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Ren W, Wang M, Wang Q, Huang Q, Feng S, Tao J, Wen C, Xu M, He J, Yang C, Zhao K, Yu X. Altered functional connectivity in patients with post-stroke fatigue: A resting-state fMRI study. J Affect Disord 2024; 350:468-475. [PMID: 38224743 DOI: 10.1016/j.jad.2024.01.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 11/24/2023] [Accepted: 01/12/2024] [Indexed: 01/17/2024]
Abstract
BACKGROUND Post-stroke fatigue (PSF) was a common complication after stroke. This study aimed to explore the neuroimaging mechanism of PSF, which was rarely studied. METHODS Patients with the first episode of ischemic stroke were recruited from the First Affiliated Hospital of Wenzhou Medical University between March 2021 and December 2022. The fatigue severity scale (FSS) was used to assess fatigue symptoms. PSF was diagnosed by a neurologist based on the FSS score and PSF diagnostic criteria. All the patients were scanned by resting-state functional MRI (rs-fMRI). Precuneus, the posterior node of default-mode network (pDMN), was related to fatigue. Therefore, imaging data were further analyzed by the seed-based resting-state functional connectivity (FC) approach, with the left (PCUN.L) and right precuneus (PCUN.R) being the seeds. RESULTS A total of 70 patients with acute ischemic stroke were finally recruited, comprising 40 patients with PSF and 30 patients without PSF. Both the PCUN.L and PCUN.R seeds (pDMN) exhibited decreased FC with the prefrontal lobes located at the anterior part of DMN (aDMN), and the FC values were negatively correlated with FSS scores (both p < 0.001). These two seeds also exhibited increased FC with the right insula, and the FC values were positively correlated with FSS scores (both p < 0.05). CONCLUSION The abnormal FC between the aDMN and pDMN was associated with PSF. Besides, the insula, related to interoception, might also play an important role in PSF.
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Affiliation(s)
- Wenwei Ren
- Department of Psychiatry, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Mengpu Wang
- School of Mental Health, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, China; School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Qiongzhang Wang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Qiqi Huang
- Pediatric nursing unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Shengchuang Feng
- Centre for Lifelong Learning and Individualised Cognition, Nanyang Technological University, Singapore
| | - Jiejie Tao
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Caiyun Wen
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Minjie Xu
- Lishui Second People's Hospital Affiliated to Wenzhou Medical University, Lishui, China
| | - Jincai He
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chuang Yang
- Department of Psychiatry, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ke Zhao
- School of Mental Health, Wenzhou Medical University, Wenzhou, China; Lishui Second People's Hospital Affiliated to Wenzhou Medical University, Lishui, China; The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, China.
| | - Xin Yu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China; Peking University Institute of Mental Health (Sixth Hospital), Beijing, China; National Clinical Research Center for Mental Disorders and Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China; Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia, Beijing, China.
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