Huiyou Chen

Tinnitus distress is linked to enhanced resting‐state functional connectivity from the limbic system to the auditory cortex

The phantom sound of tinnitus is believed to be triggered by aberrant neural activity in the central auditory pathway, but since this debilitating condition is often associated with emotional distress and anxiety, these comorbidities likely arise from maladaptive functional connections to limbic structures such as the amygdala and hippocampus. To test this hypothesis, resting‐state functional magnetic resonance imaging (fMRI) was used to identify aberrant effective connectivity of the amygdala and hippocampus in tinnitus patients and to determine the relationship with tinnitus characteristics. Chronic tinnitus patients (n = 26) and age‐, sex‐, and education‐matched healthy controls (n = 23) were included. Both groups were comparable for hearing level. Granger causality analysis utilizing the amygdala and hippocampus as seed regions were used to investigate the directional connectivity and the relationship with tinnitus duration or distress. Relative to healthy controls, tinnitus patients demonstrated abnormal directional connectivity of the amygdala and hippocampus, including primary and association auditory cortex, and other non‐auditory areas. Importantly, scores on the Tinnitus Handicap Questionnaires were positively correlated with increased connectivity from the left amygdala to left superior temporal gyrus (r = 0.570, P = 0.005), and from the right amygdala to right superior temporal gyrus (r = 0.487, P = 0.018). Moreover, enhanced effective connectivity from the right hippocampus to left transverse temporal gyrus was correlated with tinnitus duration (r = 0.452, P = 0.030). The results showed that tinnitus distress strongly correlates with enhanced effective connectivity that is directed from the amygdala to the auditory cortex. The longer the phantom sensation, the more likely acute tinnitus becomes permanently encoded by memory traces in the hippocampus. Hum Brain Mapp 38:2384–2397, 2017.

A High-Resolution MRI Study of Relationship between Remodeling Patterns and Ischemic Stroke in Patients with Atherosclerotic Middle Cerebral Artery Stenosis

Purpose: Recently, high-resolution magnetic resonance imaging (HR-MRI) has been used to depict the wall characteristics of the intracranial arteries. The aim of this study was to explain the relationship between the remodeling patterns and acute ischemic stroke in patients with atherosclerotic middle cerebral artery (MCA) stenosis using HR-MRI. Materials and Methods: From August 2015 to May 2016, we prospectively screened 33 consecutive patients with unilateral MCA stenosis using time-to-flight MR angiography, including 15 patients with symptomatic MCA stenosis and 18 patients with asymptomatic MCA stenosis. Among them, 14 patients were diagnosed as positive remodeling (PR) and 19 as negative remodeling or non-remodeling. The cross-sectional images of the stenotic MCA wall on HR-MRI including T1WI, T2WI, and PDWI were compared between the symptomatic group and the asymptomatic group as well as the PR group and the non-PR group, based on the vessel area, lumen area, wall area, plaque area, degree of stenosis, remodeling index, and NIHSS score. Results: The symptomatic group had larger wall area (P = 0.040), plaque area (P<0.001), degree of stenosis (P = 0.038), remodeling index (P < 0.001), and NIHSS score (P = 0.003) as well as smaller lumen area (P = 0.001) than the asymptomatic group. In addition, more PR patients were observed in symptomatic group. The PR group had larger plaque area (P = 0.014) and NIHSS score (P = 0.037) than the non-PR group. Demographic and clinical characteristics between the symptomatic group and the asymptomatic group, the PR group and the non-PR group showed no statistical difference. Conclusion: The current study suggests that the HR-MRI has emerged as a promising tool to detect the characteristics of intracranial arteries wall and reveal the relationship between remodeling patterns and ischemic stroke. The PR is an unsafe remodeling way and is prone to cause acute ischemic stroke.

