Functional Alterations In Patients Research Articles

Standardized phase angle: relationship with functionality, muscle mass and postoperative outcomes in surgical cancer patients.

To evaluate the association of standardized phase angle (SPA) with nutritional status, functional parameters, and postoperative outcomes in surgical cancer patients. This prospective study includes 59 cancer patients from Pelotas (Brazil) admitted for elective cancer surgery. We obtained the phase angle through Bioelectrical Impedance Analysis (BIA) and standardized it according to the population's reference values. We estimated the muscle mass using BIA for later calculation of the Skeletal Muscle Index (SMI) and performed handgrip strength (HGS) and gait speed (GS) tests. We used the Patient-Generated Subjective Global Assessment (PG-SGA) to assess the nutritional status. Postoperative complications and duration of hospital stay were evaluated as the outcomes. The prevalence of malnutrition in the sample was 28.8%, according to ASG-PPP. SPA was statistically lower in patients with malnutrition, with lower HGS and reduced GS. For postoperative outcomes, patients with severe complications and those with prolonged hospitalization also had lower SPA values. The greater the number of functional alterations in patients, the lower the SPA value, mainly when associated with reduced muscle mass assessed by BIA, suggesting that muscle mass reduction plays an important role in the association between functional alterations and phase angle in patients with cancer. According to the parameters used in this study, low SPA value was associated with impaired nutritional and functional status and negative outcomes in the analyzed sample.

Association of Anticholinergic Drug Burden With Cognitive and Functional Decline Over Time in Dementia With Lewy Bodies: 1-Year Follow-Up Study.

The purpose of this study was to investigate the relationship between anticholinergic burden (ACB), and cognitive and functional alterations in patients with dementia of Lewy bodies (DLB) during a 1-year follow-up period. This cohort study included patients diagnosed with DLB admitted to a tertiary geriatric outpatient clinic. Cognition, functional performance, and nutritional status were assessed at baseline, 6 months, and 12 months during the follow-up period. The ACB was evaluated, and participants were grouped as ACB ≥1 and ACB=0. A total of 112 patients with DLB (mean age, 79.3 ± 6.8 years; 50.9% female) were included. The mean number of medications was 5.1 ± 4, 56.9% of participants had polypharmacy, and 55.2% had an anticholinergic drug burden. Individuals with ACB ≥1 had lower instrumental activities of daily living (IADL) scores at baseline than those with ACB=0 (P=0.014). The Barthel index and Lawton-Brody IADL scores significantly decreased in the ACB ≥1 group on repetitive measurements over time, whereas only the Lawton-Brody IADL scores worsened in the ACB=0 group (all P<0.001). There were no significant differences in cognitive scores and Mini-Mental State Examination subdomains between the groups. The dependent variable repetitive test revealed a significant deterioration in the orientation subdomain in the ACB ≥1 group over time (P=0.001). Multivariable regression models showed no significant effect of ACB score on cognitive and functional impairment. Our study provides evidence that the use of anticholinergic drugs in this vulnerable population may potentially increase the morbidity by adversely affecting functional status and cognitive orientation.

Correlations between optic nerve OCT and macular functional alterations in patients who undergone successful RRD surgery

Purpose: The aim is to study the correlation between macular function measured by macular integrity assessment (MAIA) microperimetry and optic nerve (ON) evaluated by ON optical coherence tomography (OCT) in patients undergoing surgery after RRD.Methods: Cross‐sectional unicentric study including 64 eyes with RRD surgically treated compared with 136 healthy eyes. All underwent an ophthalmological examination including MAIA and ON OCT according to the total retina (TR) protocol and the retinal nerve fibre layer (RNFL) protocol.Results: Significant decrease in sensitivity and Macular Average Threshold were achieved in RRD group while macular integrity was higher. Temporal (T) sector of the TR protocol and superior (S) and inferior (I) sectors of the RNFL protocol showed greater thickness in the RRD group. Positive correlations were achieved between S sector of the OCT in both protocols and fixation stability P1; nasal (N) sector in the TR protocol and MAIA inferior outer (IO) sector; I sector in the TR protocol and MAIA IO and inferior inner (II) sectors while in the RNFL protocol with MAIA IO sector; T sector in the TR protocol and Macular Average Threshold; C (central) sector in the TR protocol and MAIA IO and II sectors. Negative correlations were showed between S sector in the RNFL protocol and MAIA C sector while in the TR protocol with BCEA 63% area; N sector in the RNFL protocol and MAIA central nasal (CN) sector; I sector in the RNFL protocol and MAIA IO sector and Macular Integrity; T sector in the RNFL protocol and MAIA C sector while in the TR protocol with BCEA 63% and 95% angles; C sector in the RNFL protocol and MAIA C and CN sectors.Conclusions: RRD causes loss of macular sensitivity together with anatomical changes in the ON. Inferior sectors of MAIA showed more correlations with the OCT TR protocol while C sectors correlated with the RNFL protocol.

