Study On The Changes Of Resting State Functional Connectivity And Amplitude Of Low Frequency Fluctuations In Patients With Post-Stroke Depression And The Correlation With Inflammatory Indicators

BackgroundPost-stroke depression(PSD)is a common sequelae of stroke,which affects the patient’s ability to recover and return to society.Resting state fMRI studies have shown that the default mode network(DMN),executive control network(ECN)and salience network(SN)play an extremely important role in regulating emotions and cognitive functions.Repetitive transcranial magnetic stimulation treats depression with dorsolateral prefrontal cortex as the standard stimulation target.ObjectiveTo analyze the changes of functional connectivity(FC)which bases on the L-DLPFC(ECN)and R-DLPFC(ECN)seed points to the whole brain and amplitude of low frequency fluctuation(ALFF),and explore the relationship between PSD functional imaging and clinical scale,inflammation indicators(hs-CRP,IL-6,IL-2,IL-10,IL-17 a and IFN-γ).MethodsThe 67 patients with ischemic stroke admitted to the First Affiliated Hospital of Xinxiang Medical College from 2016 to 2020 were included,12 patients with large head movements and incomplete data were excluded,and 55 patients were finally included.Baseline data was collected and clinical scales were evaluated.According to the HAMD-17 score ≧7,they were divided into the PSD group(n = 28)and the score <7,they was divided into the simple ischemic stroke without depression group(control group,n =27).Collect functional magnetic resonance imaging data for analysis,and determine serum inflammation indicators.Results1.Baseline information:Compared with the control group,the proportion of women in the PSD group was higher(P= 0.014),the proportion of drinking was smaller(P = 0.037),the HAMD-17 score was higher(P<0.001),the Barthel score was lower(P= 0.023),the concentration of IFN-γ is higher(P= 0.025),and there is no significant difference in lesion volume and other indicators(P> 0.05).2.fMRI:Compared with the control group,when the PSD group uses L-DLPFC as the seed point,the FC decreases in one cluster,with a voxel of 129mm~3,MNI coordinates(x=9,y=30,z=33),t=-5.38,P<0.05(GRF),AAL brain regions(Cingulum＿Ant＿L(SN),Cingulum＿Mid＿R(SN),Frontal＿Sup＿Medial＿L(ECN)),and when R-DLPFC is used as the seed point,the FC decreases in one cluster,the voxel is44mm~3,the MNI coordinates(x=-27,y=12,z=47),t=-4.32,P<0.05(GRF),AAL brain regions(Frontal＿Mid＿L(ECN)).The ALFF was not statistically significant in two comparison groups.3.Correlation analysis:In the PSD group,the FC value of abnormal brain areas with R-DLPFC as the seed point was positively correlated with stroke time(r=0.433,P=0.027).In the control group,the FC value of abnormal brain areas with L-DLPFC as the seed point was negatively correlated with Mo CA(r=-0.417,P=0.038),and the FC value with R-DLPFC as the seed point was positively correlated with IFN-γ(r=0.620,P=0.001).The FC value of abnormal areas of the brain has nothing to do with other clinical scales,inflammatory indicators and lesion volume.ConclusionAbnormal functional connections within ECN and between ECN and SN may be involved in the mechanism of PSD,and it is closely related to stroke time,improvement of cognitive function,and IFN-γ.