Altered Neurovascular Coupling in Patients With Mitochondrial Myopathy, Encephalopathy, Lactic Acidosis, and Stroke-Like Episodes (MELAS): A Combined Resting-State fMRI and Arterial Spin Labeling Study.

Autor: Wang R; Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.; Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China., Liu X; Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.; Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China., Sun C; Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China., Hu B; Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.; Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China., Yang L; Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.; Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China., Liu Y; Luhang High School, Shanghai, China., Geng D; Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.; Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China., Lin J; Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China., Li Y; Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.; Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China.
Jazyk: angličtina
Zdroj: Journal of magnetic resonance imaging : JMRI [J Magn Reson Imaging] 2024 Jul; Vol. 60 (1), pp. 327-336. Date of Electronic Publication: 2023 Oct 05.
DOI: 10.1002/jmri.29035
Abstrakt: Background: Coupling between neuronal activity and blood perfusion is termed neurovascular coupling (NVC), and it provides a potentially new mechanistic perspective into understanding numerous brain diseases. Although abnormal brain activity and blood supply have been separately reported in mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS), whether anomalous NVC would be present is unclear.
Purpose: To investigate NVC changes and potential neural basis in MELAS by combining resting-state functional MRI (rs-fMRI) and arterial spin labeling (ASL).
Study Type: Prospective.
Subjects: Twenty-four patients with MELAS (age: 29.8 ± 7.3 years) in the acute stage and 24 healthy controls (HCs, age: 26.4 ± 8.1 years). Additionally, 12 patients in the chronic stage were followed up.
Field Strength/sequence: 3.0 T, resting-state gradient-recalled echo-planar imaging and pseudo-continuous 3D ASL sequences.
Assessment: Amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF), regional homogeneity (ReHo), and functional connectivity strength (FCS) were calculated from rs-fMRI, and cerebral blood flow (CBF) was computed from ASL. Global NVC was assessed by correlation coefficients of CBF-ALFF, CBF-fALFF, CBF-ReHo, and CBF-FCS. Regional NVC was also evaluated by voxel-wise and lesion-wise ratios of CBF/ALFF, CBF/fALFF, CBF/ReHo, and CBF/FCS.
Statistical Tests: Two-sample t-test, paired-sample t-test, Gaussian random fields correction. A P value <0.05 was considered statistically significant.
Results: Compared with HC, MELAS patients in acute stage showed significantly reduced global CBF-ALFF, CBF-fALFF, CBF-ReHo, and CBF-FCS coupling (P < 0.001). Altered CBF/ALFF, CBF/fALFF, CBF/ReHo, and CBF/FCS ratios were found mainly distributed in the middle cerebral artery territory in MELAS patients. In addition, significantly increased NVC ratios were found in the acute stroke-like lesions in acute stage (P < 0.001), with a recovery trend in chronic stage.
Data Conclusions: This study showed dynamic alterations in NVC in MELAS patients from acute to chronic stage, which may provide a novel insight for understanding the pathogenesis of MELAS.
Evidence Level: 2 TECHNICAL EFFICACY: Stage 1.
(© 2023 International Society for Magnetic Resonance in Medicine.)
Databáze: MEDLINE
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