Functional Alterations in Patients with Bipolar Disorder and Their Unaffected First-Degree Relatives: Insight from Genetic, Epidemiological, and Neuroimaging Data.

Bipolar disorder (BD) profoundly affects cognitive and psychosocial functioning, leading to a significant illness burden on patients and their families. Genetic factors are predominant in the onset of bipolar disorder and functional impairments. This disorder exhibits a strong family aggregation, with heritability estimates reaching up to 80%. Individuals with BD often experience impaired functioning, especially in significant areas such as physical performance, sleep, cognition, interpersonal interactions, socioeconomic status, family and marital relationships, work and school performance, well-being, and life expectancy. However, patients with different subtypes exhibit significant heterogeneity in social functioning, cognition, and creativity levels. There are notable differences in psychosocial and cognitive function in their unaffected first-degree relatives (UFR) who do not suffer but may carry susceptibility genes compared to healthy control (HC) without a family history. The observations indicate common genetic structures between BD patients and their UFR, which results in varying degrees of functional abnormalities. Therefore, this article mainly provides evidence on cognition, creativity, and psychosocial functioning in patients with BD and their UFR to provide a more comprehensive understanding of this critical topic in the field of BD. By integrating various findings, including clinical data and neuroimaging studies, our article aims to provide insights and valuable information for a deeper exploration of the pathogenesis of BD and the development of more targeted therapeutic strategies in the future.

Structural and Functional Brain Changes After Glucocorticoid Therapy in Thyroid-Associated Ophthalmopathy.

To investigate the brain structural and functional alterations in patients with thyroid-associated ophthalmopathy (TAO) before and after glucocorticoid therapy, using voxel-based morphometry (VBM) as well as resting-state functional magnetic resonance imaging (MRI) with amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo). Between 2019 and 2022, 32 patients with TAO and 23 healthy controls underwent pre-therapy MRI in Nanjing, China. Intravenous glucocorticoid therapy was administered to all patients. At 3 months after end of therapy, 26 patients were available for rescanned MRI. VBM, ALFF, and ReHo were used to evaluate the brain structural and functional differences. Before therapy, TAO patients showed significantly decreased gray matter volume (GMV) in the left orbital part of superior frontal gyrus (ORBsup) and medial superior frontal gyrus (SFGmed) than healthy controls. Patients had higher ALFF values in bilateral gyrus rectus and olfactory cortex and lower values in bilateral cuneus. Patients also showed decreased ReHo values in bilateral lingual gyrus. After therapy, increased GMV in the left anterior cingulate gyrus and SFGmed, increased ALFF values in bilateral cuneus and superior occipital gyrus, and increased ReHo values in bilateral SFGmed were found in TAO patients compared to the pre-therapy cohort. Compared to controls, decreased GMV in left ORBsup was observed in post-therapy TAO patients. Our results indicated that TAO might cause functional and structural deficits in the visual and emotional regions of the brain, with recovery in the former and partial restoration in the latter after effective glucocorticoid therapy. These findings may lead to deeper understanding of the pathophysiological mechanism behind TAO.

A multimodal meta-analysis of gray matter alterations in trigeminal neuralgia.

