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Kagialis A, Simos N, Manolitsi K, Vakis A, Simos P, Papadaki E. Functional connectivity-hemodynamic (un)coupling changes in chronic mild brain injury are associated with mental health and neurocognitive indices: a resting state fMRI study. Neuroradiology 2024; 66:985-998. [PMID: 38605104 PMCID: PMC11133187 DOI: 10.1007/s00234-024-03352-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 04/02/2024] [Indexed: 04/13/2024]
Abstract
PURPOSE To examine hemodynamic and functional connectivity alterations and their association with neurocognitive and mental health indices in patients with chronic mild traumatic brain injury (mTBI). METHODS Resting-state functional MRI (rs-fMRI) and neuropsychological assessment of 37 patients with chronic mTBI were performed. Intrinsic connectivity contrast (ICC) and time-shift analysis (TSA) of the rs-fMRI data allowed the assessment of regional hemodynamic and functional connectivity disturbances and their coupling (or uncoupling). Thirty-nine healthy age- and gender-matched participants were also examined. RESULTS Patients with chronic mTBI displayed hypoconnectivity in bilateral hippocampi and parahippocampal gyri and increased connectivity in parietal areas (right angular gyrus and left superior parietal lobule (SPL)). Slower perfusion (hemodynamic lag) in the left anterior hippocampus was associated with higher self-reported symptoms of depression (r = - 0.53, p = .0006) and anxiety (r = - 0.484, p = .002), while faster perfusion (hemodynamic lead) in the left SPL was associated with lower semantic fluency (r = - 0.474, p = .002). Finally, functional coupling (high connectivity and hemodynamic lead) in the right anterior cingulate cortex (ACC)) was associated with lower performance on attention and visuomotor coordination (r = - 0.50, p = .001), while dysfunctional coupling (low connectivity and hemodynamic lag) in the left ventral posterior cingulate cortex (PCC) and right SPL was associated with lower scores on immediate passage memory (r = - 0.52, p = .001; r = - 0.53, p = .0006, respectively). Uncoupling in the right extrastriate visual cortex and posterior middle temporal gyrus was negatively associated with cognitive flexibility (r = - 0.50, p = .001). CONCLUSION Hemodynamic and functional connectivity differences, indicating neurovascular (un)coupling, may be linked to mental health and neurocognitive indices in patients with chronic mTBI.
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Affiliation(s)
- Antonios Kagialis
- Department of Psychiatry, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece
- Department of Radiology, School of Medicine, University of Crete, University Hospital of Heraklion, 71003, Crete, Greece
| | - Nicholas Simos
- Institute of Computer Science, Foundation for Research and Technology - Hellas, Heraklion, Crete, Greece
| | - Katina Manolitsi
- Department of Neurosurgery, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece
| | - Antonios Vakis
- Department of Neurosurgery, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece
| | - Panagiotis Simos
- Department of Psychiatry, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece
- Institute of Computer Science, Foundation for Research and Technology - Hellas, Heraklion, Crete, Greece
| | - Efrosini Papadaki
- Department of Radiology, School of Medicine, University of Crete, University Hospital of Heraklion, 71003, Crete, Greece.
- Institute of Computer Science, Foundation for Research and Technology - Hellas, Heraklion, Crete, Greece.
