Dynamic changes of resting state functional network following acute ischemic stroke

Altered Intrinsic Brain Activity in Ischemic Stroke Patients Assessed Using the Percent Amplitude of a Fluctuation Method

Ischemic stroke is a vascular disease that may cause cognitive and behavioral abnormalities. This study aims to assess abnormal brain function in ischemic stroke patients using the percent amplitude of fluctuation (PerAF) method and further explore the feasibility of PerAF as an imaging biomarker for investigating ischemic stroke pathophysiology mechanisms. Sixteen ischemic stroke patients and 22 healthy controls (HCs) underwent resting state functional magnetic resonance imaging (rs-fMRI) scanning, and the resulting data were analyzed using PerAF. Then a correlation analysis was conducted between PerAF values and Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores. Finally, the abnormal PerAF values were extracted and defined as features for support vector machine (SVM) analysis. Compared with HCs, ischemic stroke patients showed decreased PerAF in the bilateral cuneus, left middle frontal gyrus, precuneus and right inferior temporal gyrus, and increased PerAF in the bilateral orbital part of middle frontal gyrus and right orbital part of superior frontal gyrus. Correlation analyses revealed that PerAF values in the left orbital part of middle frontal gyrus was negatively correlated with the MoCA scores. The SVM classification of the PerAF values achieved an area under the curve (AUC) of 0.98 and an accuracy of 94.74%. Abnormal brain function has been found among ischemic stroke patients, which may be correlated with visual impairment, attention deficits, and dysregulation of negative emotions following a stroke. Our findings may support the potential of PerAF as a sensitive biomarker for investigating the underlying mechanisms of ischemic stroke.

Efficacy of Cerebellar Transcranial Magnetic Stimulation for Post-stroke Balance and Limb Motor Function Impairments: Meta-analyses of Random Controlled Trials and Resting-State fMRI Studies

This study aimed to investigate the potential therapeutic effects of cerebellar transcranial magnetic stimulation (TMS) on balance and limb motor impairments in stroke patients. A meta-analysis of randomized controlled trials was conducted to assess the effects of cerebellar TMS on balance and motor impairments in stroke patients. Additionally, an activation likelihood estimation (ALE) meta-analysis was performed on resting-state functional magnetic resonance imaging (fMRI) studies to compare spontaneous neural activity differences between stroke patients and healthy controls using measures including the amplitude of low frequency fluctuation (ALFF), fractional ALFF (fALFF), and regional homogeneity (ReHo). The analysis included 10 cerebellar TMS studies and 18 fMRI studies. Cerebellar TMS treatment demonstrated significant improvements in the Berg Balance Scale score (p < 0.0001) and the Fugl-Meyer Assessment lower extremity score (p < 0.0001) compared to the control group in stroke patients. Additionally, spontaneous neural activity alterations were identified in motor-related regions after stroke, including the precentral gyrus, putamen, thalamus, and paracentral lobule. Cerebellar TMS shows promise as a therapeutic intervention to enhance balance and lower limb motor function in stroke patients. It is easy for clinical application and addresses the limitations of insufficient direct stimulation depth on the leg area of the cortex. However, further research combining neuroimaging outcomes with clinical measurements is necessary to validate these findings.