Brain gray matter alterations in patients with trigeminal neuralgia (TN) have been detected in prior neuroimaging studies, but the results are heterogeneous. The current study conducted coordinate-based meta-analyses across neuroimaging studies, aiming to find the pattern of brain anatomic and functional alterations in patients with TN. We performed a systematic literature search of PubMed, Embase, and Web of Science to identify relevant publications. A multimodal meta-analysis for whole-brain voxel-based morphometry (VBM) studies and functional imaging studies in TN was performed using anisotropic effect size-based signed differential mapping. The meta-analysis comprised 10 VBM studies with 398 TN patients and 275 healthy controls, and 13 functional magnetic resonance imaging studies with 307 TN patients and 264 healthy controls. The multimodal meta-analysis showed conjoint structural and functional brain alterations in the right fusiform gyrus and inferior temporal gyrus, bilateral thalamus, left superior temporal gyrus, left insula, and inferior frontal gyrus. The unimodal meta-analysis showed decreased gray matter volume alone in the left putamen, left postcentral gyrus, and right amygdala as well as only functional abnormalities in the left cerebellum, bilateral precuneus, and left middle temporal gyrus. This meta-analysis revealed overlapping anatomic and functional gray matter abnormalities in patients with TN, which may help provide new insights into the neuropathology and potential treatment biomarkers of TN.

Brain functional alterations in patients with anorexia nervosa: A meta-analysis of task-based functional MRI studies

The goal of this study was to discern the neural activation patterns associated with anorexia nervosa (AN) in response to tasks related to body-, food-, emotional-, cognitive-, and reward- processing. A meta-analysis was performed on task-based fMRI studies, revealing that patients with AN showed increased activity in the left superior temporal gyrus and bilaterally in the ACC during a reward-related task. During cognitive-related tasks, patients with AN also showed increased activity in the left superior parietal gyrus, right middle temporal gyrus, but decreased activity in the MCC. Additionally, patients with AN showed increased activity bilaterally in the cerebellum, MCC, and decreased activity bilaterally in the bilateral precuneus/PCC, right middle temporal gyrus, left ACC when they viewed food images. During emotion-related tasks, patients with AN showed increased activity in the left cerebellum, but decreased activity bilaterally in the striatum, right mPFC, and right superior parietal gyrus. Patients with AN also showed increased activity in the right striatum and decreased activity in the right inferior temporal gyrus and bilaterally in the mPFC during body-related tasks. The present meta-analysis provides a comprehensive overview of the patterns of brain activity evoked by task stimuli, thereby augmenting the current comprehension of the pathophysiology in AN.

Mechanistic investigation of acupuncture treatment in patients with migraine: Evidence from brain imaging study (I): 针刺治疗偏头痛的效应机制研究:来自脑影像研究的证据 (I)

ObjectiveMagnetic resonance imaging (MRI) studies have demonstrated anatomical and functional alterations of brain regions in patients with migraine, and the efficacy of acupuncture for migraine could regulate these abnormal alterations. However, its pathogenesis remains ambiguous, and inconsistent results have been reported. The purpose of this study was to explore abnormal structural and functional alterations in patients with migraine using voxel-based morphometry (VBM) analysis and a seed-based functional connectivity (FC) approach and to provide a basis for future research. MethodsThe study recruited 34 patients with migraine and 38 healthy controls who underwent structural and resting-state functional magnetic resonance imaging (fMRI). VBM was evaluated across the whole brain, and group differences in the gray matter (GM) were compared. The significantly altered GM volumes considered as the seeding area were further calculated for the FC of the whole brain. The correlation between structural or functional changes of the brain and clinical features was also evaluated. ResultsPatients with migraine manifested higher GM volumes in the left occipital lobe than healthy controls. Seed-based analyses demonstrated reduced FC between the left occipital lobe and right inferior frontal gyrus, extending to the anterior cingulate cortex (ACC) and right insula. Decreased FC in the left ACC was positively correlated with visual analog scale (VAS) and self-rating anxiety scale (SAS). ConclusionsThis study indicated that patients with migraine exhibited abnormal changes in brain regions, which could facilitate a better understanding of how brain structure and function impact the symptoms of migraine and provide the basis for elucidating the potential mechanisms of acupuncture for migraine. Trial registrationChinese Clinical Trial Registry, Chi CTR2000033995. Registered on 20 June 2020.

