Korean J Radiol.  2018 Jun;19(3):452-462. 10.3348/kjr.2018.19.3.452.

Brain Regional Homogeneity Changes in Cirrhotic Patients with or without Hepatic Encephalopathy Revealed by Multi-Frequency Bands Analysis Based on Resting-State Functional MRI

• Zhang G
• Cheng Y
• Shen W
• Liu B
• Huang L
• Xie S

• KMID: 2410816
• DOI: http://doi.org/10.3348/kjr.2018.19.3.452

Abstract

OBJECTIVE
To investigate brain regional homogeneity (ReHo) changes of multiple sub-frequency bands in cirrhotic patients with or without hepatic encephalopathy using resting-state functional MRI.
MATERIALS AND METHODS
This study recruited 46 cirrhotic patients without clinical hepatic encephalopathy (noHE), 38 cirrhotic patients with clinical hepatic encephalopathy (HE), and 37 healthy volunteers. ReHo differences were analyzed in slow-5 (0.010−0.027 Hz), slow-4 (0.027−0.073 Hz), and slow-3 (0.073−0.198 Hz) bands. Routine analysis of (0.010−0.080 Hz) band was used as a benchmark. Associations of abnormal ReHo values in each frequency band with neuropsychological scores and blood ammonia level were analyzed. Pattern classification analyses were conducted to determine whether ReHo differences in each band could differentiate the three groups of subjects (patients with or without hepatic encephalopathy and healthy controls).
RESULTS
Compared to routine analysis, more differences between HE and noHE were observed in slow-5 and slow-4 bands (p < 0.005, cluster > 12, overall corrected p < 0.05). Sub-frequency band analysis also showed that ReHo abnormalities were frequency-dependent (overall corrected p < 0.05). In addition, ReHo abnormalities in each sub-band were correlated with blood ammonia level and neuropsychological scores, especially in the left inferior parietal lobe (overall corrected p < 0.05 for all frequency bands). Pattern classification analysis demonstrated that ReHo differences in lower slow-5 and slow-4 bands (both p < 0.05) and higher slow-3 band could differentiate the three groups (p < 0.05). Compared to routine analysis, ReHo features in slow-4 band obtained better classification accuracy (89%).
CONCLUSION
Cirrhotic patients showed frequency-dependent changes in ReHo. Sub-frequency band analysis is important for understanding HE and clinical monitoring.

Keyword

Hepatic encephalopathy; Frequency-dependent; Regional homogeneity (ReHo); Resting-state functional MRI; Brain; Liver cirrhosis

MeSH Terms

Ammonia
Benchmarking
Brain*
Classification
Healthy Volunteers
Hepatic Encephalopathy*
Humans
Liver Cirrhosis
Magnetic Resonance Imaging*
Parietal Lobe
Ammonia

Figure

• 

  Fig. 1 Regional homogeneity change pattern across frequency bands.A. One-way ANCOVA result in slow-5 frequency band. B. One-way ANCOVA result in slow-4 frequency band. C. One-way ANCOVA result in slow-3 frequency band. ANCOVA = analysis of covariance

• 

  Fig. 2 Between-group regional homogeneity differences in routine analysis and in sub-frequency band analysis.A. Two-sample t test result in 0.010−0.080 Hz. B. Two-sample t test result in slow-5 frequency band. C. Two-sample t test result in slow-4 frequency band. D. Two-sample t test result in slow-3 frequency band. HC = healthy control, HE = cirrhotic patients with clinical hepatic encephalopathy, noHE = cirrhotic patients without clinical hepatic encephalopathy

• 

  Fig. 3 Correlation of regional homogeneity values in group-difference regions with DST, NCT-A scores, and blood ammonia level.A. Correlation map in 0.010−0.080 Hz. B. Correlation map in slow-5 band. C. Correlation map in slow-4 band. D. Correlation map in slow-3 band. DST = digit-symbol test, NCT-A = number connection test of type A

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