Alterations in brain function in patients with post-stroke cognitive impairment: a resting-state functional magnetic resonance imaging study

Kaiyue Han ^1,2 Linghui Dong ^2,3 Xingxing Liao ^1,2,4 Junzi Long ^1,2,4 Chen Jiarou ^2,5 Haitao Lu ^1,2 Hao Zhang ^1,2,3,6*

• ¹ School of Rehabilitation, Capital Medical University, Beijing, China
• ² Beijing Bo’ai Hospital, China Rehabilitation Research Center, Beijing, China
• ³ Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
• ⁴ Changping Laboratory, Beijing, China
• ⁵ School of Second Clinical Medical, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
• ⁶ University of Health and Rehabilitation Sciences, Qingdao, China

Background: Cognitive impairment is a common dysfunction following stroke, significantly affecting patients' quality of life. Studies suggest that post-stroke cognitive impairment (PSCI) may be related to neural activity in specific brain regions. However, the neural mechanisms remain to be further explored. This study aimed to investigate the alterations in brain function in patients with PSCI.Methods: This was a case-control study. Thirty patients with PSCI, thirty with non-PSCI (NPSCI), and thirty age-and gender-matched healthy controls (HCs) were selected in a 1:1:1 ratio.Resting-state functional magnetic resonance imaging (rs-fMRI) were acquired from all participants to study the potential neural mechanisms of PSCI patients by comparing the differences in fractional amplitude of low-frequency fluctuation (fALFF), Kendall's coefficient of concordance-regional homogeneity (KCC-ReHo), and seed-based functional connectivity (FC). Additionally, the Montreal Cognitive Assessment (MoCA) scores of PSCI patients were collected, and Pearson correlation was used to analyze the correlation between functional indicators and cognitive performance in PSCI patients. Results: fALFF analysis revealed that the PSCI group had decreased zfALFF values in the left caudate, right inferior temporal gyrus (ITG), anterior cingulate cortex (ACC), left putamen, and left superior temporal gyrus. In contrast, increased zfALFF values were observed in the right Cerebellum_6. KCC-ReHo analysis indicated that the PSCI group had decreased SzKCC-ReHo values in the right middle frontal gyrus (MFG) and left postcentral lobe, while increased SzKCC-ReHo values in the left cerebellum_ crus 1, and left cerebellum_4-5. Furthermore, seed-based FC analysis revealed decreased zFC values between brain regions in the PSCI group, especially between the angular gyrus and precuneus. Additionally, correlation analysis showed that the zfALFF value of ACC was positively correlated with MoCA scores in the PSCI group.This study demonstrated significant changes in the spontaneous neural activity intensity, regional homogeneity, and FC of multiple cognition-related brain regions in PSCI patients, shedding light on the underlying neural mechanisms of brain function in PSCI.relationships that could be construed as a potential conflict of interest.We acknowledge our colleagues from the Medical Records Department and the MRI Radiology Department at the China Rehabilitation Research Center for their contributions to this study.