Resting-state functional alterations in patients with brain arteriovenous malformations involving language areas.

Brain arteriovenous malformations (AVMs) may involve language areas but usually do not lead to aphasia. This study evaluated resting-state functional alterations and investigated the language reorganization mechanism in AVM patients. Thirty-nine patients with AVMs involving language areas and 32 age- and sex-matched healthy controls were prospectively enrolled. The AVM patients were categorized into three subgroups according to lesion location: the frontal (15 patients), temporal (14 patients), and parietal subgroups (10 patients). All subjects underwent resting-state functional magnetic resonance imaging (rs-fMRI), and the amplitude of low-frequency fluctuation (ALFF) approach was applied to analyze rs-fMRI data. Language abilities were normal in all participants based on the Western Aphasia Battery. Compared with those of healthy subjects, ALFF values significantly increased (FDR corrected p < .01) in the anterior part of the right putamen in the frontal AVM subgroup, in the posterior part of the right inferior and middle temporal gyrus in the temporal AVM subgroup, and in the inferior lateral part of the left cerebellar hemisphere (lobule VIII) and the right inferior parietal lobule in the parietal AVM subgroup. Functional annotation using Neurosynth indicated that the ALFF t-map was only significantly positively associated with the language-related domain (FDR corrected p < .01). In patients with AVMs involving the language cortex, language network reorganization occurs to maintain normal language abilities. The brain areas recruited into the reorganized language network were located in the right cerebral and left cerebellar hemispheres, both of which are nondominant hemispheres. Differences in lesion location led to distinct reorganization patterns.

Resting-state brain functional alterations and their genetic mechanisms in drug-naive first-episode psychosis

Extensive research has established the presence of resting-state brain functional damage in psychosis. However, the genetic mechanisms of such disease phenotype are yet to be unveiled. We investigated resting-state brain functional alterations in patients with drug-naive first-episode psychosis (DFP) by performing a neuroimaging meta-analysis of 8 original studies comprising 500 patients and 469 controls. Combined with the Allen Human Brain Atlas, we further conducted transcriptome-neuroimaging spatial correlations to identify genes whose expression levels were linked to brain functional alterations in DFP, followed by a range of gene functional characteristic analyses. Meta-analysis revealed a mixture of increased and decreased brain function in widespread areas including the default-mode, visual, motor, striatal, and cerebellar systems in DFP. Moreover, these brain functional alterations were spatially associated with the expression of 1662 genes, which were enriched for molecular functions, cellular components, and biological processes of the cerebral cortex, as well as psychiatric disorders including schizophrenia. Specific expression analyses demonstrated that these genes were specifically expressed in the brain tissue, in cortical neurons and immune cells, and during nearly all developmental periods. Concurrently, the genes could construct a protein-protein interaction network supported by hub genes and were linked to multiple behavioral domains including emotion, attention, perception, and motor. Our findings provide empirical evidence for the notion that brain functional damage in DFP involves a complex interaction of polygenes with various functional characteristics.

Cerebellar functional disruption and compensation in mesial temporal lobe epilepsy.

Cerebellar functional alterations are common in patients with mesial temporal lobe epilepsy (MTLE), which contribute to cognitive decline. This study aimed to deepen our knowledge of cerebellar functional alterations in patients with MTLE. In this study, participants were recruited from an ongoing prospective cohort of 13 patients with left TLE (LTLE), 17 patients with right TLE (RTLE), and 30 healthy controls (HCs). Functional magnetic resonance imaging data were collected during a Chinese verbal fluency task. Group independent component (IC) analysis (group ICA) was applied to segment the cerebellum into six functionally separated networks. Functional connectivity was compared among cerebellar networks, cerebellar activation maps, and the centrality parameters of cerebellar regions. For cerebellar functional profiles with significant differences, we calculated their correlation with clinical features and neuropsychological scores. Compared to HCs and patients with LTLE, patients with RTLE had higher cerebellar functional connectivity between the default mode network (DMN) and the oculomotor network and lower cerebellar functional connectivity from the frontoparietal network (FPN) to the dorsal attention network (DAN) (p < 0.05, false discovery rate- (FDR-) corrected). Cerebellar degree centrality (DC) of the right lobule III was significantly higher in patients with LTLE compared to HC and patients with RTLE (p < 0.05, FDR-corrected). Higher cerebellar functional connectivity between the DMN and the oculomotor network, as well as lower cerebellar degree centrality of the right lobule III, was correlated with worse information test performance. Cerebellar functional profiles were altered in MTLE and correlated with long-term memory in patients.

