Tracking Brain Network and Cognitive Recovery in DAVF: A Longitudinal rsfMRI Study of Low-Frequency Fluctuations

Area of Science:

• Neuroimaging
• Neurology
• Cognitive Neuroscience

Background:

• Intracranial dural arteriovenous fistula (DAVF) impairs cerebral hemodynamics, affecting brain connectivity and cognitive function.
• Understanding the dynamic changes in brain activity and cognition post-treatment is crucial for DAVF management.

Purpose of the Study:

• To evaluate spontaneous brain activity and cognitive changes in DAVF patients using rsfMRI and neuropsychological assessments.
• To track recovery longitudinally at baseline, 1 month, and 1 year post-embolization.

Main Methods:

• Fifty DAVF patients and 50 controls underwent rsfMRI, analyzing Amplitude of Low-Frequency Fluctuation (ALFF) and fractional ALFF (fALFF).
• Cognitive performance was assessed using the Addenbrooke's Cognitive Examination (ACE).
• ACE scores were used as covariates to investigate cognitive-network associations.

Main Results:

• DAVF patients exhibited altered ALFF/fALFF in frontal, insular, and parietal regions, particularly in the Default Mode Network (DMN) and Dorsal Attention Network (DAN).
• Post-embolization, rsfMRI metrics and ACE scores showed improvement and normalization trends.
• Memory and visuospatial scores correlated with ALFF in the DMN and DAN, respectively.

Conclusions:

• DAVF disrupts brain network integrity and cognition, with partial recovery observed after treatment.
• rsfMRI-derived ALFF/fALFF measures, combined with cognitive scores, show potential for DAVF prognosis and monitoring.