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Huang Y, Shen C, Zhao W, Zhang HT, Li C, Ju C, Ouyang R, Liu J. Multilayer network analysis of dynamic network reconfiguration in patients with moderate-to-severe obstructive sleep apnea and its association with neurocognitive function. Sleep Med 2023; 112:333-341. [PMID: 37956645 DOI: 10.1016/j.sleep.2023.10.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/26/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Brain functional network disruption and neurocognitive dysfunction have been reported in obstructive sleep apnea (OSA) patients. Nevertheless, most research studies static networks, while brain evolution continues dynamically. PURPOSE To investigate the characteristics of dynamical networks in moderate-to-severe OSA patients using multilayer network analysis of dynamic networks and compare their association with neurocognitive function. METHODS Twenty-seven moderate-to-severe OSA patients and twenty-five matched healthy controls (HCs) who completed the examination of the Epworth sleepiness scale (ESS), neurocognitive function, polysomnography, and functional magnetic resonance imaging (fMRI) were prospectively included. The dynamic variations of resting-state functional networks in both groups were described via network switching rate. Switching rates and their correlation with clinical parameters were analyzed. RESULTS At the global level, network switching rates were notably lower in the OSA group than in the HCs group (p = 0.002). More specifically, the differences include the default mode network (DMN), auditory network, and ventral attention network at the subnetwork level, and the right rolandic operculum, left middle temporal gyrus, and right precentral gyrus at the nodal level. Furthermore, these altered switching rates have a close correlation with ESS, sleep parameters, and neurocognitive function. CONCLUSION Patients with moderate-to-severe OSA showed lower network switching rates, especially in the DMN, auditory network, and ventral attention network. The disruption of dynamic functional networks may be a potentially crucial mechanism of neurocognitive dysfunction in moderate-to-severe OSA patients.
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Affiliation(s)
- Yijie Huang
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Chong Shen
- Department of Respiratory and Critical Care Medicine, Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Wei Zhao
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China; Department of Radiology, The Second Xiangya Hospital of Central South University, China; Clinical Research Center for Medical Imaging in Hunan Province, China; Department of Radiology Quality Control Center, Hunan Province, Changsha, Hunan Province, China
| | - Hui-Ting Zhang
- MR Research Collaboration Team, Siemens Healthineers, Wuhan, China
| | - Chang Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Chao Ju
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Ruoyun Ouyang
- Department of Respiratory and Critical Care Medicine, Second Xiangya Hospital, Central South University, Changsha, 410011, China.
| | - Jun Liu
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China; Department of Radiology, The Second Xiangya Hospital of Central South University, China; Clinical Research Center for Medical Imaging in Hunan Province, China; Department of Radiology Quality Control Center, Hunan Province, Changsha, Hunan Province, China.
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Voon NS, Manan HA, Yahya N. Role of resting-state functional MRI in detecting brain functional changes following radiotherapy for head and neck cancer: a systematic review and meta-analysis. Strahlenther Onkol 2023; 199:706-717. [PMID: 37280382 DOI: 10.1007/s00066-023-02089-3] [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: 12/25/2022] [Accepted: 04/23/2023] [Indexed: 06/08/2023]
Abstract
PURPOSE Increasing evidence implicates changes in brain function following radiotherapy for head and neck cancer as precursors for brain dysfunction. These changes may thus be used as biomarkers for early detection. This review aimed to determine the role of resting-state functional magnetic resonance imaging (rs-fMRI) in detecting brain functional changes. METHODS A systematic search was performed in the PubMed, Scopus, and Web of Science (WoS) databases in June 2022. Patients with head and neck cancer treated with radiotherapy and periodic rs-fMRI assessments were included. A meta-analysis was performed to determine the potential of rs-fMRI for detecting brain changes. RESULTS Ten studies with a total of 513 subjects (head and neck cancer patients, n = 437; healthy controls, n = 76) were included. A significance of rs-fMRI for detecting brain changes in the temporal and frontal lobes, cingulate cortex, and cuneus was demonstrated in most studies. These changes were reported to be associated with dose (6/10 studies) and latency (4/10 studies). A strong effect size (r = 0.71, p < 0.001) between rs-fMRI and brain changes was also reported, suggesting rs-fMRI's capability for monitoring brain alterations. CONCLUSION Resting-state functional MRI is a promising tool for detecting brain functional changes following head and neck radiotherapy. These changes are correlated with latency and prescription dose.