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Bai X, Wang W, Zhang X, Hu Z, Zhang X, Zhang Y, Tang H, Zhang Y, Yu X, Yuan Z, Zhang P, Li Z, Pei X, Wang Y, Sui B. Hyperperfusion of bilateral amygdala in patients with chronic migraine: an arterial spin-labeled magnetic resonance imaging study. J Headache Pain 2023; 24:138. [PMID: 37848831 PMCID: PMC10583377 DOI: 10.1186/s10194-023-01668-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 09/21/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Amygdala, an essential element of the limbic system, has served as an important structure in pain modulation. There is still a lack of clarity about altered cerebral perfusion of amygdala in migraine. This study aimed to investigate the perfusion variances of bilateral amygdala in episodic migraine (EM) and chronic migraine (CM) using multi-delay pseudo-continuous arterial spin-labeled magnetic resonance imaging (pCASL-MRI). METHODS Twenty-six patients with EM, 55 patients with CM (33 CM with medication overuse headache (MOH)), and 26 age- and sex-matched healthy controls (HCs) were included. All participants underwent 3D multi-delay pCASL MR imaging to obtain cerebral perfusion data, including arrival-time-corrected cerebral blood flow (CBF) and arterial cerebral blood volume (aCBV). The CBF and aCBV values in the bilateral amygdala were compared among the three groups. Correlation analyses between cerebral perfusion parameters and clinical variables were performed. RESULTS Compared with HC participants, patients with CM were found to have increased CBF and aCBV values in the left amygdala, as well as increased CBF values in the right amygdala (all P < 0.05). There were no significant differences of CBF and aCBV values in the bilateral amygdala between the HC and EM groups, the EM and CM groups, as well as the CM without and with MOH groups (all P > 0.05). In patients with CM, the increased perfusion parameters of bilateral amygdala were positively correlated with MIDAS score after adjustments for age, sex, and body mass index (BMI). CONCLUSION Hyperperfusion of bilateral amygdala might provide potential hemodynamics evidence in the neurolimbic pain network of CM.
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Affiliation(s)
- Xiaoyan Bai
- Tiantan Neuroimaging Center for Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital and Beijing Neurosurgical Institute, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wei Wang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Xueyan Zhang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | | | - Xue Zhang
- Tiantan Neuroimaging Center for Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital and Beijing Neurosurgical Institute, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yingkui Zhang
- Tiantan Neuroimaging Center for Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital and Beijing Neurosurgical Institute, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Hefei Tang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Yaqing Zhang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Xueying Yu
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Ziyu Yuan
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Peng Zhang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Zhiye Li
- Tiantan Neuroimaging Center for Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital and Beijing Neurosurgical Institute, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xun Pei
- Tiantan Neuroimaging Center for Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital and Beijing Neurosurgical Institute, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yonggang Wang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China.
| | - Binbin Sui
- Tiantan Neuroimaging Center for Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital and Beijing Neurosurgical Institute, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China.
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Pentari A, Simos N, Tzagarakis G, Kagialis A, Bertsias G, Kavroulakis E, Gratsia E, Sidiropoulos P, Boumpas DT, Papadaki E. Altered hippocampal connectivity dynamics predicts memory performance in neuropsychiatric lupus: a resting-state fMRI study using cross-recurrence quantification analysis. Lupus Sci Med 2023; 10:e000920. [PMID: 37400223 DOI: 10.1136/lupus-2023-000920] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 06/13/2023] [Indexed: 07/05/2023]
Abstract
OBJECTIVE Τo determine whole-brain and regional functional connectivity (FC) characteristics of patients with neuropsychiatric SLE (NPSLE) or without neuropsychiatric manifestations (non-NPSLE) and examine their association with cognitive performance. METHODS Cross-recurrence quantification analysis (CRQA) of resting-state functional MRI (rs-fMRI) data was performed in 44 patients with NPSLE, 20 patients without NPSLE and 35 healthy controls (HCs). Volumetric analysis of total brain and specific cortical and subcortical regions, where significant connectivity changes were identified, was performed. Cognitive status of patients with NPSLE was assessed by neuropsychological tests. Group comparisons on nodal FC, global network metrics and regional volumetrics were conducted, and associations with cognitive performance were estimated (at p<0.05 false discovery rate corrected). RESULTS FC in patients with NPSLE was characterised by increased modularity (mean (SD)=0.31 (0.06)) as compared with HCs (mean (SD)=0.27 (0.06); p=0.05), hypoconnectivity of the left (mean (SD)=0.06 (0.018)) and right hippocampi (mean (SD)=0.051 (0.0.16)), and of the right amygdala (mean (SD)=0.091 (0.039)), as compared with HCs (mean (SD)=0.075 (0.022), p=0.02; 0.065 (0.019), p=0.01; 0.14 (0.096), p=0.05, respectively). Hyperconnectivity of the left angular gyrus (NPSLE/HCs: mean (SD)=0.29 (0.26) and 0.10 (0.09); p=0.01), left (NPSLE/HCs: mean (SD)=0.16 (0.09) and 0.09 (0.05); p=0.01) and right superior parietal lobule (SPL) (NPSLE/HCs: mean (SD)=0.25 (0.19) and 0.13 (0.13), p=0.01) was noted in NPSLE versus HC groups. Among patients with NPSLE, verbal episodic memory scores were positively associated with connectivity (local efficiency) of the left hippocampus (r2=0.22, p=0.005) and negatively with local efficiency of the left angular gyrus (r2=0.24, p=0.003). Patients without NPSLE displayed hypoconnectivity of the right hippocampus (mean (SD)=0.056 (0.014)) and hyperconnectivity of the left angular gyrus (mean (SD)=0.25 (0.13)) and SPL (mean (SD)=0.17 (0.12)). CONCLUSION By using dynamic CRQA of the rs-fMRI data, distorted FC was found globally, as well as in medial temporal and parietal brain regions in patients with SLE, that correlated significantly and adversely with memory capacity in NPSLE. These results highlight the value of dynamic approaches to assessing impaired brain network function in patients with lupus with and without neuropsychiatric symptoms.