Corticospinal tract changes in acute brainstem ischemic stroke patients: A diffusion kurtosis imaging study

Purpose: The present study aimed to investigate the corticospinal tract (CST) changes in patients with brainstem ischemic stroke by using the diffusion kurtosis imaging (DKI) approach.. Materials and Methods: Twenty-one patients with brainstem stroke and 21 group-matched healthy controls underwent brain DKI with 3.0 T magnetic resonance imaging (MRI). The DKI was obtained by using three b values of 0, 1,000, 2,000 s/mm2 with 15 diffusion directions. Regions of interest (ROIs) were placed at four levels: the pons, posterior limb of the internal capsule (PLIC), corona radiata, and precentral gyrus. The DKI parameters, including fractional anisotropy (FA), mean diffusivity (MD), and mean kurtosis (MK) values, in these regions were measured from the contralateral to the ipsilateral side of patients and both the left and right sides of healthy controls at all the four selected levels. Results: The ipsilateral side of the ischemic lesion showed a decrease in FA and MD and an increase in MK when compared with the contralateral normal region at all the four selected levels with statistically differences (P < 0.05). At these four selected levels, there were no differences between the left and right sides in healthy controls with MD, FA, and MK (P > 0.05). The MD values of the contralateral side of the ischemic lesion in patients at the four selected levels were significantly higher than those in the corresponding side of the healthy controls (P < 0.05). Compared to the healthy controls, there was a decrease at the posterior limb of the internal capsule (PLIC) in FA of the contralateral side of the ischemic lesion in stroke patients (P < 0.05). However, no significant differences were observed for MK values between the groups (P > 0.05). Conclusion: The current results suggest that the DKI technique could identify the early microstructural changes along the motor pathway and that these changes were not limited to the ipsilateral side of the ischemic lesion; in fact, the contralateral changes also occurred, especially at the PLIC.

Disrupted functional connectivity of the amygdala is associated with depressive mood in type 2 diabetes patients

BACKGROUND Type 2 diabetes mellitus (T2DM) and mood disorders share pathophysiological commonalities in the central nervous system. The purpose of this study was to investigate the alterations in amygdala-based emotional processing circuits in T2DM patients with depressive mood using resting-state functional magnetic resonance imaging (rs-fMRI). METHODS T2DM patients with depressive mood (n = 25), T2DM patients without depressive mood (n = 28) and matched healthy controls (n = 25) underwent neuropsychological testing and rs-fMRI scanning. A seed-based correlation analysis was conducted to reveal the altered functional connectivity (FC) of the amygdala. The bilateral amygdala FC was compared among the three groups. Pearson correlation analyses were performed in a voxel-wise manner to investigate the relationship between amygdala FC and the clinical characteristics. RESULTS The depressed T2DM patients exhibited the worst performance on the neuropsychological tests among the three groups. Compared to the non-depressed T2DM patients, the depressed T2DM patients showed decreased amygdala FC in the cingulate cortex, inferior frontal gyrus, fusiform gyrus, and precentral gyrus. Moreover, the amygdala FC in the cingulate cortex was associated with the Self-Rating Depression Scale (SDS) score in the T2DM patients. LIMITATIONS Cross-sectional design. CONCLUSIONS The current study revealed the cognitive changes and alterations in the amygdala-cingulate functional disconnections in T2DM patients with depressive mood, which will advance the understanding of the neural mechanisms underlying depression in T2DM patients.

Disrupted spontaneous neural activity related to cognitive impairment in postpartum women

Purpose: Prior research has demonstrated that the postpartum period is associated with an increased risk of cognitive impairment. This study aims to investigate whether disrupted spontaneous neural activity exists in postpartum women without depression using resting-state functional magnetic resonance imaging (rs-fMRI) and to detect the relationship between these abnormalities and cognitive impairment. Materials and Methods: Postpartum women (n = 22) were compared with age- and education-matched nulliparous women (n = 23) using rs-fMRI. We calculated the amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) values to evaluate spontaneous neural activity and detect the relationship between rs-fMRI data and cognitive performance. Results: Relative to nulliparous women, postpartum women had significantly decreased ALFF and ReHo values primarily in the left posterior cingulate cortex (PCC) and prefrontal cortex and increased ALFF values in left cerebellar posterior lobe. We found a positive correlation between the ALFF and ReHo values in the PCC and the complex figure test (CFT)-delayed scores in postpartum women (r = 0.693, p = 0.001; r = 0.569, p = 0.011, respectively). Moreover, the clock-drawing test (CDT) scores showed positive correlations with the ALFF and ReHo values in the right superior frontal gyrus (SFG; r = 0.492, p = 0.033; r = 0.517, p = 0.023, respectively). Conclusion: Our combined ALFF and ReHo analyses revealed decreased spontaneous neural activity, mainly in the PCC and prefrontal cortex, which was correlated with specific impaired cognitive functioning in postpartum women. This study may elucidate the neurophysiological mechanisms underlying postpartum cognitive impairment and enhance our understanding of the neurobiological aspects of the postpartum period.

