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Electroencephalography Network Indices as Biomarkers of Upper Limb Impairment in Chronic Stroke
Published on: July 14, 2023
Structural-informed functional MRI analysis of patients with empathy impairment following stroke
Jian-Feng Qu1, Xiao-Wen Liu1, Ming-Zi Wang1
1From the Department of Neurology, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People's Hospital), Dongguan, Guangdong Province, China (Qu, Liu, Wang, Chen); the Faculty of Neurology, Graduate School of Guangdong Medical University, Zhanjiang, Guangdong Province, China (Qu, Liu); the Faculty of Neurology, Graduate School of Southern Medical University, Guangzhou, Guangdong Province, China (Wang); the BrainNow Research Institute, Shenzhen, Guangdong Province, China (Luo, Shi); the School of Mathematics and Statistics, Huazhong University of Science and Technology, China (Gao); the Center for Mathematical Science, Huazhong University of Science and Technology, China (Gao); the Intelligent Brain Imaging and Brain Function Laboratory (Dongguan Key Laboratory), Dongguan People's Hospital, Dongguan, Guangdong, China (Qu, Chen); the Guangdong Provincial Key Laboratory of Mathematical and Neural Dynamical Systems, Great Bay University, Dongguan, Guangdong, China (Qu, Gao, Chen).
Background:
The underlying functional alterations of brain structural changes among patients with empathy impairment following stroke remain unclear. We sought to investigate functional connectivity changes informed by brain structural abnormalities in multimodal magnetic resonance imaging (MRI) among patients with empathy impairment following stroke.
Methods:
We enrolled people who had experienced their first ischemic stroke, along with healthy controls. We assessed empathy 3 months after stroke using the Chinese version of the Empathy Quotient (EQ). During the acute phase, all patients underwent basic magnetic resonance imaging (MRI), followed by multimodal MRI during follow-up. Our MRI analyses encompassed acute infarction segmentation, volumetric brain measurements, regional quantification of diffusion parameters, and both region-of-interest-based and seed-based functional connectivity assessments. We grouped patients based on the severity of their empathy impairment for comparative analysis.
Results:
We included 84 patients who had stroke and 22 healthy controls. Patients had lower EQ scores than controls. Patients with low empathy had larger left cortical infarcts (odds ratio [OR] 4.082, 95% confidence interval [CI] 1.183-14.088), more pronounced atrophy in the right cingulate cortex (OR 1.248, 95% CI 1.038-1.502), and lower scores on the Montreal Cognitive Assessment (OR 0.873, 95% CI 0.74-0.947). In addition, the cingulate cortex served as the seed in the seed-based analysis, which showed heightened functional connectivity between the anterior cingulate gyrus and the right superior parietal lobule, specifically in the low-empathy group.
Limitations:
We did not evaluate the relationship between specific network involvement and empathy impairment among patients following stroke.
Conclusion:
Among patients with subacute ischemic stroke, reduced empathy was strongly associated with a more severe cognitive profile and atrophy of the right cingulate cortex. Our subsequent structural-informed functional MRI analysis suggests that the enhanced connectivity between the anterior cingulate gyrus and the superior parietal lobule may function as a compensatory mechanism for this atrophy.