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Affiliation(s)
- Anastasia Pentari
- Computational Bio-Medicine Laboratory, Institute of Computer Science, Foundation for Research and Technology - Hellas, Heraklion, Greece
| | - Nicholas Simos
- Computational Bio-Medicine Laboratory, Institute of Computer Science, Foundation for Research and Technology - Hellas, Heraklion, Greece
| | - George Tzagarakis
- Computational Bio-Medicine Laboratory, Institute of Computer Science, Foundation for Research and Technology - Hellas, Heraklion, Greece
| | - Antonios Kagialis
- Department of Psychiatry, University of Crete School of Medicine, Heraklion, Greece
- Department of Radiology, University of Crete School of Medicine, Heraklion, Greece
| | - George Bertsias
- Laboratory of Autoimmunity and Inflammation, Institute of Molecular Biology and Biotechnology, Heraklion, Greece
- Department of Rheumatology, Clinical Immunology and Allergy, School of Medicine, University of Crete, University Hospital of Heraklion, Heraklion, Greece
| | | | - Eirini Gratsia
- Department of Radiology, University of Crete School of Medicine, Heraklion, Greece
| | - Prodromos Sidiropoulos
- Department of Rheumatology, Clinical Immunology and Allergy, School of Medicine, University of Crete, University Hospital of Heraklion, Heraklion, Greece
| | - Dimitrios T Boumpas
- Department of Rheumatology, Clinical Immunology and Allergy, School of Medicine, University of Crete, University Hospital of Heraklion, Heraklion, Greece
- Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Efrosini Papadaki
- Computational Bio-Medicine Laboratory, Institute of Computer Science, Foundation for Research and Technology - Hellas, Heraklion, Greece
- Department of Radiology, University of Crete School of Medicine, Heraklion, Greece
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Antypa D, Simos NJ, Panou T, Spyridaki E, Kagialis A, Kosteletou E, Kavroulakis E, Mastorodemos V, Papadaki E. Distinct hemodynamic and functional connectivity features of fatigue in clinically isolated syndrome and multiple sclerosis: accounting for the confounding effect of concurrent depression symptoms. Neuroradiology 2023:10.1007/s00234-023-03174-1. [PMID: 37301785 DOI: 10.1007/s00234-023-03174-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 06/04/2023] [Indexed: 06/12/2023]
Abstract
PURPOSE This study aims to identify common and distinct hemodynamic and functional connectivity (FC) features for self-rated fatigue and depression symptoms in patients with clinically isolated syndrome (CIS) and relapsing-remitting multiple sclerosis (RR-MS). METHODS Twenty-four CIS, 29 RR-MS patients, and 39 healthy volunteers were examined using resting-state fMRI (rs-fMRI) to obtain whole-brain maps of (i) hemodynamic response patterns (through time shift analysis), (ii) FC (via intrinsic connectivity contrast maps), and (iii) coupling between hemodynamic response patterns and FC. Each regional map was correlated with fatigue scores, controlling for depression, and with depression scores, controlling for fatigue. RESULTS In CIS patients, the severity of fatigue was associated with accelerated hemodynamic response in the insula, hyperconnectivity of the superior frontal gyrus, and evidence of reduced hemodynamics-FC coupling in the left amygdala. In contrast, depression severity was associated with accelerated hemodynamic response in the right limbic temporal pole, hypoconnectivity of the anterior cingulate gyrus, and increased hemodynamics-FC coupling in the left amygdala. In RR-MS patients, fatigue was associated with accelerated hemodynamic response in the insula and medial superior frontal cortex, increased functional role of the left amygdala, and hypoconnectivity of the dorsal orbitofrontal cortex, while depression symptom severity was linked to delayed hemodynamic response in the medial superior frontal gyrus; hypoconnectivity of the insula, ventromedial thalamus, dorsolateral prefrontal cortex, and posterior cingulate; and decreased hemodynamics-FC coupling of the medial orbitofrontal cortex. CONCLUSION There are distinct FC and hemodynamic responses, as well as different magnitude and topography of hemodynamic connectivity coupling, associated with fatigue and depression in early and later stages of MS.
