Resting State FMRI Study Of Brain Function Of Brain Heart Syndrome After Acute Ischemic Stroke

Objective: Acute cerebral ischemia can lead to cardiac damage in patients without an underlying cardiac disease,severe cases can occur myocardial damage or even sudden death,the mechanism is not clear.The aim of this study was to investigate the change of brain function in patients with brain heart syndrome(BHS)after acute cerebral infarction by resting-state functional magnetic resonance imaging(rs-fMRI).Methods: Sixteen patients with BHS after acute cerebral infarction(sex:14M,2F,mean age: 52.2±13.4 years)and twenty patients with acute cerebral infarction(sex: 17 M,3F,mean age: 56.5±11.1years)matched for age,sex and education,were recruited in this study.Each subject had no history of brain injury,stroke,brain tumor,mental disorder,major cardiovascular disease,alcohol or illict drug abuse.Functional MRI scan were conducted on all Subjects with MRI(Philips Achieva 3.0T X-series)equipped with a 8-channel head orthogonal coil under resting state conditions.Data preprocessing,statistical analysis and results demonstration were performed using REST V1.6 package and DPARSF V2.0 package based on Matlab R2009 a software.Data were eliminated according criteria as follows:(1)Head translation was more than 1mm or rotation more than 1°when detected by realign;(2)Normalization was undesirability.statistical analysis was conducted with two sample t-test between two groups.Demographic or clinical data were analyzed using the SPSS21.0statistical software package.Ages,education and national institute of health stroke scale(NISSH)score were subject to normal distribution and independent sample t-test was performed between two groups.Constituent ratio of sex between two groups were compared using fisher's exact test for fourfold table data.The difference was statistically significant(P<0.05).Results:1 Demographic variables(age,sex and education)were no statistically significant difference between two groups.Clinical data(NISSH score)were statistically significant difference between two groups.2 Compared with control group,BHS group significantly increased activation in right thalamus,right pons,callosum,left supplementary motor area,left paracentral lobule,left cerebellar anterior lobe,left cerebellar posterior lobe,right cingulate gyrus,left praecuneus,left superior occipital gyrus,left middle occipital gyrus.3 Compared with control group,BHS group significantly decreased activation in brain stem,left insula,right superior frontal orbit,left middle frontal gyrus,left middle temporal pole.Conclusions:1 Enhancement in excitability of brain areas remote from an ischaemic brain lesion,indicated that BHS induced and aggravated diaschisis after cerebral infarction.This may be one of the causes of progressive cerebral infarction or poor prognosis.2 The occurrence of BHS was closely related to the damage of brainstem and limbic system(mainly insular cortex)that dominated cardiac activity.3 Rs-fMRI has a potential clinical usefulness in assessing the location and mechanism of brain regions and predicting the occurrence of BHS after acute cerebral infarction.