Resting Functional Magnetic Resonance Imaging Study Of Cognitive Dysfunction In Convalescent Stroke Patients

Part 1: Changes of ALFF,ReHo and FC in patients with cognitive impairment after stroke and their relationship with cognitive levelObjective: Cognitive dysfunction after stroke has a great influence on patients’ mental health and family life,and the pathogenesis of cognitive dysfunction after stroke is unknown.In this study,the techniques of Amplitude of Low Frequency Fluctuation(ALFF),Regional Homogeneity(ReHo)and Functional Connectivity(FC)of resting-state functional magnetic resonance imaging(rs-f MRI)based on blood oxygen level dependence(BOLD)were used to explore the abnormal changes of brain neuron activity in patients with cognitive impairment after stroke compared with healthy people and its correlation with clinical scale.Methods:From June 2020 to January 2021,26 stroke patients admitted to the Fifth Treatment and Rehabilitation Department of Inner Mongolia International Mongolian Medical Hospital were collected,and 28 healthy control(HC)groups without cognitive impairment matched with gender,ethnicity,age and years of education were collected.All the staff were evaluated by Nati onal Institutes of Health Stroke Scale(NIHSS),Mini-Mental State Examination,(MMSE)and Montreal Cognitive Assessment(MoCA),and the stroke patients were divided into two groups: post-stroke patients with cognitive impairment(CI)and post-stroke patients with cognitive normal function(CN).The resting functional magnetic resonance data of all personnel were collected,and the data were analyzed by post-processing software,and the activated brain region with statistical significance was obtained,and the correlation between it and clinical scale was analyzed.Results: 1.There was no statistical difference in demographic data among CI group,CN group and HC group(P > 0.05),but there was comparability among them.The scores of Montreal Cognitive Assessment Scale and Simplified Mental State Scale in CI Group and CN Group were lower than those in HC Group,and the difference was statistically significant(P < 0.01).After variance analysis,the activated brain regions with increased ALFF value in 3 CI group,CN group and HC group were right anterior cingulate gyrus,right medial orbitofrontal lobe,left hippocampus,left parahippocampal gyrus,left superior occipital gyrus and right thalamus,with statistical difference(F = 21.62,P < 0.01).The brain areas activated by FC value were left inferior parietal lobe,right inferior temporal gyrus,left parahippocampal gyrus,right central sulcus cover,left thalamus and left superior temporal gyrus,with statistical difference(F= 9.41,P <0.01).After analysis of variance,t test results of pairwise samples were as follows:(1)The brain area with decreased ALFF value in HC group in CN group was the right thalamus,with statistical difference(t =-6.93,P < 0.01);(2)compared with CI group,the increased ALFF value in HC group was putamen,with statistical difference(t = 6.68,P< 0.01).(3)in CI group,the brain area with decreased ALFF in CN group was left superior marginal gyrus,with statistical difference(t =-6.64,P < 0.01).(4)In HC group,the brain area with higher ReHo value in CI group was the right superior temporal gyrus,with statistical difference(t = 7.04,P< 0.01).The ALFF,ReHo and FC values of the three groups all had activated brain regions related to MMSE and MoCA,which had statistical significance(P < 0.05).Conclusion: In patients with post-stroke cognitive dysfunction,there are cognitive abnormalities in local brain neurons and brain regions at rest.The main brain regions are left superior marginal gyrus,right thalamus,putamen and right superior temporal gyrus.The above research results show that ALFF,ReHo and FC methods can be effectively used to evaluate the cognitive state of patients after stroke,and play an important role in predicting and evaluating the rehabilitation effect and expectation of patients with cognitive dysfunction after stroke in the future,which is expected to become an imaging examination project and be applied in clinic.Part 2: Changes of ALFF,ReHo and FC in cognitive dysfunction of stroke patients treated with Mongolian medicine acupuncture and moxibustion and their relationship with cognitive levelObjective: The effect of Mongolian acupuncture on patients with cognitive dysfunction after stroke was confirmed by resting functional magnetic resonance examination technology.The differences of brain regions after Mongolian acupuncture treatment compared with those before treatment and their correlation with clinical scale were discussed by using ALFF,ReHo and FC methods.Methods: 17 stroke patients were collected from June 2020 to January 2021 in the Department of Fifth Therapy and Rehabilitation,Inner Mongolia International Mongolian Medical Hospital.The stroke patients were divided into two groups according to the time : before the Mongolian acupuncture treatment group(BT)and afer the Mongolian acupuncture treatment group(AT).The patients were evaluated by NIHSS,MMSE,MoCA clinical scale before and after treatment,and the rest MRI data of all patients were collected.The data were analyzed by post-processing software,and the brain regions with statistical significance were obtained.Results: Compared with BT group,the clinical scale of AT group was statistically significant(P < 0.01).(1)The brain areas with higher ALFF value are anterior cuneiform lobe and superior parietal gyrus;The decreased brain areas were inferior temporal gyrus and fusiform gyrus.(2)The brain areas with increased ReHo value were superior parietal gyrus and anterior cuneiform lobe.The decreased brain areas were middle temporal gyrus,parahippocampal gyrus,lentiform nucleus and ventrolateral thalamic nucleus.(3)The brain areas with higher FC value are inferior parietal lobe,anterior cuneiform lobe,posterior cingulate gyrus,superior occipital gyrus,angular gyrus,superior marginal gyrus and superior temporal gyrus.The decreased brain area is the middle occipital gyrus.Conclusion:Mongolian medicine acupuncture and moxibustion treatment of stroke patients with cognitive dysfunction has shown remarkable improvement through resting functional magnetic resonance ALFF,ReHo and FC methods and correlation analysis.after Mongolian medicine acupuncture and moxibustion treatment,compared with before treatment,the brain regions which show positive activation in the three methods are the precuneus lobe and parietal lobe,and their corresponding cortical regions may be potential targets of Mongolian medicine acupuncture and moxibustion treatment for cognitive function.the resting blood oxygen level depends on functional magnetic resonance imaging technology combined with traditional Mongolian medicine acupuncture and moxibustion therapy can help the diagnosis and treatment of cognitive dysfunction after stroke.