3.1 General information
According to the diagnostic inclusion and exclusion criteria, 30 patients were selected into patient groups from 1983 patients suspected of acute ischemic stroke. 5 cases in DH and 3 in NDH failed to complete fMRI-BOLD data collection as participants were unable to withstand long magnetic resonance scans. The EPI scanning parameters of 2 cases in NDH were different from the experimental design and the data were thus stripped out. Participants in 1 case of the noamal group fell asleep during the test, and 2 cases had different T1 MPRAGE scanning parameters from the experimental design and the data were all removed. Flowchart of participants is shown in Fig.1.
There were no significant differences among the three groups in their gender, course of disease, systolic and diastolic blood pressure, and NHISS scores (P >0.05) (Table 1). However, the age difference of the included subjects in the three groups was statistically significant (P <0.05) (Table 1).
Table 1: Demographic and clinical characteristics of all patients in three groups.
Group
|
Case
(n)
|
Gender (case)
|
Age
(year)
|
Course of disease
|
systolic pressure (mmHg)
|
diastolic pressure (mmHg)
|
NHISS
|
male
|
female
|
HS
|
12
|
4
|
8
|
56.17±3.83
|
\
|
\
|
\
|
\
|
DH
|
10
|
7
|
3
|
63.70±6.00
|
2.15±0.94
|
147.80±13.14
|
84.90±10.07
|
5.30±4.99
|
NDH
|
10
|
8
|
2
|
59.40±7.65
|
2.10±0.88
|
152.90±12.34
|
90.40±10.74
|
3.80±1.03
|
S tatistics
|
χ2=5.728
|
F=4.437
|
t=0.123
|
t=-0.895
|
t=-1.181
|
t=0.931
|
P Value
|
0.057
|
0.021
|
0.904
|
0.383
|
0.253
|
0.374
|
Notes:Values presented are mean ± SD (range) or median [IQR]. NIHSS= National Institutes of Health Stroke Scale.
3.2 fMRI results
3.2.1 Normal Group VS Dominant hemisphere Group
Compared with HS, DH showed significantly increased ALFF values in right midbrain and lobus anterior cercbelli, extending to vermis(including cerebellar lingual), and in left midbrain and mammillary body.
Increased ReHo values appeared mainly in the left caudate tai, extending to pulvinar in DH. On the contrary, the ReHo values decreased mainly in right inferior orbital gyrus (including BA47), triangular inferior frontal gyrus(BA45), supra marginal and postcentral gyrus(mostly in BA3), extending to the precentral gyrus (BA4). (Table 2, Fig.2, and Fig. 3)
Table 2 Regions of DH showing significant changes in ALFF and ReHo values compared with HS
Parameter
|
Effect
|
Brain region
|
MNI coordinate
|
Intensity
(T-value)
|
X
|
Y
|
Z
|
ALFF
|
Enhanced
|
Right midbrain, lobus anterior cercbelli and Vermis
|
9
|
-33
|
-18
|
5.6226
|
Enhanced
|
Left Midbrain and Mammillary Body
|
-3
|
-12
|
-12
|
5.0006
|
ReHo
|
Enhanced
|
Left Caudate Tai and Pulvinar
|
-21
|
-36
|
15
|
5.3222
|
Reduced
|
Right inferior orbital gyrus (including BA47)
|
27
|
33
|
-9
|
-5.1493
|
Reduced
|
Right triangular inferior frontal gyrus(BA45)
|
48
|
30
|
24
|
-7.3696
|
Reduced
|
Right supramarginal gyrus
|
66
|
-42
|
30
|
-4.876
|
Reduced
|
Right postcentral gyrus(mostly in BA3) and precentral gyrus (BA4)
|
60
|
-15
|
30
|
-6.2719
|
Note: X、Y、Z represent the brain space position axis respectively in the MiNi standardized spatial coordinate system in the left and right, front and back and up and down position of the coordinate position.
3.2.2 Normal Group VS Non-dominant hemisphere Group
Compared with HS, ALFF values of NDH increased significantly mainly in left inferior orbital gyrus(including BA47) ,extending to left BA25, mainly in the left cerebellum anterior lobe (including cerebellar lingual) and Vermis, in left lentiform nuclei and globus pallidus, in medial dorsal nucleus, extending to left midbrain, in right caudate head, in left BA6 and paracentral lobule. On the contrary, the ALFF values decreased in right BA9 and precentral gyrus.
ReHo values were increased mainly in left Precuneus (BA7) and rectal gyrus, extending to orbital gyrus (including BA11), mainly in left parahippocampal gyrus, extending to BA47.
In contrast, the ReHo values decreased mainly in the left cerebellum posterior lobe , tubera valvulae, right BA9 and precentral gyrus. (Table 3, Fig.4, and Fig. 5)
Table 3 Regions of NDH showing significant changes in ALFF and ReHo values compared with HS
Parameter
|
Effect
|
Brain region
|
MNI coordinate
|
Intensity
(T-value)
|
X
|
Y
|
Z
|
ALFF
|
Enhanced
|
Left inferior orbital gyrus (including BA47), BA25
|
-15
|
12
|
-24
|
6.8358
|
Enhanced
|
Left cerebellum anterior lobe (including cerebellar lingual) and Vermis
|
0
|
-39
|
-28
|
4.633
|
Enhanced
|
Left lentiform nuclei and globus pallidus
|
-9
|
3
|
3
|
7.4651
|
Enhanced
|
Left medial dorsal nucleus and midbrain
|
-3
|
-12
|
3
|
5.3041
|
Enhanced
|
Right caudate head
|
9
|
6
|
0
|
6.6047
|
Enhanced
|
Left BA6 and paracentral lobule
|
-3
|
-15
|
66
|
5.0251
|
Reduced
|
Right BA9 and precentral gyrus
|
57
|
9
|
36
|
-4.9502
|
ReHo
|
Enhanced
|
Left precuneus(BA7)
|
-9
|
-54
|
45
|
5.1723
|
Enhanced
|
Left rectal gyrus and orbital gyrus (including BA11)
|
-6
|
33
|
-27
|
4.5542
|
Enhanced
|
Left parahippocampal gyrus and BA47
|
-15
|
6
|
-24
|
4.386
|
Reduced
|
Left cerebellum posterior lobe and tubera valvulae
|
-30
|
-75
|
-36
|
-5.4037
|
Reduced
|
Right BA9 and precentral gyrus
|
54
|
12
|
36
|
-5.0544
|
Note: X、Y、Z represent the brain space position axis respectively in the MiNi standardized spatial coordinate system in the left and right, front and back and up and down position of the coordinate position.
3.2.3 Non-dominant hemisphere Group VS Dominant hemisphere Group
Compared with NDH, DH indicated significantly decreased ALFF values mainly in left supplementary motor area(including BA6). While decreased ReHo values appeared mainly in the right BA10. (Table 4, Fig.6 and Fig.7)
Table 4, Regions of DH showing significant changes in ALFF and ReHo values compared with NDH
Parameter
|
Effect
|
Brain region
|
MNI coordinate
|
Intensity
(T-value)
|
X
|
Y
|
Z
|
ALFF
|
Reduced
|
Left supplementary motor area(including BA6)
|
-12
|
15
|
63
|
-4.9172
|
ReHo
|
Reduced
|
Right BA10
|
30
|
69
|
9
|
-5.6143
|