Functional network reorganization and memory impairment in unruptured brain arteriovenous malformations

Brain arteriovenous malformations (AVMs) are congenital vascular anomalies that can affect cognitive, particularly memory functions. However, the underlying mechanisms of neurocognitive abnormalities in unruptured AVMs remain unclear. This study aimed to explore spontaneous functional network reorganization associated with memory impairment in unruptured AVM patients using resting-state functional MRI (rsfMRI).

Using rsfMRI data, we compared functional activity and connectivity patterns between 25 AVM patients and healthy controls, including regional homogeneity (ReHo), fractional amplitude of low-frequency fluctuations (fALFF), seed-based functional connectivity (FC), and lesion network mapping. Correlation analysis was performed to clarify the relationship between these parameters and memory performance in AVM patients.

We identified memory-related spontaneous functional network reorganization in AVM patients, particularly involving the somatomotor network (SMN), frontoparietal control network (FPN), and default mode network (DMN). Subgroup analyses based on lesion location (frontal vs. non-frontal) and laterality (left vs. right) revealed location-dependent differences in connectivity reorganization. In particular, left-sided AVMs showed disrupted FC within the SMN, correlated with working memory and executive function, while right-sided and frontal AVMs exhibited more complex patterns involving multiple networks. Moreover, functional disconnection maps indicated that AVM lesions did not directly impair resting-state memory networks.

Patients with unruptured AVMs exhibit resting-state memory network reorganization, which is closely related to the lesion location. These findings highlight the functional network alterations in AVM patients and suggest the potential neural mechanisms underlying memory deficits.