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Abnormal brain functional and structural connectivity between the left supplementary motor area and inferior frontal
Junwen Hu1, Yin Li1, Zhaoqing Li2
1Department of Neurosurgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Jiefang Road 88th, Hangzhou, 310009, China.
Background:
Disruption of brain functional connectivity has been detected after stroke, but whether it also occurs in moyamoya disease (MMD) is unknown. Impaired functional connectivity is always correlated with abnormal white matter fibers. Herein, we used multimodal imaging techniques to explore the changes in brain functional and structural connectivity in MMD patients.
Methods:
We collected structural images, resting-state functional magnetic resonance imaging (rs-fMRI) and diffusion tensor imaging for each subject. Cognitive functions of MMD patients were evaluated using the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Trail Making Test parts A and B (TMT-A/-B). We calculated the functional connectivity for every paired region using 90 regions of interest from the Anatomical Automatic Labeling Atlas and then determined the differences between MMD patients and HCs. We extracted the functional connectivity of paired brain regions with significant differences between the two groups. Correlation analyses were then performed between the functional connectivity and variable cognitive functions. To explore whether the impaired functional connectivity and cognitive performances were attributed to the destruction of white matter fibers, we further analyzed fiber integrity using tractography between paired regions that were correlated with cognition.
Results:
There was lower functional connectivity in MMD patients as compared to HCs between the bilateral inferior frontal gyrus, between the bilateral supramarginal gyrus, between the left supplementary motor area (SMA) and the left orbital part of the inferior frontal gyrus (IFGorb), and between the left SMA and the left middle temporal gyrus (P < 0.01, FDR corrected). The decreased functional connectivity between the left SMA and the left IFGorb was significantly correlated with the MMSE (r = 0.52, P = 0.024), MoCA (r = 0.60, P = 0.006), and TMT-B (r = -0.54, P = 0.048) in MMD patients. White matter fibers were also injured between the SMA and IFGorb in the left hemisphere and were positively correlated with reduced functional connectivity.
Conclusions:
Brain functional and structural connectivity between the supplementary motor area and inferior frontal gyrus in the left hemisphere are damaged in MMD. These findings could be useful in the evaluation of disease progression and prognosis of MMD.
Insights
Moyamoya disease (MMD) patients show reduced brain connectivity, impacting cognitive function. This study reveals damaged functional and structural connections, particularly between the supplementary motor area and inferior frontal gyrus, offering insights into MMD progression.
Area of Science:
- Neuroscience
- Radiology
- Neurology
Background:
- Stroke disrupts brain functional connectivity; MMD's impact is unknown.
- MMD may involve impaired functional connectivity and abnormal white matter.
- Multimodal imaging is crucial for understanding MMD's neurological effects.
Purpose of the Study:
- To investigate changes in brain functional and structural connectivity in MMD patients.
- To correlate connectivity changes with cognitive function in MMD.
- To explore the role of white matter integrity in MMD-related cognitive deficits.
Main Methods:
- Collected structural MRI, resting-state fMRI, and diffusion tensor imaging.
- Assessed cognitive functions using MMSE, MoCA, and TMT.
- Analyzed functional connectivity using 90 regions of interest and tractography for white matter integrity.
Main Results:
- MMD patients exhibited lower functional connectivity compared to healthy controls.
- Significant correlations found between reduced functional connectivity (SMA-IFGorb) and cognitive scores (MMSE, MoCA, TMT-B).
- White matter fiber integrity was compromised between the SMA and IFGorb, correlating with reduced functional connectivity.
Conclusions:
- MMD is associated with damaged functional and structural connectivity in the left hemisphere's SMA and IFG.
- These connectivity deficits are linked to cognitive impairments in MMD patients.
- Findings aid in evaluating MMD disease progression and prognosis.
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