Abstract：
The central autonomic network (CAN) plays a critical role in the body\'s sympathetic and parasympathetic control. However, functional connectivity (FC) changes of the CAN in patients with multiple system atrophy (MSA) remain unknown.
To investigate FC alterations of CAN in MSA patients.
Prospective.
Eighty-two subjects (47 patients with MSA [44.7% female, 60.5 ± 6.9 years], 35 age- and sex-matched healthy controls [HC] [57.1% female, 62.5 ± 6.6 years]).
3-T, resting-state functional magnetic resonance imaging (rs-fMRI) using gradient echo-planar imaging (EPI), T1-weighted three-dimensional magnetization-prepared rapid gradient echo (3D MPRAGE) structural MRI.
FC alterations were explored by using core modulatory regions of CAN as seeds, including midcingulate cortex, insula, amygdala, and ventromedial prefrontal cortex. Bartlett factor score (BFS) derived from a factor analysis of clinical assessments on disease severity was used as a grouping factor for moderate MSA (mMSA: BFS < 0) and severe MSA (sMSA: BFS > 0).
For FC analysis, the one-way ANCOVA with cluster-level family-wise error correction (statistical significance level of P < 0.025), and post hoc t-testing with Bonferroni correction or Tamhane\'s T2 correction (statistical significance level of adjusted-P < 0.05) were adopted. Correlation was assessed using Pearson correlation or Spearman correlation (statistical significance level of P < 0.05).
Compared with HC, patients with MSA exhibited significant FC aberrances between the CAN and brain areas of sensorimotor control, limbic network, putamen, and cerebellum. For MSA patients, most FC alterations of CAN, especially concerning FC between the right anterior insula and right primary sensorimotor cortices, were found to be significantly correlated with disease severity. FC changes were found to be more significant in sMSA group than in mMSA group when compared with HCs.
MSA shows widespread FC changes of CAN, suggesting that abnormal functional integration of CAN may be involved in disease pathogenesis of MSA.
2 TECHNICAL EFFICACY: Stage 3.
To investigate FC alterations of CAN in MSA patients.
Prospective.
Eighty-two subjects (47 patients with MSA [44.7% female, 60.5 ± 6.9 years], 35 age- and sex-matched healthy controls [HC] [57.1% female, 62.5 ± 6.6 years]).
3-T, resting-state functional magnetic resonance imaging (rs-fMRI) using gradient echo-planar imaging (EPI), T1-weighted three-dimensional magnetization-prepared rapid gradient echo (3D MPRAGE) structural MRI.
FC alterations were explored by using core modulatory regions of CAN as seeds, including midcingulate cortex, insula, amygdala, and ventromedial prefrontal cortex. Bartlett factor score (BFS) derived from a factor analysis of clinical assessments on disease severity was used as a grouping factor for moderate MSA (mMSA: BFS < 0) and severe MSA (sMSA: BFS > 0).
For FC analysis, the one-way ANCOVA with cluster-level family-wise error correction (statistical significance level of P < 0.025), and post hoc t-testing with Bonferroni correction or Tamhane\'s T2 correction (statistical significance level of adjusted-P < 0.05) were adopted. Correlation was assessed using Pearson correlation or Spearman correlation (statistical significance level of P < 0.05).
Compared with HC, patients with MSA exhibited significant FC aberrances between the CAN and brain areas of sensorimotor control, limbic network, putamen, and cerebellum. For MSA patients, most FC alterations of CAN, especially concerning FC between the right anterior insula and right primary sensorimotor cortices, were found to be significantly correlated with disease severity. FC changes were found to be more significant in sMSA group than in mMSA group when compared with HCs.
MSA shows widespread FC changes of CAN, suggesting that abnormal functional integration of CAN may be involved in disease pathogenesis of MSA.
2 TECHNICAL EFFICACY: Stage 3.
摘要：
背景：中枢自主神经网络（CAN）在人体的交感神经和副交感神经控制中起着至关重要的作用。然而,多系统萎缩（MSA）患者CAN的功能连接（FC）变化尚不清楚。
目的：研究MSA患者CAN的FC改变。
方法：前瞻性。
方法：82名受试者(47例MSA患者[44.7%女性，60.5±6.9年]，35个年龄和性别匹配的健康对照[HC][57.1%女性，62.5±6.6年]）。
■3-T,使用梯度回波平面成像（EPI）的静息态功能磁共振成像（rs-fMRI），T1加权三维磁化制备的快速梯度回波（3DMPRAGE）结构MRI。
结果：通过使用CAN的核心调节区域作为种子来探索FC的改变，包括中扣带皮质，脑岛,杏仁核,和腹内侧前额叶皮质。来自疾病严重程度的临床评估的因素分析的Bartlett因子评分（BFS）用作中度MSA（mMSA：BFS<0）和重度MSA（sMSA：BFS>0）的分组因子。
方法：对于FC分析，单因素方差分析与聚类水平的家庭误差校正(统计显著性水平P<0.025)，采用Bonferroni校正或Tamhane'sT2校正的事后t检验（调整后P<0.05的统计学意义水平）。相关性评价采用Pearson相关或Spearman相关(统计学显著性水平P<0.05)。
结果：与HC相比，MSA患者在CAN和感觉运动控制的大脑区域之间表现出明显的FC异常，边缘网络，壳核,还有小脑.对于MSA患者，CAN的大多数FC更改，特别是关于右前脑岛和右初级感觉运动皮质之间的FC，被发现与疾病严重程度显著相关。与HC相比，sMSA组的FC变化比mMSA组更为显着。
结论：MSA显示了CAN的广泛FC变化，提示CAN功能整合异常可能参与了MSA的发病机制。
方法：2技术效果：阶段3。
目的：研究MSA患者CAN的FC改变。
方法：前瞻性。
方法：82名受试者(47例MSA患者[44.7%女性，60.5±6.9年]，35个年龄和性别匹配的健康对照[HC][57.1%女性，62.5±6.6年]）。
■3-T,使用梯度回波平面成像（EPI）的静息态功能磁共振成像（rs-fMRI），T1加权三维磁化制备的快速梯度回波（3DMPRAGE）结构MRI。
结果：通过使用CAN的核心调节区域作为种子来探索FC的改变，包括中扣带皮质，脑岛,杏仁核,和腹内侧前额叶皮质。来自疾病严重程度的临床评估的因素分析的Bartlett因子评分（BFS）用作中度MSA（mMSA：BFS<0）和重度MSA（sMSA：BFS>0）的分组因子。
方法：对于FC分析，单因素方差分析与聚类水平的家庭误差校正(统计显著性水平P<0.025)，采用Bonferroni校正或Tamhane'sT2校正的事后t检验（调整后P<0.05的统计学意义水平）。相关性评价采用Pearson相关或Spearman相关(统计学显著性水平P<0.05)。
结果：与HC相比，MSA患者在CAN和感觉运动控制的大脑区域之间表现出明显的FC异常，边缘网络，壳核,还有小脑.对于MSA患者，CAN的大多数FC更改，特别是关于右前脑岛和右初级感觉运动皮质之间的FC，被发现与疾病严重程度显著相关。与HC相比，sMSA组的FC变化比mMSA组更为显着。
结论：MSA显示了CAN的广泛FC变化，提示CAN功能整合异常可能参与了MSA的发病机制。
方法：2技术效果：阶段3。