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Affiliation(s)
- Despina Antypa
- Department of Psychiatry, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece
| | - Nicholas John Simos
- Computational Bio-Medicine Laboratory, Institute of Computer Science, Foundation for Research and Technology, Hellas, Heraklion, Crete, Greece
| | - Theodora Panou
- Department of Psychiatry, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece
| | - Eirini Spyridaki
- Department of Psychiatry, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece
| | - Antonios Kagialis
- Department of Psychiatry, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece
| | - Emmanouela Kosteletou
- Institute of Applied Mathematics, Foundation for Research and Technology, Hellas, Heraklion, Crete, Greece
| | - Eleftherios Kavroulakis
- Department of Radiology, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece
| | - Vasileios Mastorodemos
- Department of Neurology, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece
| | - Efrosini Papadaki
- Computational Bio-Medicine Laboratory, Institute of Computer Science, Foundation for Research and Technology, Hellas, Heraklion, Crete, Greece.
- Department of Radiology, School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece.
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Emerson JS, Gruenewald SM, Gomes L, Lin MW, Swaminathan S. The conundrum of neuropsychiatric systemic lupus erythematosus: Current and novel approaches to diagnosis. Front Neurol 2023; 14:1111769. [PMID: 37025200 PMCID: PMC10070984 DOI: 10.3389/fneur.2023.1111769] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/07/2023] [Indexed: 04/08/2023] Open
Abstract
Recognising neuropsychiatric involvement by systemic lupus erythematosus (SLE) is of growing importance, however many barriers to this exist at multiple levels of our currently available diagnostic algorithms that may ultimately delay its diagnosis and subsequent treatment. The heterogeneous and non-specific clinical syndromes, serological and cerebrospinal fluid (CSF) markers and neuroimaging findings that often do not mirror disease activity, highlight important research gaps in the diagnosis of neuropsychiatric SLE (NPSLE). Formal neuropsychological assessments or the more accessible screening metrics may also help improve objective recognition of cognitive or mood disorders. Novel serum and CSF markers, including autoantibodies, cytokines and chemokines have also shown increasing utility as part of diagnosis and monitoring, as well as in distinguishing NPSLE from SLE patients without SLE-related neuropsychiatric manifestations. Novel neuroimaging studies also expand upon our existing strategy by quantifying parameters that indicate microarchitectural integrity or provide an assessment of neuronal function. Some of these novel markers have shown associations with specific neuropsychiatric syndromes, suggesting that future research move away from considering NPSLE as a single entity but rather into its individually recognized neuropsychiatric manifestations. Nevertheless, it is likely that a composite panel of these investigations will be needed to better address the gaps impeding recognition of neuropsychiatric involvement by SLE.
