Resting-state functional connectivity alterations in post-stroke cognitive impairment: a systematic review

Area of Science:

• Neuroscience
• Radiology
• Cognitive Science

Background:

• Post-stroke cognitive impairment (PSCI) is a prevalent, disabling condition with poorly understood mechanisms.
• Functional neuroimaging, specifically resting-state functional magnetic resonance imaging (rs-fMRI), offers potential insights into PSCI pathophysiology.
• Understanding connectivity changes is crucial for predicting cognitive decline and optimizing rehabilitation.

Purpose of the Study:

• To synthesize current knowledge on rs-fMRI findings in PSCI.
• To correlate these findings with cognitive performance and compensatory connectivity changes.
• To explore the potential of rs-fMRI in understanding PSCI and guiding interventions.

Main Methods:

• A qualitative systematic literature review was conducted.
• Searched major electronic databases (Medline, Scopus, Web of Science, Cochrane, BASE) until June 2024.
• Included 23 studies reporting rs-fMRI data in PSCI patients.

Main Results:

• Key areas with decreased functional connectivity in PSCI include the medial prefrontal cortex, inferior frontal gyrus, cingulate cortex, precuneus, and hippocampus.
• The default mode network was the principal network showing altered connectivity.
• Increased connectivity in contralesional areas may indicate compensatory or maladaptive changes.

Conclusions:

• rs-fMRI is a promising tool for investigating functional alterations in PSCI.
• It enhances understanding of PSCI pathophysiology and associated network changes.
• rs-fMRI may aid in selecting optimal timing and candidates for cognitive rehabilitation.