Dynamics Of Cerebral Function In Patients With Acute Cerebellar Infarction Based On EEG Microstate Analysis

Objective: Few studies were devoted to investigating cerebral functional changes after acute cerebellar infarction(CI).The purpose of this study was to examine the brain functional dynamics of cerebellar infarction using electroencephalographic(EEG)microstate analysis.Additionally,the possible heterogenicity of neural dynamics in patients with dizziness and vertigo after cerebellar infarction and in patients with different infarction locations.Methods: Thirty-four patients with acute cerebellar infarction attending the Affiliated Hospital of Southwest Medical University were included in this study,while thirty-seven age-and sex-matched healthy controls were included in the study.Each included subject underwent a 19-channel video EEG examination.Five 10-s resting-state EEG epochs were extracted after data preprocessing.Then,microstate analysis and source localization analysis were performed using the LORETA-KEY tool.Microstate parameters such as duration,coverage,occurrence,and transition probability are all extracted.The cerebellar infarction group was divided into two subgroups by clinical characteristics and different infarct locations,and the differences in microstate parameters between the two groups were compared.Finally,we randomized 34 patients with cerebellar infarction into two groups for five times and compared the microstate topography and source localization results between the two groups to verify the stability of the data.Results: The microstate topography is marked into four categories A,B,C,and D respectively.The results of this study are as follows: 1.The comparison of the microstate results between patients with cerebellar infarction and healthy controls: the duration,coverage,and occurrence of microstate B(Ms B)were significantly increased in patients with cerebellar infarction,however,the duration and coverage of microstate A(Ms A)and Microstate D(Ms D)were decreased.The mutual transition of microstate C(Ms C)and Ms B was increased with cerebellar infarction,as well as the transition from Ms A to Ms B,but the transition from Ms B to Ms A and Ms D,Ms C to Ms A,and Ms A to Ms D decreased.2.Results of microstate analysis of patients with cerebellar infarction and healthy controls: Source localization from Ms A to Ms D in patients with cerebellar infarction in the order of Anterior Cingulate and Limbic Lobe(BA25),Anterior Cingulate Limbic Lobe(BA32),Paracentral Lobule and Frontal Lobe(BA5),and Cingulate Gyrus and Limbic Lobe(BA23),while in healthy controls in the order of Postcentral Gyrus and Parietal Lobe(BA3),Anterior Cingulate and Limbic Lobe(BA25),Cingulate Gyrus and Limbic Lobe(BA31),and Cingulate Gyrus and Limbic Lobe(BA23).3.Results of subgroup analysis by clinical characteristics: Compared with patients with vertigo after cerebellar infarction to dizziness,finding an increase in the coverage of Ms D and an increase in the transition from Ms A and Ms B to Ms D.4.Results of the subgroup analysis by the infarct locations: Compared to patients with multi-domain task battery(MDTB)atlas of cognitive areas with ≤2 infarct locations to >2,finding an increase in the coverage and occurrence of Ms B and a decrease in the coverage and occurrence of Ms A and Ms D,furthermore,the transition of Ms B and Ms C were increased and the transition from Ms B to Ms A and Ms D,Ms C to Ms D,and Ms D to Ms A were decreased.Subgroup comparison divided by anatomical localization revealed no statistically significant differences in microstates between patients with anterior and posterior cerebellar infarction.Subgroup comparison divided by Macro functional localization also revealed no statistically significant differences in microstates between corticocerebellar infarction patients and spinocerebellar infarction patients.5.Random grouping results: comparison of the results of five random groupings revealed no statistically significant differences in microstate parameters among the subgroups and maintained stability,and with similar source localization distribution regions.Conclusion: Taken together,our study sheds new light on the dynamics of cerebral function after cerebellar infarction,mainly reflecting increased activity in functional networks involved in Ms B and decreased activity in functional networks involved in Ms A and Ms D.Furthermore,source analysis revealed the structural basis of abnormal brain function in patients with acute cerebellar infarction on a spatial scale.Alterations in cerebellar functional dynamics correlate with the location of infarction and clinical features after cerebellar infarction.Cerebellar infarction in different functional regions may have different effects on brain function,and there are some objective differences in brain dynamics between dizziness and vertigo after cerebellar infarction,mainly in the form of decreased network activity associated with microstate D in patients with vertigo.Further longitudinal studies are needed to explore the alterations in brain dynamics to what extent depict the clinical traits and their potential applications in the recovery of CI.