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Affiliation(s)
- Noor Shatirah Voon
- Diagnostic Imaging and Radiotherapy, Centre of Diagnostic, Therapeutic and Investigative Sciences, Faculty of Health Sciences, National University of Malaysia, Jalan Raja Muda Aziz, 50300, Kuala Lumpur, Malaysia
- Department of Radiotherapy & Oncology, National Cancer Institute, Putrajaya, Malaysia
| | - Hanani Abdul Manan
- Functional Image Processing Laboratory, Department of Radiology, Universiti Kebangsaan Malaysia Medical Centre, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Noorazrul Yahya
- Diagnostic Imaging and Radiotherapy, Centre of Diagnostic, Therapeutic and Investigative Sciences, Faculty of Health Sciences, National University of Malaysia, Jalan Raja Muda Aziz, 50300, Kuala Lumpur, Malaysia.
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Huang L, Yang Z, Zeng Z, Ren H, Jiang M, Hu Y, Xu Y, Zhang H, Ma K, Long L. MRI-based radiomics models for the early prediction of radiation-induced temporal lobe injury in nasopharyngeal carcinoma. Front Neurol 2023; 14:1135978. [PMID: 37006478 PMCID: PMC10060957 DOI: 10.3389/fneur.2023.1135978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 02/09/2023] [Indexed: 03/18/2023] Open
Abstract
ObjectiveThis study was conducted to develop and validate a radiomics-clinics combined model-based magnetic resonance imaging (MRI) radiomics and clinical features for the early prediction of radiation-induced temporal lobe injury (RTLI) in patients with nasopharyngeal carcinoma (NPC).MethodsThis retrospective study was conducted using data from 130 patients with NPC (80 patients with and 50 patients without RTLI) who received radiotherapy. Cases were assigned randomly to training (n = 91) and testing (n = 39) datasets. Data on 168 medial temporal lobe texture features were extracted from T1WI, T2WI, and T1WI-CE MRI sequences obtained at the end of radiotherapy courses. Clinics, radiomics, and radiomics–clinics combined models (based on selected radiomics signatures and clinical factors) were constructed using machine learning software. Univariate logistic regression analysis was performed to identify independent clinical factors. The area under the ROC curve (AUC) was performed to evaluate the performance of three models. A nomogram, decision curves, and calibration curves were used to assess the performance of the combined model.ResultsSix texture features and three independent clinical factors associated significantly with RTLI were used to build the combined model. The AUCs for the combined and radiomics models were 0.962 [95% confidence interval (CI), 0.9306–0.9939] and 0.904 (95% CI, 0.8431–0.9651), respectively, for the training cohort and 0.947 (95% CI, 0.8841–1.0000) and 0.891 (95% CI, 0.7903–0.9930), respectively, for the testing cohort. All of these values exceeded those for the clinics model (AUC = 0.809 and 0.713 for the training and testing cohorts, respectively). Decision curve analysis showed that the combined model had a good corrective effect.ConclusionThe radiomics–clinics combined model developed in this study showed good performance for predicting RTLI in patients with NPC.
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Affiliation(s)
- Lixuan Huang
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Zongxiang Yang
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Zisan Zeng
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Hao Ren
- Department of Radiology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Muliang Jiang
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Yao Hu
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Yifan Xu
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Huiting Zhang
- MR Scientific Marketing, Siemens Healthineers Ltd., Wuhan, China
| | - Kun Ma
- CT Imaging Research Center, GE Healthcare China, Guangzhou, China
| | - Liling Long
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Gaungxi Medical University, Ministry of Education, Nanning, Guangxi, China
- Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning, Guangxi, China
- *Correspondence: Liling Long
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Zhu W, Chen F, Yin D, Chen K, Wang S. Changes in brain gray matter volume in nasopharyngeal carcinoma patients after radiotherapy in long-term follow-up. Braz J Otorhinolaryngol 2023; 89:477-484. [PMID: 36805347 PMCID: PMC10165243 DOI: 10.1016/j.bjorl.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/13/2022] [Accepted: 01/28/2023] [Indexed: 02/10/2023] Open
Abstract
