A Resting-state Functional MRI Study On Stress Hyperglycemia After Acute Cerebral Infarction

Objective:Acute cerebral infarction(ACI)can lead to stress hyperglycemia(SH)in a minority of patients.However,the neural mechanism that underline this disorder remains unclear.To investigate the changes of the brain function in the patients with SH after ACI,we conducted this research with the method of resting-stating functional magnetic resonance imaging(rs-f MRI).Methods: All the subjects consisted of 23 patients with SH after ACI(15 males,8 females,55±13 years)and 29 controls without SH after ACI(20 males,9 females,55±10 years).The two groups were matched with age,gender and education.Data of resting blood oxygen level dependent(BOLD)functional magnetic resonance imaging were collected from all subjects.Then data preprocessing,statistical analysis and result display were performed using the REST v1.6 package and DPARSF 2.0 package based on Matlab R2012-a software platform.Data exclusion criteria:(1)Head translation was more than 1 mm or rotation more than 1°by realign;(2)Normalization with undesirability.Demographic variables and clinical data were performed on SPSS21.0 statistical analysis software.Age,education,and the NIHSS scores were subject to normal distribution.Then we conducted independent sample t-test between the two groups with a significant P value of 0.05.Fisher's exact test for fourfold table data was used to compare the difference of gender composition ratio between the two groups,and P<0.05 was statistically significant.Results:1.Demographic variables(gender,age and education)and clinical data(NIHSS score)between the two groups were no statistically significance.Clinical data(Fasting plasma glucose)were statistically significant difference between the two groups.2.Compared with the control group,SH group significantly increased activation in insular lobe,frontal inferior gyrus,right temporal inferior gyrus,frontal cortex,right middle gyrus upon ALFF values.3.Compared with the control group,SH group significantly increased activation in anterior cingulate gyrus,left recutus gyrus,right middle temporal gyrus,right cerebellar hemispheres,brainstem,parietal lobe upon Re Ho values.4.Compared with the control group,SH group significantly decreased activation in left insular cortex,hippocampus,corpus albicans,fornix upon Re Ho values.Conclusions:1.The occurrence of SH after acute cerebral infarction was highly correlated to the right insular cortex.2.The limbic system and brainstem may participate in the regulation of SH after acute cerebral infarction to some extent.3.In contrast to patients without SH after stroke,patients with SH after stroke were more likely to get poor prognosis on learning,memory,and cognitive functions.4.Rs-f MRI has a potential usefulness in assessing the location and mechanism of brain regions and predicting the occurrence and progress of SH after acute cerebral infarction.