Abnormal Resting-State Functional Connectivity of the Anterior Cingulate Cortex in Unilateral Chronic Tinnitus Patients

Purpose: The anterior cingulate cortex (ACC) has been suggested to be involved in chronic subjective tinnitus. Tinnitus may arise from aberrant functional coupling between the ACC and cerebral cortex. To explore this hypothesis, we used resting-state functional magnetic resonance imaging (fMRI) to illuminate the functional connectivity (FC) network of the ACC subregions in chronic tinnitus patients. Methods: Resting-state fMRI scans were obtained from 31 chronic right-sided tinnitus patients and 40 healthy controls (age, sex, and education well-matched) in this study. Rostral ACC and dorsal ACC were selected as seed regions to investigate the intrinsic FC with the whole brain. The resulting FC patterns were correlated with clinical tinnitus characteristics including the tinnitus duration and tinnitus distress. Results: Compared with healthy controls, chronic tinnitus patients showed disrupted FC patterns of ACC within several brain networks, including the auditory cortex, prefrontal cortex, visual cortex, and default mode network (DMN). The Tinnitus Handicap Questionnaires (THQ) scores showed positive correlations with increased FC between the rostral ACC and left precuneus (r = 0.507, p = 0.008) as well as the dorsal ACC and right inferior parietal lobe (r = 0.447, p = 0.022). Conclusions: Chronic tinnitus patients have abnormal FC networks originating from ACC to other selected brain regions that are associated with specific tinnitus characteristics. Resting-state ACC-cortical FC disturbances may play an important role in neuropathological features underlying chronic tinnitus.

Presbycusis Disrupts Spontaneous Activity Revealed by Resting-State Functional MRI

Purpose: Presbycusis, age-related hearing loss, is believed to involve neural changes in the central nervous system, which is associated with an increased risk of cognitive impairment. The goal of this study was to determine if presbycusis disrupted spontaneous neural activity in specific brain areas involved in auditory processing, attention and cognitive function using resting-state functional magnetic resonance imaging (fMRI) approach. Methods: Hearing and resting-state fMRI measurements were obtained from 22 presbycusis patients and 23 age-, sex- and education-matched healthy controls. To identify changes in spontaneous neural activity associated with age-related hearing loss, we compared the amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo) of fMRI signals in presbycusis patients vs. controls and then determined if these changes were linked to clinical measures of presbycusis. Results: Compared with healthy controls, presbycusis patients manifested decreased spontaneous activity mainly in the superior temporal gyrus (STG), parahippocampal gyrus (PHG), precuneus and inferior parietal lobule (IPL) as well as increased neural activity in the middle frontal gyrus (MFG), cuneus and postcentral gyrus (PoCG). A significant negative correlation was observed between ALFF/ReHo activity in the STG and average hearing thresholds in presbycusis patients. Increased ALFF/ReHo activity in the MFG was positively correlated with impaired Trail-Making Test B (TMT-B) scores, indicative of impaired cognitive function involving the frontal lobe. Conclusions: Presbycusis patients have disrupted spontaneous neural activity reflected by ALFF and ReHo measurements in several brain regions; these changes are associated with specific cognitive performance and speech/language processing. These findings mainly emphasize the crucial role of aberrant resting-state ALFF/ReHo patterns in presbycusis patients and will lead to a better understanding of the neuropathological mechanisms underlying presbycusis.