Alterations of degree centrality and functional connectivity in classic trigeminal neuralgia.

Recent neuroimaging studies have indicated a wide range of structural and regional functional alterations in patients with classic trigeminal neuralgia (CTN). However, few studies have focused on the intrinsic functional characteristics of network organization in the whole brain. Therefore, the present study aimed to characterize the potential intrinsic dysconnectivity pattern of the whole brain functional networks at the voxel level using the degree centrality (DC) analysis in CTN patients. Thirty-four patients with CTN and twenty-nine well-matched healthy controls (HCs) participated in this study. All subjects underwent resting-state functional magnetic resonance imaging (rs-MRI) examination and clinical and neuropsychologic assessments. DC is a graph theory-based measurement that represents the overall functional connectivity (FC) numbers between one voxel and other brain voxels. We first investigated brain regions exhibiting abnormal DC, and further identified their perturbation on FC with other brain regions using a seed-based FC analysis in patients with CTN. In addition, correlation analyses were performed to evaluate the relationship between the abnormal DC value and clinical variables in CTN patients. Compared with the HCs, the patients with CTN exhibited significantly greater DC values in the right pallidum and right putamen, and lower DC values in the right lingual gyrus, right calcarine sulcus, left paracentral lobule, and left midcingulate cortex. A further seed-based FC analysis revealed that the right lingual gyrus showed decreased FC within the visual network and with other core brain networks, including the sensorimotor network, default mode network, and salience network, relative to HCs. Additionally, the left midcingulate cortex exhibited decreased FC within the middle cingulate cortex and the visual network in CTN patients. Moreover, the DC value in the left midcingulate cortex was negatively correlated with the illness duration. The present study shows that CTN patients exhibited specific functional connectivity network alterations in the basal ganglia, visual network, and salience network, which may reflect the aberrant neural network communication in pain processing and modulation. These findings may provide novel insight for understanding the mechanisms of pain chronicity in CTN patients.

The impacts of anhedonia on brain functional alterations in patients with major depressive disorder: A resting-state functional magnetic resonance imaging study of regional homogeneity

BackgroundAnhedonia, as one of the core manifestations of major depressive disorder (MDD), has an effect on prognosis of the disease. However, the neuropathology of MDD is complex and the neural basis of anhedonia remains unclear. The aim of the present study was to investigate the impacts of anhedonia on brain functional alterations in patients with MDD. MethodsA total of 62 individuals including MDD patients with anhedonia (n = 22), MDD patients without anhedonia (n = 20), and healthy controls (HCs, n = 20) were recruited. All participants underwent resting-state functional magnetic resonance imaging scanning and intrinsic brain function was explored by using regional homogeneity (ReHo) method. A two-sample t-test was performed to explore ReHo differences between MDD patients and HCs, then analysis of variance (ANOVA) was introduced to obtain brain regions with significant differences among three groups, and finally post hoc tests were calculated for inter-group comparisons. Correlations between ReHo values of each survived area and clinical characteristics in MDD patients were further analyzed. ResultsCompared with HCs, MDD showed increased ReHo in the left superior temporal gyrus (STG) and bilateral inferior frontal gyrus (IFG), as well as decreased ReHo in the left superior frontal gyrus (SFG). Interestingly, this relationship was attenuated and no longer significant after consideration for the effect of anhedonia in MDD patients. MDD patients with anhedonia were more likely to exhibit decreased ReHo in the left SFG and left middle cingulate gyrus (MCG) when comparing to HCs. No significant difference was found between MDD patients without anhedonia and HCs, either the two groups of MDD patients. There was no significant association between ReHo values of each survived area and clinical characteristics in MDD patients. ConclusionsThe present results suggest that the impacts of anhedonia on brain functional alterations in MDD should be emphasized and disturbed intrinsic brain function in the frontal-limbic regions may be associated with anhedonia in MDD patients.

