Jia-Hui Lin1, Yun-Bin Cao1, Qiu-Yi Dong1, and Hua-Jun Chen1
1Fujian Medical University Union Hospital, Fuzhou, China
Synopsis
Keywords: Neurodegeneration, fMRI (resting state)
Amplitude of
low-frequency fluctuation (ALFF) can identify abnormal regional neural activity
in minimal hepatic encephalopathy (MHE). This work sought to evaluate the
temporal variability of ALFF to reveal MHE-related alterations in the dynamics
of spontaneous neural activity. Healthy controls and patients with cirrhosis
[including MHE and without MHE (NHE)] were enrolled in this investigation.
Utilizing a sliding-window approach to calculate the dynamic ALFF (dALFF)
variability. The dALFF variability in some brain region progressively decreased
from NHE to MHE group and it can distinguish NHE and MHE patients. Our findings
highlight aberrant dynamic brain function in MHE.
Background and aims:
Abnormal regional neural activity has been identified
by the analysis of the static amplitude of low-frequency fluctuation (ALFF) in
the setting of minimal hepatic encephalopathy (MHE). Brain activity is highly
dynamic. This work sought to evaluate the temporal variability of ALFF to reveal
MHE-related alterations in the dynamics of spontaneous neural activity. Methods:
A total of 29 healthy controls and 49 patients with cirrhosis [including 20 patients with MHE and 29 patients without MHE (NHE)] who underwent resting-state functional magnetic resonance imaging and Psychometric Hepatic Encephalopathy Score (PHES) examination were enrolled in this investigation. Utilizing a sliding-window approach, we calculated the dynamic ALFF (dALFF) variability to reflect the temporal dynamics of regional neural activity. An analysis of the correlation between dALFF variability and PHES was performed, and receiver operating characteristic (ROC) curve analysis to determine the potential of the dALFF variability index in identifying MHE was completed.Results:
The dALFF variability in the bilateral precuneus/posterior cingulate
gyrus and left middle frontal gyrus progressively decreased from NHE to
MHE group. In cirrhotic patients, the value of dALFF variability in the bilateral
precuneus/posterior cingulate gyrus was positively correlated with their
neurocognitive performance (r = 0.383 and P = 0.007). The index of dALFF
variability in the bilateral precuneus/posterior cingulate gyrus could be used to
distinguish NHE and MHE patients, with moderate power (area under the ROC
curve = 0.712 and P = 0.012). Conclusion:
Our findings highlight the existence of aberrant dynamic
brain function in MHE, which could underlie the neural basis of cognitive
impairments and could be associated with the development of the disease.
Analyzing dALFF could facilitate new biomarker identification for MHE. Acknowledgements
This research was supported by grants from the National
Natural Science Foundation of China (No. 82071900), Fujian
Provincial Health Technology Project (No. 2021CXA010), and
Fujian Province Joint Funds for the Innovation of Science and
Technology (No. 2019Y9067). References
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