Mapping altered brain connectivity and its clinical associations in adult moyamoya disease: A resting-state functional MRI study

• Published in: PloS one Vol. 12; no. 8; p. e0182759
• Main Authors: Kazumata, Ken, Tha, Khin Khin, Uchino, Haruto, Ito, Masaki, Nakayama, Naoki, Abumiya, Takeo
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 04-08-2017; Public Library of Science (PLoS)
• Subjects: Adult; Adults; Age; Alzheimer's disease; Alzheimers disease; Biology and Life Sciences; Blood flow; Brain; Brain - diagnostic imaging; Brain - pathology; Brain - physiopathology; Brain architecture; Brain injury; Brain Mapping; Brain research; Cerebral blood flow; Cognition; Cognitive ability; Correlation; Correlation analysis; Cortex (cingulate); Cortex (frontal); Cortex (insular); Cortex (motor); Cortex (occipital); Cortex (parietal); Cortex (temporal); Disease control; Female; Frontal gyrus; Functional magnetic resonance imaging; Functional morphology; Health aspects; Hemodynamics; Hippocampus; Humans; Intelligence; Ischemia; Lesions; Magnetic resonance; Magnetic Resonance Imaging; Male; Medicine; Medicine and Health Sciences; Middle Aged; Motor task performance; Moyamoya disease; Moyamoya Disease - diagnostic imaging; Moyamoya Disease - pathology; Moyamoya Disease - physiopathology; Nerve Net - diagnostic imaging; Nerve Net - pathology; Nerve Net - physiopathology; Neural networks; Neuroimaging; Neurosurgery; NMR; Nuclear magnetic resonance; Optimization; Patient outcomes; Patients; Pattern analysis; Research and Analysis Methods; Rest; Signal Processing, Computer-Assisted; Stroke; Studies; Surgery; Temporal lobe; Time Factors; University graduates; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0182759

Detection of subtle ischemic injuries in moyamoya disease may enable optimization of timing of revascularization surgery, and could potentially improve functional outcomes. Resting-state functional magnetic resonance imaging (rs-fMRI) is widely used to study functional organization of the brain, but it remains unclear whether rs-fMRI could elucidate distinct characteristics in moyamoya disease. Here, we aimed to determine changes in a conventional rs-fMRI measure and analyze any associations with clinical symptoms and cerebral hemodynamics. Thirty-one adults with moyamoya disease and 25 adult controls underwent rs-fMRI, in which we measured brain connectivity via temporal correlations of low-frequency BOLD signals. We identified the extent of between-group differences with multivoxel pattern analysis. Seed-based analysis was performed to determine associations with vascular lesions, symptoms, and regional cerebral blood flow (rCBF). There was significantly altered connectivity in the precentral gyrus, operculo-insular region, precuneus, cingulate cortex, and middle frontal gyrus in moyamoya disease. There was reduced connectivity in the left insula, left precuneus, right precentral, and right middle frontal regions, which form part of the salience, default mode, motor, and central executive networks, respectively. Patients with ischemic motor-related symptoms showed significantly decreased connectivity in precentral homotopic regions compared with those without, while there were no differences in vascular lesions or rCBF. Connectivity between the right occipital and left hippocampus was significantly associated with cognitive performance and posterior cerebral artery involvement. Our results demonstrate distinct alterations in the temporal correlations of low-frequency BOLD signals, predominantly in resting-state networks in moyamoya disease. Additionally, rs-fMRI measures were associated with ischemic motor-related symptoms and cognitive performance in the patients. Thus, rs-fMRI may offer a useful non-invasive method of acquiring additional information beyond cerebral perfusion as part of clinical investigations in patients with moyamoya disease.