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Affiliation(s)
- Jonathan S. Emerson
- Department of Clinical Immunology and Immunopathology, Westmead Hospital, Sydney, NSW, Australia
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
- Centre for Immunology and Allergy Research, The Westmead Institute for Medical Research, Sydney, NSW, Australia
- *Correspondence: Jonathan S. Emerson,
| | - Simon M. Gruenewald
- Department of Nuclear Medicine, PET and Ultrasound, Westmead Hospital, Sydney, NSW, Australia
| | - Lavier Gomes
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
- Department of Radiology, Westmead Hospital, Sydney, NSW, Australia
| | - Ming-Wei Lin
- Department of Clinical Immunology and Immunopathology, Westmead Hospital, Sydney, NSW, Australia
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Sanjay Swaminathan
- Department of Clinical Immunology and Immunopathology, Westmead Hospital, Sydney, NSW, Australia
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
- Department of Clinical Immunology, Blacktown Hospital, Sydney, NSW, Australia
- School of Medicine, Western Sydney University, Sydney, NSW, Australia
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Simos NJ, Manolitsi K, Luppi AI, Kagialis A, Antonakakis M, Zervakis M, Antypa D, Kavroulakis E, Maris TG, Vakis A, Stamatakis EA, Papadaki E. Chronic Mild Traumatic Brain Injury: Aberrant Static and Dynamic Connectomic Features Identified Through Machine Learning Model Fusion. Neuroinformatics 2022; 21:427-442. [PMID: 36456762 PMCID: PMC10085953 DOI: 10.1007/s12021-022-09615-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 10/25/2022] [Accepted: 11/13/2022] [Indexed: 12/04/2022]
Abstract
AbstractTraumatic Brain Injury (TBI) is a frequently occurring condition and approximately 90% of TBI cases are classified as mild (mTBI). However, conventional MRI has limited diagnostic and prognostic value, thus warranting the utilization of additional imaging modalities and analysis procedures. The functional connectomic approach using resting-state functional MRI (rs-fMRI) has shown great potential and promising diagnostic capabilities across multiple clinical scenarios, including mTBI. Additionally, there is increasing recognition of a fundamental role of brain dynamics in healthy and pathological cognition. Here, we undertake an in-depth investigation of mTBI-related connectomic disturbances and their emotional and cognitive correlates. We leveraged machine learning and graph theory to combine static and dynamic functional connectivity (FC) with regional entropy values, achieving classification accuracy up to 75% (77, 74 and 76% precision, sensitivity and specificity, respectively). As compared to healthy controls, the mTBI group displayed hypoconnectivity in the temporal poles, which correlated positively with semantic (r = 0.43, p < 0.008) and phonemic verbal fluency (r = 0.46, p < 0.004), while hypoconnectivity in the right dorsal posterior cingulate correlated positively with depression symptom severity (r = 0.54, p < 0.0006). These results highlight the importance of residual FC in these regions for preserved cognitive and emotional function in mTBI. Conversely, hyperconnectivity was observed in the right precentral and supramarginal gyri, which correlated negatively with semantic verbal fluency (r=-0.47, p < 0.003), indicating a potential ineffective compensatory mechanism. These novel results are promising toward understanding the pathophysiology of mTBI and explaining some of its most lingering emotional and cognitive symptoms.
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Affiliation(s)
- Nicholas J. Simos
- Computational Bio-Medicine Laboratory, Institute of Computer Science, Foundation for Research and Technology–Hellas, 70013 Heraklion, Greece
| | - Katina Manolitsi
- Department of Neurosurgery, School of Medicine & University Hospital of Heraklion, University of Crete, Crete, Greece
- Department of Psychiatry, School of Medicine & University Hospital of Heraklion, University of Crete, Crete, Greece
| | - Andrea I. Luppi
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Rd, CB2 0SP Cambridge, UK
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Rd, CB2 0SP Cambridge, UK
| | - Antonios Kagialis
- Department of Psychiatry, School of Medicine & University Hospital of Heraklion, University of Crete, Crete, Greece
| | - Marios Antonakakis
- Digital Image and Signal Processing Laboratory, School of Electrical and Computer Engineering, Technical University of Crete, Chania, Greece
| | - Michalis Zervakis
- Digital Image and Signal Processing Laboratory, School of Electrical and Computer Engineering, Technical University of Crete, Chania, Greece
| | - Despina Antypa
- Department of Psychiatry, School of Medicine & University Hospital of Heraklion, University of Crete, Crete, Greece
| | - Eleftherios Kavroulakis
- Department of Radiology, School of Medicine & University Hospital of Heraklion, University of Crete, Crete, Greece
| | - Thomas G. Maris