Altered dynamic functional connectivity in rectal cancer patients with and without chemotherapy: a resting-state fMRI study

Purpose: Understanding the mechanism of brain functional alterations in rectal cancer (RC) patients is of great significance to improve the prognosis and quality of life of patients. Additionally, the influence of chemotherapy on brain function in RC patients is still unclear. In this study, we aimed to investigate the alterations of brain functional network dynamics in RC patients and explore the effects of chemotherapy on temporal dynamics of dynamic functional connectivity (DFC). Methods: The group independent component analysis (GICA) and sliding window method were applied to investigate abnormalities of DFC based on resting-state functional magnetic resonance imaging (rs-fMRI) of 18 RC patients without chemotherapy (RC_NC), 21 RC patients with chemotherapy (RC_C) and 33 healthy controls (HC). Then, the Spearman correlation between aberrant properties and clinical measures was calculated. Results: Two discrete states were identified. Compared to HC, RC_NC exhibited increased mean dwell time (MDT) and fractional windows (FW) in state 2 and decreased transition numbers between the two states. Notably, three temporal properties in RC_C showed an intermediate trend in comparison with RC_NC and HC. Furthermore, RC_C also demonstrated abnormal intra- and inter-network connections, involving the visual (VIS), default mode (DM), and cognitive control (CC) networks, and most connections related to VIS were correlated with the severity of anxiety and depression. Conclusions: Our study suggested that abnormal DFC patterns could be manifested in RC patients and chemotherapy would further correct abnormalities of network dynamics, which may provide new insights into the brain functional alterations in patients with RC from the time-varying connectivity perspective.

Altered local gyrification and functional connectivity in type 2 diabetes mellitus patients with mild cognitive impairment: A pilot cross-sectional small-scale single center study

AimsThis research aimed to explore alterations in the local gyrification index (GI) and resting-state functional connectivity (RSFC) in type 2 diabetes mellitus (T2DM) patients with mild cognitive impairment (MCI).MethodsIn this study, 126 T2DM patients with MCI (T2DM-MCI), 154 T2DM patients with normal cognition (T2DM-NC), and 167 healthy controls (HC) were recruited. All subjects underwent a battery of neuropsychological tests. A multimodal approach combining surface-based morphometry (SBM) and seed-based RSFC was used to determine the structural and functional alterations in patients with T2DM-MCI. The relationships among the GI, RSFC, cognitive ability, and clinical variables were characterized.ResultsCompared with the T2DM-NC group and HC group, T2DM-MCI patients showed significantly reduced GI in the bilateral insular cortex. Decreased RSFC was found between the left insula and right precuneus, and the right superior frontal gyrus (SFG). The altered GI was correlated with T2DM duration, global cognition, and episodic memory. The mediation effects of RSFC on the association between GI and cognition were not statistically significant.ConclusionOur results suggest that GI may serve as a novel neuroimaging biomarker to predict T2DM-related MCI and help us to improve the understanding of the neuropathological effects of T2DM-related MCI.

Altered spontaneous brain activity in patients with comitant exotropia before and after surgery: A resting-state fMRI study

Patients with comitant exotropia (CE) would usually develop compromised binocular vision and impaired stereoscopic depth perception, which could result in a profound decrease in quality of life. Although the deviated optic axis could be corrected surgically, the impaired stereovision and sensory eye balance may sometimes remain remnant. This study was to investigate the brain functional alterations in patients with CE before and after surgery, using resting-state functional magnetic resonance imaging (fMRI) with amplitude of low-frequency fluctuation (ALFF). Thirty-five patients with CE were recruited to undergo a preoperative fMRI scan, as well as 24 healthy controls (HCs). Twenty-four of the patients were available for rescanned fMRI one month after surgery. The ALFF method was used to evaluate the group differences of spontaneous brain activity. The correlations between ALFF values and clinical variables were analyzed in the patient group. Preoperatively, compared with HCs, 35 patients with CE showed significantly decreased ALFF values in one cluster involving bilateral calcarine sulcus, lingual gyrus and cuneus. The ALFF values in the above cluster were negatively correlated with disease duration (r = −0.379, P = 0.033). One month after surgery, 24 patients with available rescanned fMRI demonstrated increased ALFF values in one cluster located in bilateral cuneus, calcarine sulcus and lingual gyrus relative to the preoperative collection, while still reduced ALFF values in the cluster involving left calcarine sulcus and lingual gyrus compared with HCs. Our study revealed the functional changes of patients with CE in visual-associated brain areas before and after surgery. The findings may provide a new perspective for understanding the underlying pathological mechanisms of CE.