Increased Resting-State Cerebellar-Cerebral Functional Connectivity Underlying Chronic Tinnitus

Purpose: Chronic subjective tinnitus may arise from aberrant functional coupling between the cerebellum and the cerebral cortex. To explore this hypothesis, we used resting-state functional magnetic resonance imaging (fMRI) to illuminate the functional connectivity network of the cerebellar regions in chronic tinnitus patients and controls. Methods: Resting-state fMRI scans were obtained from 28 chronic tinnitus patients and 29 healthy controls (well matched for age, sex and education) in this study. Cerebellar-cerebral functional connectivity was characterized using a seed-based whole-brain correlation method. The resulting cerebellar functional connectivity measures were correlated with each clinical tinnitus characteristic. Results: Chronic tinnitus patients demonstrated increased functional connectivity between the cerebellum and several cerebral regions, including the superior temporal gyrus (STG), parahippocampal gyrus (PHG), inferior occipital gyrus (IOG), and precentral gyrus. The enhanced functional connectivity between the left cerebellar Lobule VIIb and the right STG was positively correlated with the Tinnitus Handicap Questionnaires (THQ) score (r = 0.577, p = 0.004). Furthermore, the increased functional connectivity between the cerebellar vermis and the right STG was also associated with the THQ score (r = 0.432, p = 0.039). Conclusions: Chronic tinnitus patients have greater cerebellar functional connectivity to certain cerebral brain regions which is associated with specific tinnitus characteristics. Resting-state cerebellar-cerebral functional connectivity disturbances may play a pivotal role in neuropathological features of tinnitus.

Decreased functional connectivity within the default-mode network in acute brainstem ischemic stroke

PURPOSE Ischemic stroke within the brainstem is associated with an increased risk of cognitive dysfunction. This study aimed to explore the integrity of a default-mode network (DMN) and its relationship with clinical variables in patients with acute ischemic brainstem stroke using an independent component analysis (ICA) approach. MATERIALS AND METHODS Twenty-one patients with acute ischemic brainstem stroke and 25 well-matched healthy subjects were enrolled in this study and underwent resting-state functional magnetic resonance imaging. The ICA was adopted to extract the DMN, including its anterior and posterior components. Pearson correlation analyses were performed to investigate the relationship between DMN connectivity and clinical variables. RESULTS Compared with healthy controls, patients with acute ischemic stroke showed significantly decreased functional connectivity in the right medial prefrontal cortex (mPFC) and right precuneus within the anterior and posterior DMN, respectively. After correcting for age, sex, and education, hypoconnectivity in the right mPFC and right precuneus was negatively correlated with higher homocysteine in patients with stroke (r = -0.592, p = 0.010 and r = -0.491, p = 0.039, respectively). CONCLUSION The finding of decreased functional connectivity within the DMN of patients with acute brainstem stroke provides novel insight into the neural mechanisms that underlie cognitive impairment following ischemic insult to this brain region.

Collateral vessels on magnetic resonance angiography in endovascular-treated acute ischemic stroke patients associated with clinical outcomes

Purpose Collateral vessels were considered to be related with outcome in endovascular-treated acute ischemic stroke patients. This study aimed to evaluate whether the collateral vessels on magnetic resonance angiography (MRA) could predict the clinical outcome. Materials and Methods Acute stroke patients with internal carotid artery or middle cerebral artery occlusion within 6 hours of symptom onset were included. All patients underwent MRI and received endovascular treatment. The collateral circulations at the Sylvian fissure and the leptomeningeal convexity were evaluated. The preoperative and postoperative infarct volume was measured. The clinical outcome was evaluated by mRS score at 3 months after stroke. Results Of 55 patients, Cases with insufficient collateral circulation at the Sylvian fissure and leptomeningeal convexity showed that the NIHSS score at arrival and preoperative infarct volume were significantly lower in mRS score of 0–2 (both P < 0.05) than mRS score of 3–6. Multivariate testing revealed age and collateral status at the leptomeningeal convexity were independent of the clinical outcome at 3 months after stroke (odds ratio (95% confidence interval): 1.094 (1.025–1.168); 9.542 (1.812–50.245) respectively). The change of infarct volume in the group with mRS score of 0–2 was smaller than that with mRS score of 3–6. While multivariate logistic models showed that postoperative infarct volume was non-significant in predicting the clinical outcome after stroke. Conclusions The extent of collateral circulation at the leptomeningeal convexity may be useful for predicting the functional recovery while the relationship between postoperative infarct volume and clinical outcome still requires for further study.