The Changes In Brain Network And Functional Connectivity Of Stress-induced Hyperglycemia After Acute Cerebral Infarction

Objective: Stress-induced hyperglycemia is a common complication after acute cerebral infarction,seriously affecting patients’ prognosis,but the changes in the brain function network are unclear.This study explored the changes in brain networks and functional connectivity in patients with stress hyperglycemia after acute cerebral infarction.Methods:We collected 53 patients with different degrees of hyperglycemia after acute cerebral infarction from the second hospital of Hebei Medical University.The fasting glucose-to-glycated hemoglobin ratio was defined as the rate of stress hyperglycemia(SHR),and the subjects were divided into two groups based on SHR according to the 50 th percentile,named as low-level P50-group(SHR≤0.92,n=25)and high-level P50+ group(SHR>0.92,n=28),respectively.All subjects underwent resting-state functional magnetic resonance imaging and collected data based on the MATLAB R2013 b platform,(1)Using the GRETNA software package,the whole brain’s functional connectivity matrix was pre-processed using AAL 90 × 90 map.The related parameters of the brain network were calculated by limiting the sparsity of the brain network in the range of 0.05～0.4: small-world property(σvalue),standardized clustering coefficient(γ value),standardized shortest path(λ value);(2)Conn toolkit was used for data pre-processing and noise reduction,and the right insula was selected as the seed point for whole-brain functional connectivity analysis,followed by intra-group first-order analysis and inter-group second-order analysis.Results: The statistical results of two independent samples t-test showed that:(1)both P50-and P50+ groups had small-world attributes(σ>1),and there was no significant difference in σ values between the two groups(P>0.05);there was no significant difference in γ value between the two groups(P>0.05);there was a significant difference in λ value between the two groups(P<0.05),and λ value of P50+ group was higher than that of P50-group,compared with the P50-group,the functional connectivity of the right insular lobe to the right pallidum,the right anterior cuneiform lobe,the left inferior occipital cortex,the bilateral fusiform gyrus,and the right talar fissure was weakened in the P50+ Group.Conclusions:1.The topological structure of the brain network tends to change to the regular network when blood glucose increases after acute cerebral infarction.2.The functional connections between the right insula and multiple brain regions were weakened during the stress hyperglycemia after acute cerebral infarction.And the related brain regions involved multiple brain networks,which may be the nerve basis of impaired brain function.