Brain Structural and Functional Alterations in Multiple Sclerosis-Related Fatigue: A Systematic Review.

Fatigue is one of the most disabling symptoms of multiple sclerosis (MS); it influences patients’ quality of life. The etiology of fatigue is complex, and its pathogenesis is still unclear and debated. The objective of this review was to describe potential brain structural and functional dysfunctions underlying fatigue symptoms in patients with MS. To reach this purpose, a systematic review was conducted of published studies comparing functional brain activation and structural brain in MS patients with and without fatigue. Electronic databases were searched until 24 February 2021. The structural and functional outcomes were extracted from eligible studies and tabulated. Fifty studies were included: 32 reported structural brain differences between patients with and without fatigue; 14 studies described functional alterations in patients with fatigue compared to patients without it; and four studies showed structural and functional brain alterations in patients. The results revealed structural and functional abnormalities that could correlate to the symptom of fatigue in patients with MS. Several studies reported the differences between patients with fatigue and patients without fatigue in terms of conventional magnetic resonance imaging (MRI) outcomes and brain atrophy, specifically in the thalamus. Functional studies showed abnormal activation in the thalamus and in some regions of the sensorimotor network in patients with fatigue compared to patients without it. Patients with fatigue present more structural and functional alterations compared to patients without fatigue. Specifically, abnormal activation and atrophy of the thalamus and some regions of the sensorimotor network seem linked to fatigue.

Gray Matter Structural and Functional Alterations in Idiopathic Blepharospasm: A Multimodal Meta-Analysis of VBM and Functional Neuroimaging Studies

BackgroundNeuroimaging studies have shown gray matter structural and functional alterations in patients with idiopathic blepharospasm (iBSP) but with variations. Here we aimed to investigate the specific and common neurostructural/functional abnormalities in patients with iBSP.MethodsA systematic literature search from PubMed, Web of Science and Embase was conducted to identify relevant publications. We conducted separate meta-analysis for whole-brain voxel-based morphometry (VBM) studies and for functional imaging studies, and a multimodal meta-analysis across VBM and functional studies in iBSP, using anisotropic effect size-based signed differential mapping.ResultsThe structural database comprised 129 patients with iBSP and 144 healthy controls whilst the functional database included 183 patients with iBSP and 253 healthy controls. The meta-analysis of VBM studies showed increased gray matter in bilateral precentral and postcentral gyri, right supplementary motor area and bilateral paracentral lobules, while decreased gray matter in right superior and inferior parietal gyri, left inferior parietal gyrus, left inferior temporal gyrus, left fusiform gyrus and parahippocampal gyrus. The meta-analysis of functional studies revealed hyperactivity in right dorsolateral superior frontal gyrus, left thalamus and right fusiform gyrus, while hypoactivity in left temporal pole, left insula, left precentral gyrus, bilateral precuneus and paracentral lobules, right supplementary motor area and middle frontal gyrus. The multimodal meta-analysis identified conjoint anatomic and functional changes in left precentral gyrus, bilateral supplementary motor areas and paracentral lobules, right inferior occipital gyrus and fusiform gyrus.ConclusionsThe patterns of conjoint and dissociated gray matter alterations identified in the meta-analysis may enhance our understanding of the pathophysiological mechanisms underlying iBSP.

Concurrent brain structural and functional alterations in patients with chronic unilateral vestibulopathy.