OBJECTIVES The aim of this study was to examine the changes in gray matter in nasopharyngeal carcinoma patients with normal hearing (Group 1) and nasopharyngeal carcinoma patients with hearing loss (Group 2) after radiotherapy using voxel-based morphological analysis and to analyze the relationship with the radiation doses of the temporal lobe. METHODS 21 patients in Group 1, 14 patients in Group 2, and 21 healthy volunteers were selected. All participants underwent an otologic examination and three-dimensional magnetization preparatory rapid acquisition gradient echo sequence scan. The correlation between the variation of whole brain gray matter volume and the doses of the temporal lobe was analyzed by Data Processing & Analysis for Brain Imaging software. RESULTS Compared with the normal control group, the brain areas with reduced gray matter volume in nasopharyngeal carcinoma patients after radiotherapy were mainly in the left posterior cerebellar lobe (T = -8.797), left insular lobe (T = -7.96), and the right insular lobe (T = -6.632). Compared to Group 1, the brain areas of Group 2 patients with reduced gray matter volume were mainly in the left superior temporal gyrus (T = -2.366), left olfactory bulb (T = -2.52), left Rolandic operculum (T = -2.431), and right olfactory bulb (T = -3.100). Compared with Group 1, the brain areas of Group 2 patients with increased gray matter volume were mainly in the left calcarine sulcus (T=3.425) and right calcarine sulcus (T=3.169). There were no correlations between the changes of brain gray matter volume and the radiation doses of the temporal lobe in both Group 1 and Group 2. CONCLUSIONS The radiotherapy may cause the changes of brain areas associated with cognitive function in nasopharyngeal carcinoma in a long-term follow-up. At the same time, nasopharyngeal carcinoma patients with the radiation-induced hearing loss had abnormal gray matter volumes in the auditory center and other sensory centers. Our findings might provide new understanding into the pathogenesis of radiation-induced brain damage in normal-appearing brain tissue. Yet this exploratory study should be taken with caution.
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Affiliation(s)
- Wenjia Zhu
- Fudan University, Shanghai Medical College, Huashan Hospital, Department of Radiotherapy, Shanghai, China; Eye & ENT Hospital of Fudan University, Department of Radiation Oncology, Shanghai, China
| | - Fu Chen
- Eye & ENT Hospital of Fudan University, Department of Radiation Oncology, Shanghai, China
| | - Dongming Yin
- Zhongshan Hospital Fudan University, Department of Otorhinolaryngology-Head and Neck Surgery, Shanghai, China
| | - Keguang Chen
- Zhongshan Hospital Fudan University, Department of Otorhinolaryngology-Head and Neck Surgery, Shanghai, China.
| | - Shengzi Wang
- Eye & ENT Hospital of Fudan University, Department of Radiation Oncology, Shanghai, China.
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Zhang X, Pan J, Lin Y, Fu G, Xu P, Liang J, Ye C, Peng J, Lv X, Yang Y, Feng Y. Structural network alterations in patients with nasopharyngeal carcinoma after radiotherapy: A 1-year longitudinal study. Front Neurosci 2022; 16:1059320. [DOI: 10.3389/fnins.2022.1059320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 10/31/2022] [Indexed: 11/18/2022] Open
Abstract
This longitudinal study explored the changed patterns of structural brain network after radiotherapy (RT) in patients with nasopharyngeal carcinoma (NPC). Diffusion tensor imaging (DTI) data were gathered from 35 patients with NPC at four time points: before RT (baseline), 0∼3 (acute), 6 (early delayed), and 12 months (late-delayed) after RT. The graph theory was used to characterize the dynamic topological properties after RT and the significant changes were detected over time at the global, regional and modular levels. Significantly altered regional metrics (nodal efficiency and degree centrality) were distributed in the prefrontal, temporal, parietal, frontal, and subcortical regions. The module, that exhibited a significantly altered within-module connectivity, had a high overlap with the default mode network (DMN). In addition, the global, regional and modular metrics showed a tendency of progressive decrease at the acute and early delayed stages, and a partial/full recovery at the late-delayed stage. This changed pattern illustrated that the radiation-induced brain damage began at the acute reaction stage and were aggravated at the early-delayed stage, and then partially recovered at the late-delayed stage. Furthermore, the spearman’s correlations between the abnormal nodal metrics and temporal dose were calculated and high correlations were found at the temporal (MTG.R and HES.L), subcortical (INS.R), prefrontal (ORBinf.L and ACG.L), and parietal (IPL.R) indicating that these regions were more sensitive to dose and should be mainly considered in radiotherapy treatment plan.
