Preoperative Brain Functional Connectivity Improve Predictive Accuracy of Outcomes After Revascularization in Moyamoya Disease

被引:9
作者
Hu, Junwen [1 ]
Wang, Yongjie [1 ]
Zhu, Yuhan [1 ]
Li, Yin [1 ]
Chen, Jingyin [1 ]
Zhang, Yifan [2 ]
Xu, Duo [3 ]
Bai, Ruiliang [2 ,4 ,5 ,6 ]
Wang, Lin [1 ]
机构
[1] Zhejiang Univ, Affiliated Hosp 2, Sch Med, Dept Neurosurg, Jiefang Rd 88th, Hangzhou 310009, Peoples R China
[2] Zhejiang Univ, Coll Biomed Engn & Instrument Sci, Key Lab Biomed Engn, Educ Minist, 268 Kaixuan Rd, Hangzhou 310027, Peoples R China
[3] Zhejiang Univ, Affiliated Hosp 2, Sch Med, Dept Radiol, Hangzhou, Peoples R China
[4] Zhejiang Univ, Sch Med, Affiliated Sir Run Run Shaw Hosp, Dept Phys Med & Rehabil, Hangzhou, Peoples R China
[5] Zhejiang Univ, Sch Med, Interdisciplinary Inst Neurosci & Technol, Hangzhou, Peoples R China
[6] Zhejiang Univ, MOE Frontier Sci Ctr Brain Sci & Brain Machine In, Sch Brain Sci & Brain Med, Hangzhou, Peoples R China
基金
中国国家自然科学基金;
关键词
Moyamoya disease; rs-fMRI; Functional connectivity; Discriminant function analysis; Prognosis; STROKE RECURRENCE; ISCHEMIC-STROKE; MANAGEMENT; ANATOMY; RISK; FMRI;
D O I
10.1227/neu.0000000000002205
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND:In patients with moyamoya disease (MMD), focal impairments in cerebral hemodynamics are often inconsistent with patients' clinical prognoses. Evaluation of entire brain functional networks may enable predicting MMD outcomes after revascularization.OBJECTIVE:To investigate whether preoperative brain functional connectivity could predict outcomes after revascularization in MMD.METHODS:We included 34 patients with MMD who underwent preoperative MRI scanning and combined revascularization surgery. We used region of interest analyses to explore the differences in functional connectivity for 90 paired brain regions between patients who had favorable outcomes 1 year after surgery (no recurrent stroke, with improved preoperative symptoms, or modified Rankin Scale [mRS]) and those who had unimproved outcomes (recurrent stroke, persistent symptoms, or declined mRS). Variables, including age, body mass index, mRS at admission, Suzuki stage, posterior cerebral artery involvement, and functional connectivity with significant differences between the groups, were included in the discriminant function analysis to predict patient outcomes.RESULTS:Functional connectivity between posterior cingulate cortex and paracentral lobule within the right hemisphere, and interhemispheric connection between superior parietal gyrus and middle frontal gyrus, precuneus and middle cingulate cortex, cuneus and precuneus, differed significantly between the groups (P < .001, false discovery rate corrected) and had the greatest discriminant function in the prediction model. Although clinical characteristics of patients with MMD showed great accuracy in predicting outcomes (64.7%), adding information on functional connections improved accuracy to 91.2%.CONCLUSION:Preoperative functional connectivity derived from rs-fMRI may be an early hallmark for predicting patients' prognosis after revascularization surgery for MMD.
引用
收藏
页码:344 / 352
页数:9
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