Regional Homogeneity Of Resting-state Brain Activity In Patients With Cerebrocardiac Syndrome After Acute Ischemic Stroke

Objective: The aim of this study was to identify regional alterations in brain function associated with cerebrocardiac syndrome after acute ischemic stroke in patients by resting-state functional magnetic resonance imaging(rs-fMRI).Methods: Twenty-one patients with CCS(sex: 16 M,5F,mean age:64.6±5.0 years,range from 56 to 74 years)and thirty-five patients with acute ischemic stroke(sex: 27 M,8F,mean age: 62.6±4.5 years,range from 54 to 72years)matched for age,sex and education,were recruited in this study.There was no history of traumatic brain injury,ischemic stroke,hemorrhagic stroke,mental illness,severe cardiovascular disease,smoking,alcohol,drugs and psychotropic substance abuse in the experimental group and the control group.Subjects were performed rs-fMRI scan within 72 hours after onset if they met the inclusive criteria after routine brain scans.The raw data were processed with data processing assistant for rs-fMRI(DPARSF 2.2 Basic Edition)on the Matlab R2012 a software.We got Regional Homogeneity(ReHo),then,to analyse the maps using rs-fMRI data analysis toolkit(REST 1.8,http://www.restfmri.net)and make the statistical analysis using two sample t-test.Next,we could display functional activation areas,peak MNI coordinate,cluster sizes and T value with statistical significance in two groups.Basic data were analyzed using the SPSS statistical software package(version 21.0).Ages,education level were subject to normal distribution and independent sample t-test was performed between the experimental group and the control group.And the difference was statistically significant(P<0.05).Constituent ratio of sex between the experimental group and the control group were compared using fisher’s exact test for fourfold table data.And the difference was statistically significant(P<0.05).Results:1.The comparison of the general data between the two groups: the age,sex and educational level of the CCS group and the matched group have no significant statistical significance.2.Compared with the matched group,the brain areas with significant higher Re Ho value in CCS group were as follow: right thalamus,dorsal medial nucleus,bilateral pons,midbrain,corpus callosum,right paracentral lobule,right precuneus,right middle frontal gyrus,right inferior frontal gyrus,left superior occipital gyrus,left parahippocampal gyrus,left middle occipital gyrus,left middle occipital gyrus.3.Compared with the matched group,ReHo value in CCS group were significantly decreased in left insula,amygdale,right anterior cingulate gyrus,left marginal lobe,both middle temporal pole,right superior temporal gyrus.Conclusions:1.Limbic system(insula,amygdale)brain activity synchronism weakened,indicating that the location of ischemic stroke may be associated with CCS.2.In the case of acute ischemic stroke patients with CCS,there may be damage to the distant site,which may lead to stroke progression.,and the necessary measures should be taken in time.3.CCS patients with subcortical reticular structure(in the medulla oblongata,pons,midbrain and thalamus)brain activity synchronism enhanced,to maintain a level of arousal,it may be a compensatory mechanism.