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Suo X, Zuo C, Lan H, Li W, Li L, Kemp GJ, Wang S, Gong Q. Multilayer Network Analysis of Dynamic Network Reconfiguration in Adults With Posttraumatic Stress Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 8:452-461. [PMID: 36152949 DOI: 10.1016/j.bpsc.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 08/20/2022] [Accepted: 09/12/2022] [Indexed: 01/29/2023]
Abstract
BACKGROUND Brain functional network abnormalities are reported in posttraumatic stress disorder (PTSD). Most resting-state functional magnetic resonance imaging studies have assumed that the functional networks remain static during the scans. How these might change dynamically in PTSD remains unclear. METHODS Resting-state functional magnetic resonance imaging data were collected from 71 noncomorbid, treatment-naïve patients with PTSD and 70 demographically matched, trauma-exposed non-PTSD control subjects. Network switching rate was used to characterize dynamic changes of individual resting-state functional networks. Results were analyzed by comparing switching rates between the PTSD and trauma-exposed non-PTSD groups, testing for diagnosis × sex interactions, and examining correlations with PTSD symptom severity. RESULTS At the global level, the PTSD group showed significantly lower network switching rates than the trauma-exposed non-PTSD group. These were observed mainly in the frontoparietal, default mode, and limbic networks at the subnetwork level and in the frontal and temporal regions at the nodal level. These network switching rate alterations were correlated with PTSD symptom severity. There were no significant effects of sex. CONCLUSIONS These disruptions of dynamic functional network stability, reflected by lower network switching rates in the resting state, are a feature of PTSD and suggest that the frontoparietal, default mode, and limbic networks may play a critical role in the underlying neural mechanisms.
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Affiliation(s)
- Xueling Suo
- Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Chao Zuo
- Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Huan Lan
- Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China; Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Wenbin Li
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lingjiang Li
- Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Graham J Kemp
- Liverpool Magnetic Resonance Imaging Centre and Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Song Wang
- Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.
| | - Qiyong Gong
- Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, China.
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Hu F, Nie H, Xu R, Cai X, Shao L, Zhang P. Vinpocetine and coenzyme Q10 combination alleviates cognitive impairment caused by ionizing radiation by improving mitophagy. Brain Res 2022; 1792:148032. [PMID: 35907514 DOI: 10.1016/j.brainres.2022.148032] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/21/2022] [Accepted: 07/23/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE This research was designed to ascertain the effect and mechanism of vinpocetine (VIN) and coenzyme Q10 (CoQ10) combination on cognitive impairment induced by ionizing radiation (IR). METHODS Cognitive impairment in mice was induced by 9-Gy IR, and they were intraperitoneally injected with VIN, CoQ10, or VIN + CoQ10. Then novel object recognition and Morris water maze tests were used to detect cognitive function. The number of hippocampal neurons and BrdU+Dcx+ cells was observed by Nissl and immunofluorescence staining. Mitochondrial respiratory complex I, adenosine triphosphate (ATP), and mitochondrial membrane potential (MMP) were evaluated, as well as oxidative stress injury. Mitophagy in hippocampal neurons was evaluated by observing the ultrastructure of hippocampal neurons and assessing the expression of mitophagy-related proteins. RESULTS IR reduced novel object discrimination index, the time for platform crossing, and the time spent in platform quadrant, in addition to neuron loss, downregulated levels of mitochondrial respiratory complex I, ATP, and MMP, aggravated oxidative stress injury, increased expression of LC3 II/I, Beclin1, PINK1, and parkin, and decreased P62 expression. VIN or CoQ10 treatment mitigated cognitive dysfunction, neurons loss, mitochondrial damage, and oxidative stress injury, and enhanced mitophagy in hippocampal neurons. VIN and CoQ10 combination further protected against IR-induced cognitive dysfunction than VIN or CoQ10 alone. CONCLUSION VIN combined with CoQ10 improved neuron damage, promoted mitophagy, and ameliorated cognitive impairment in IR mice.
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Affiliation(s)
- Fan Hu
- Department of Neurology, Jiangxi Provincial People's Hospital, the First Affiliated to Nanchang Medical College, Nanchang 330006, Jiangxi, China
| | - Hongbing Nie
- Department of Neurology, Jiangxi Provincial People's Hospital, the First Affiliated to Nanchang Medical College, Nanchang 330006, Jiangxi, China
| | - Renxu Xu
- Department of Neurology, Jiangxi Provincial People's Hospital, the First Affiliated to Nanchang Medical College, Nanchang 330006, Jiangxi, China
| | - Xinyong Cai
- Department of Cardiology, Jiangxi Provincial People's Hospital, the First Affiliated to Nanchang Medical College, Nanchang 330006, Jiangxi, China
| | - Liang Shao
- Department of Cardiology, Jiangxi Provincial People's Hospital, the First Affiliated to Nanchang Medical College, Nanchang 330006, Jiangxi, China
| | - Ping Zhang
- Department of Neurology, Jiangxi Provincial People's Hospital, the First Affiliated to Nanchang Medical College, Nanchang 330006, Jiangxi, China.
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