Functional Network-Based Statistics Reveal Abnormal Resting-State Functional Connectivity in Minimal Hepatic Encephalopathy

Abstract

Purpose: Whole-brain functional network analysis is an emerging methodology for exploring the mechanisms underlying hepatic encephalopathy (HE). This study aimed to identify the brain subnetwork that is significantly altered within the functional connectome in minimal HE (MHE), the earliest stage of HE.Materials and Methods: The study enrolled 19 cirrhotic patients with MHE and 19 controls who underwent the resting-state functional magnetic resonance imaging and cognitive assessment based on the Psychometric Hepatic Encephalopathy Score (PHES). A whole-brain functional connectivity (FC) matrix was calculated for each subject. Then, network-based statistical analyses of the functional connectome were used to perform group comparisons, and correlation analyses were conducted to identify the relationships between FC alterations and cognitive performance.Results: MHE patients showed significant reduction of positive FC within a subnetwork that predominantly involved the regions of the default-mode network, such as the bilateral posterior cingulate gyrus, bilateral medial prefrontal cortex, bilateral hippocampus and parahippocampal gyrus, bilateral angular gyrus, and left lateral temporal cortex. Meanwhile, MHE patients showed significant reduction of negative FC between default-mode network regions (such as the bilateral posterior cingulate gyrus, medial prefrontal cortex, and angular gyrus) and the regions involved in the somatosensory network (i.e., bilateral precentral and postcentral gyri) and the language network (i.e., the bilateral Rolandic operculum). The correlations of FC within the default-mode subnetwork and PHES results were noted.Conclusion: Default-mode network dysfunction may be one of the core issues in the pathophysiology of MHE. Our findings support the notion that HE is a neurological disease related to intrinsic brain network disruption.

Disrupted Patterns of Rich-Club and Diverse-Club Organizations in Subjective Cognitive Decline and Amnestic Mild Cognitive Impairment

“…The operculum, adjacent to the insula, was responsible for sensory, motor, autonomic, and cognitive processing ( Maliia et al, 2018 ). The ROL was a major region involved in the language processing system, which played an important role in a variety of neurologic and psychiatric conditions ( Maliia et al, 2018 ; Shan et al, 2018 ; Zhan et al, 2019 ). The proximity of the anatomical structures may be the reason why they have a similar tendency to change in the progression of the AD spectrum.…”

The Application of rs-fMRI in Vascular Cognitive Impairment

“…In addition, studies have found that Parkinson's disease (PD), Huntington's disease, schizophrenia, major depressive disorder, type 2 diabetes mellitus (T2DM), chronic obstructive pulmonary disease (COPD), lung cancer following chemotherapy, hepatic encephalopathy, kidney deficiency syndrome, and other diseases can also cause CI (70)(71)(72)(73)(74)(75)(76)(77)(78)(79), but the relationships between these diseases and cognitive function and the pathogenesis of CI are still unknown, necessitating further in-depth studies. rs-fMRI will play an important role in the exploration of these unknown areas.…”

Heart Rate and Respiration Affect the Functional Connectivity of Default Mode Network in Resting-State Functional Magnetic Resonance Imaging

“…In order to investigate the FC strength within each subnetwork identified by NBS analysis, paired t-test was performed to compare the FC survived with NBS in the three conditions using SPSS version 25 (IBM Corp., Armonk, NY, United States). To correct for multiple comparisons, a false discovery rate (FDR) procedure was performed at q < 0.05 (Zhan et al, 2019). Following statistical analysis of the association between FC and physiological noise, multiple regression with interaction analysis was performed to compare slopes between rs-fMRI data that was Drif_NO, Drif_C, and Drif_CR in order to assess whether differential relationships exist between RR, PR, and z scores, with the z scores being the dependent variables in each regression model.…”

“…In order to investigate the FC strength within each subnetwork identified by NBS analysis, paired t -test was performed to compare the FC survived with NBS in the three conditions using SPSS version 25 (IBM Corp., Armonk, NY, United States). To correct for multiple comparisons, a false discovery rate (FDR) procedure was performed at q < 0.05 ( Zhan et al, 2019 ).…”