Lin S, Li J, Chen S, Lin X, Ye M, Qiu Y. Progressive Disruption of Dynamic Functional Network Connectivity in Patients With Hepatitis B Virus-related cirrhosis.
J Magn Reson Imaging 2021;
54:1830-1840. [PMID:
34031950 DOI:
10.1002/jmri.27740]
[Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/13/2021] [Accepted: 05/13/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND
The diseased-related dynamic functional network connectivity (dFNC) disruption and its relationship with cognitive impairment in hepatitis B virus-related cirrhosis (HBV-RC) patients with minimal hepatic encephalopathy (MHE) and no MHE (NMHE) remain unknown. This knowledge would help identify MHE pathophysiology and monitor disease progression in HBV-RC patients.
PURPOSE
To investigate the dFNC in patients with NMHE and MHE and the relationship between dFNC indices with the psychometric hepatic encephalopathy score (PHES).
STUDY TYPE
Prospective.
POPULATION
Thirty HBV-RC patients (including 17 NMHE and 13 MHE) and 38 healthy controls (HC).
FIELD STRENGTH/SEQUENCE
A 1.5 T MRI and gradient-echo echo-planar imaging and fast field echo three-dimensional T1-weighted imaging.
ASSESSMENT
The independent components, dFNC matrix and dFNC indices (mean dwell times [DT], number of states, number of transitions, and fraction time in each state), were obtained through GIFT package. Cognitive measurement and patients grouping were based on PHES tests.
STATISTICAL TESTS
One-way ANOVA, chi-square test, two-sample t-test, Kruskal-Wallis test, spearman's correlation analysis and the false discovery rate. Significance level: P < 0.05.
RESULTS
Compared to HC (21.1 ± 4.02), the DT of state 1 decreased in NMHE (9.0 ± 3.04, P = 0.062, 95% confidence interval [CI] is -0.65 to 24.88) and significantly in MHE stage (1.2 ± 1.01) and was significantly correlated with PHES (r = 0.5) for all patients. The DT of state 2 increased gradually in NMHE (75.2 ± 13.10, P = 0.052, 95% CI, -54.23 to 0.28) and significantly in MHE stage (94.6 ± 15.61) when compared to HC (48.2 ± 6.97). Moreover, the connectivity between cognitive control network (CCN) and visual network (VIS) in state 1 (0.7 ± 0.79) and between default mode (DMN) and VIS in state 2 (-0.2 ± 0.29) decreased significantly in MHE when compared to HC (0.1 ± 0.68 for CCN-VIS in state 1 and 0.1 ± 0.17 for DMN-VIS for state 2). DATA CONCLUSION: dFNC exhibited progressive impairment as the disease advances in patients with HBV-RC.
EVIDENCE LEVEL
2 TECHNICAL EFFICACY: Stage 2.
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