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Study on the changes in low-frequency amplitude and regional homogeneity of the cerebral cortex in children with congenital deafness.1Department of Radiology, Affiliated Hospital of Guizhou Medical University, Guiyang, China, 2Guizhou Medical University, Guiyang, China, 3Philips Healthcare, Shanghai, China
Synopsis
Keywords: Functional Connectivity, fMRI (resting state), congenital deafness, functional magnetic resonance imaging, cochlear implantation
Motivation: To investigate the changes in low frequency fluctuation amplitude (mALFF) and regional homogeneity (ReHo) in the brains of children with congenital Sensorineural hearing loss (SNHL) by resting state fMRI.
Goal(s): The primary objective of this research was to improve understanding of the changes in neural functional activity within the cortical regions of SNHL patients during a resting state.
Approach: The study's goal is to establish a neuroimaging pathological foundation, which could potentially provide significant neuroimaging biomarkers.
Results: These biomarkers could aid in the clinical selection of appropriate candidates for cochlear implantation (CI), thereby enhancing the effectiveness of this therapeutic intervention.
Impact: The findings offer a fresh insight into the neuropathological mechanisms that drive functional reorganization in the cerebral cortex of children with congenital deafness after auditory deprivation. Moreover, these results provide valuable neuroimaging evidence for assessing the prognosis of post-CI patients.
Introduction
Congenital deafness (CD) leads to varying degrees of hearing loss in individuals after birth, with about 90% of cases being severe1. Cochlear implantation is the primary treatment for children with severe hearing loss. Delayed intervention can affect a child's cortical function development and post-surgery auditory rehabilitation2. Therefore, assessing preoperative brain function in hearing loss patients is critical. Resting-state fMRI3 is a reliable and repeatable method that detects neural activity based on changes in cerebral blood oxygen levels. It can identify changes in brain function under different conditions, offering valuable biomarkers for preoperative evaluation in cochlear implant patients.Materials and Methods
We collected resting-state functional magnetic resonance imaging (rs-fMRI) data from 43 individuals diagnosed with congenital sensorineural hearing loss (SNHL) and 32 healthy control (HC) subjects of similar age between May 2017 and June 2020. After cochlear implantation (CI), a 6-month follow-up was conducted to assess auditory behavioral grading scale scores (Clinical Assessment of Prelingual Auditory Performance, CAP). The rs-fMRI data was preprocessed using DPABI and SPM12 software. Whole-brain functional parameters, such as the amplitude of mALFF and ReHo, were calculated. Subsequently, two-sample t-tests were performed on mALFF and ReHo values, with gender, age, and head motion parameters as covariates. Cluster-level family-wise error (FEW) or false discovery rate (FDR) correction was applied. For brain regions that exhibited statistically significant differences in mALFF and ReHo, Spearman correlation analysis was conducted to examine the relationship between their values and the clinical CAP scores. Results with P < 0.05 were considered statistically significant.Results
Compared to controls, the SNHL group showed decreased mALFF in regions including the bilateral superior frontal gyrus (BA9), middle frontal gyrus (BA10), and superior temporal gyrus (BA38) among others, but increased mALFF in the bilateral thalamus and fusiform gyrus (BA17). (Figure 1). The ReHo analysis showed that compared to the healthy control (HC) group, the SNHL group exhibited decreased synchronized ReHo in the bilateral superior temporal gyrus (BA38, 41), bilateral BA11, BA10, BA47, and left insula (BA13). However, there was an increased ReHo in the bilateral thalamus, right caudate nucleus, and right precentral gyrus (BA3) (Figure 3). Correlation analysis revealed the following: The mALFF values of the left/right middle frontal gyrus (r = -0.2826, P = 0.0248; r = -0.2521, P = 0.0463), right superior frontal gyrus (r = -0.2728, P = 0.0305), left inferior frontal gyrus (r = -0.2507, P = 0.0475), right orbitofrontal gyrus (r = -0.2554, P = 0.0434), and left orbitofrontal gyrus (r = -0.2573, P = 0.0418) were negatively correlated with CAP scores (Figure 2). However, there was no correlation between ReHo values in different brain regions and clinical CAP scores.Dicussion
Functional MRI (fMRI) is a non-invasive technique used to study changes in brain function in various diseases. It provides valuable information for understanding the development of these diseases and guiding clinical practice4. fMRI, which is based on Blood oxygen level dependent (BOLD) signals, has been shown to reflect underlying neuronal activity. In this study, we examined the neural activity in the auditory, visual, and somatosensory cortices of individuals with congenital deafness. The results revealed significant changes in neuronal activity in these regions. Specifically, there was a significant decrease in the mean amplitude of mALFF in the auditory cortex, while the mALFF activity in the visual and somatosensory regions showed a significant increase5-7. Furthermore, we observed abnormal desynchronization between the auditory cortex and other cortical regions, characterized by a decrease in regional homogeneity8 in the auditory cortex. After the loss of auditory function in individuals with congenital deafness, the prefrontal cortex (PFC) underwent functional alterations9. Correlation analysis demonstrated a negative correlation between the mALFF values of the bilateral middle frontal gyrus (MFG), right superior frontal gyrus (SFG), left inferior prefrontal gyrus (InPFG_Orb), bilateral orbitofrontal gyrus (OrbitoFG), and clinical scores on the CAP evaluation (A-F).Conclusion
This study used resting-state fMRI to observe brain function changes in children with congenital deafness. Findings include: (1) Abnormal functional changes in motor-related cortical regions were noted following auditory loss in pre-school deaf children, possibly due to cross-modal reorganization; (2) Decreased activity was observed in the prefrontal cortex, suggesting that auditory loss may affect cognitive functions; (3) Correlation analysis showed a decrease in cognitive functions mediated by the prefrontal cortex after auditory loss, and compensatory changes in other sensory-motor cortices may not benefit auditory-language function recovery post cochlear implantation.Funding
This study is supported by the Guizhou Provincial Science and Technology Plan Project (Contract No.: Qiankehe Foundation-ZK[2023] General 355) and the Guizhou Medical University National Natural Science Foundation Cultivation Project (Project No.: 22NSFCP53).Acknowledgements
We are grateful to all the participants for their cooperation and patience.References
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