Chronic unilateral vestibulopathy (CUVP) is a common chronic vestibular syndrome which may be caused by incomplete vestibular dynamic compensation. Neuroimaging technology provides important clues to explore the mechanism of complicated by vestibular dynamic compensation in patients with CUVP. However, previous studies mostly used positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) to investigate the changes of brain function in these patients during the task state, few studies have investigated the alterations during the resting state, Therefore, the study aimed to investigate the possible brain structural and functional alterations in patients with CUVP and explore the dynamic compensation state in patients with CUVP. We recruited 18 patients with right CUVP and 18 age-, gender-, and education level-matched healthy controls (HCs). Vestibular evaluations, such as videonystagmography and caloric tests, were performed. All participants underwent Dizziness Handicap Inventory (DHI) assessment. All participants underwent multimodal magnetic resonance imaging of the brain, including fMRI and three-dimensional T1-weighted MRI. We analyzed the amplitude of low frequency fluctuations (ALFF), regional homogeneity (ReHo), seed based functional connectivity, and voxel-based morphometry (VBM). Compared with HCs, CUVP patients showed significantly increased ALFF values in the right supplementary motor area, significantly decreased ALFF values in the right middle occipital gyrus, significantly decreased ReHo values in the bilateral superior parietal lobule, and significantly enhanced ReHo values in the bilateral cerebellar hemisphere [both P<0.05, family-wise error (FWE) corrected]. Compared with HCs, patients with CUVP showed increased gray matter volumes in the left medial superior frontal gyrus and left middle cingulate gyrus [P<0.001, false discovery rate (FDR) corrected]. Compared with HCs, in patients with CUVP, functional connectivity was enhanced between the left medial superior frontal gyrus and the left orbital inferior frontal gyrus and left angular gyrus and was significantly decreased between the left medial superior frontal gyrus and the right dorsolateral superior frontal gyrus (both P<0.01, FWE corrected). Pearson correlation analysis showed that there was a positive correlation between DHI score and VBM value of the left medial superior frontal gyrus in patients with CUVP (r=-0.430, P=0.003). This study identified abnormalities of neuronal activity intensity and overall activity synchronization in multiple brain regions in patients with CUVP, suggesting that patients with CUVP have extensive brain functional abnormalities, which in turn affects their spatial perception and motor perception. Increased gray matter volume and functional connectivity of the default mode network may be used as potential imaging biomarkers of chronic symptoms in patients with CUVP.

Concurrent Structural and Functional Patterns in Patients With Amnestic Mild Cognitive Impairment.

Amnestic mild cognitive impairment (aMCI) is a clinical subtype of MCI, which is known to have a high risk of developing Alzheimer’s disease (AD). Although neuroimaging studies have reported brain abnormalities in patients with aMCI, concurrent structural and functional patterns in patients with aMCI were still unclear. In this study, we combined voxel-based morphometry (VBM), amplitude of low-frequency fluctuations (ALFFs), regional homogeneity (Reho), and resting-state functional connectivity (RSFC) approaches to explore concurrent structural and functional alterations in patients with aMCI. We found that, compared with healthy controls (HCs), both ALFF and Reho were decreased in the right superior frontal gyrus (SFG_R) and right middle frontal gyrus (MFG_R) of patients with aMCI, and both gray matter volume (GMV) and Reho were decreased in the left inferior frontal gyrus (IFG_L) of patients with aMCI. Furthermore, we took these overlapping clusters from VBM, ALFF, and Reho analyses as seed regions to analyze RSFC. We found that, compared with HCs, patients with aMCI had decreased RSFC between SFG_R and the right temporal lobe (subgyral) (TL_R), the MFG_R seed and left superior temporal gyrus (STG_L), left inferior parietal lobule (IPL_L), and right anterior cingulate cortex (ACC_R), the IFG_L seed and left precentral gyrus (PRG_L), left cingulate gyrus (CG_L), and IPL_L. These findings highlighted shared imaging features in structural and functional magnetic resonance imaging (MRI), suggesting that SFG_R, MFG_R, and IFG_L may play a major role in the pathophysiology of aMCI, which might be useful to better understand the underlying neural mechanisms of aMCI and AD.