- Computational Bio-Medicine Laboratory, Institute of Computer Science, Foundation for Research and Technology–Hellas, 70013 Heraklion, Greece
- Department of Radiology, School of Medicine & University Hospital of Heraklion, University of Crete, Crete, Greece
| | - Antonios Vakis
- Department of Neurosurgery, School of Medicine & University Hospital of Heraklion, University of Crete, Crete, Greece
| | - Emmanuel A. Stamatakis
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Rd, CB2 0SP Cambridge, UK
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Rd, CB2 0SP Cambridge, UK
| | - Efrosini Papadaki
- Computational Bio-Medicine Laboratory, Institute of Computer Science, Foundation for Research and Technology–Hellas, 70013 Heraklion, Greece
- Department of Radiology, School of Medicine & University Hospital of Heraklion, University of Crete, Crete, Greece
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Wang XH, Liu XF, Ao M, Wang T, He J, Gu YW, Fan JW, Yang L, Yu R, Guo S. Cerebral Perfusion Patterns of Anxiety State in Patients With Pulmonary Nodules: A Study of Cerebral Blood Flow Based on Arterial Spin Labeling. Front Neurosci 2022; 16:912665. [PMID: 35615271 PMCID: PMC9125149 DOI: 10.3389/fnins.2022.912665] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 04/21/2022] [Indexed: 12/14/2022] Open
Abstract
Background and Purpose The proportion of patients with somatic diseases associated with anxiety is increasing each year, and pulmonary nodules have become a non-negligible cause of anxiety, the mechanism of which is unclear. The study focus on the cerebral blood flow (CBF) of anxiety in patients with pulmonary nodules to explore the cerebral perfusion pattern of anxiety associated with pulmonary nodules, blood perfusion status and mode of pulmonary nodule induced anxiety state. Materials and Methods Patients with unconfirmed pulmonary nodules were evaluated by Hamilton Anxiety Scale (HAMA). The total score > 14 was defined as anxiety group, and the total score ≤ 14 points was defined as non-anxiety group. A total of 38 patients were enrolled, of which 19 patients were the anxiety group and 19 were the non-anxiety group. All subjects underwent arterial spin labeling imaging using a 3.0 T MRI. A two-sample t-test was performed to compare the CBF between the two groups. The CBF was extracted in brain regions with difference, and Spearman correlation was used to analyze the correlation between CBF and HAMA scores; ROC was used to analyze the performance of CBF to distinguish between the anxiety group and the non-anxiety group. Results The CBF in the right insula/Heschl’s cortex of the anxiety group decreased (cluster = 109, peak t = 4.124, and P < 0.001), and the CBF in the right postcentral gyrus increased (cluster = 53, peak t = −3.912, and P < 0.001) in the anxiety group. But there was no correlation between CBF and HAMA score. The ROC analysis of the CBF of the right insula/Heschl’s cortex showed that the AUC was 0.856 (95%CI, 0.729, 0.983; P < 0.001), the optimal cutoff value of the CBF was 50.899, with the sensitivity of 0.895, and specificity of 0.789. The ROC analysis of CBF in the right postcentral gyrus showed that the AUC was 0.845 (95%CI, 0.718, 0.972; P < 0.001), the optimal cutoff value of CBF was 43.595, with the sensitivity of 0.737, and specificity of 0.842. Conclusion The CBF of the right insula/Heschl’s cortex decreased and the CBF of the right postcentral gyrus increased in patients with pulmonary nodules under anxiety state, and the CBF of the aforementioned brain regions can accurately distinguish the anxiety group from the non-anxiety group.
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Affiliation(s)
- Xiao-Hui Wang
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiao-Fan Liu
- School of Medical Technology, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Min Ao
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ting Wang
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jinglan He
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yue-Wen Gu
- Department of Clinical Psychology, Fourth Military Medical University, Xi’an, China
| | - Jing-Wen Fan
- Department of Clinical Psychology, Fourth Military Medical University, Xi’an, China
| | - Li Yang
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Li Yang,
| | - Renqiang Yu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Renqiang Yu,
| | - Shuliang Guo
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Shuliang Guo, , orcid.org/0000-0003-3572-7421
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Papadaki E, Simos NJ, Kavroulakis E, Bertsias G, Antypa D, Fanouriakis A, Maris T, Sidiropoulos P, Boumpas DT. Converging evidence of impaired brain function in systemic lupus erythematosus: changes in perfusion dynamics and intrinsic functional connectivity. Neuroradiology 2022; 64:1593-1604. [DOI: 10.1007/s00234-022-02924-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 02/24/2022] [Indexed: 10/18/2022]
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