic resonance imaging,rs-fMRI)数据.基于图论分析方法构建大脑功能网络,比较两组受试者治疗前后的全局与局部拓扑属性差异,以及与认知量表评分改善的相关性.结果 电刺激组与对照组治疗后的简易精神状态检查(Mini-Mental State Examination,MMSE)量表与蒙特利尔认知评估(Montreal Cognitive Assessment,MoCA)量表评分均优于治疗前,但电刺激组的MMSE与MoCA量表评分改善值高于对照组(P＜0.05).电刺激组治疗后全局效率(global efficiency,Eg)和标准化聚类系数(normalized clustering coefficient,γ)升高(P＜0.05,FDR校正);左侧三角部额下回的节点效率(nodal efficiency,Enodal)以及左侧眶部额上回和左侧中央后回的节点聚类系数(nodal clustering coefficient,Cp nodal)升高(P＜0.05,FDR校正).对照组治疗后全局与局部网络拓扑属性差异无统计学意义.相关性分析发现电刺激组治疗后Eg的升高值与MMSE量表评分的改善值呈正相关(r=0.47,P=0.02).结论 tDCS治疗可以改善IS患者的认知功能,并且对部分脑功能网络全局或局部属性结果产生影响,其中Eg的升高可能是认知功能康复的有效预测指标.
The application value of brain functional network topology properties in evaluating tDCS in improving cognitive impairment after ischemic stroke
Objective:To explore the application value of brain functional network topology properties in evaluating transcranial Direct Current Stimulation(tDCS)in improving cognitive impairment after ischemic stroke(IS).Materials and Methods:Prospective inclusion of 51 IS patients with mild or above cognitive impairment,randomly assigned to an electrical stimulation group(26 cases)and a control group(25 cases)for 15 days of routine rehabilitation treatment,as well as tDCS treatment or sham stimulation.Collect cognitive scale scores and resting state functional magnetic resonance imaging(rs-fMRI)data from two groups of subjects before and after treatment.Constructing a brain functional network based on graph theory analysis methods,comparing the differences in global and local topological properties between two groups of subjects before and after treatment,as well as their correlation with cognitive scale scores.Results:The Mini Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA)scores of the electrical stimulation group and the control group after treatment were both better than before treatment,but the improvement in MMSE and MoCA scores of the electrical stimulation group after treatment was higher than that of the control group,with P＜0.05.The global efficiency(Eg)and normalized clustering coefficient(γ)of the electrical stimulation group increased after treatment(P＜0.05,FDR correction);The nodal efficiency(Enodal)of the inferior frontal gyrus in the left triangle and the nodal clustering coefficient(Cp nodal)of the superior frontal gyrus and posterior central gyrus in the left orbit increased(P＜0.05,FDR correction).There was no significant difference in the global and local network topology properties between the control group after treatment.Correlation analysis found that the increase in Eg in the electrical stimulation group after treatment was positively correlated with the improvement in MMSE score(r=0.47,P=0.02).Conclusions:The improvement of cognitive function in IS patients by tDCS combined with conventional rehabilitation therapy is superior to that of conventional rehabilitation therapy alone.At the same time,tDCS can have an impact on the global or local properties results of some brain functional networks,and the increase of Eg may be an effective predictor of cognitive function rehabilitation.
ischemic strokecognitive impairmentmagnetic resonance imagingresting state functional networkgraph theory
国家科技期刊平台
NSTL
万方数据
