Long-and short-range functional connectivity density alteration in non-alcoholic cirrhotic patients one month after liver transplantation: A resting-state fMRI study.
OBJECTIVE
To longitudinally evaluate long- and short-range functional connectivity density (FCD) alteration in cirrhotic patients one month after liver transplantation (LT) and their correlation with cognitive changes by using resting-state functional magnetic resonance imaging (rs-fMRI).


METHODS
Twenty seven candidates awaiting LT and 24 age-, gender-, and education-matched healthy controls (HCs) were studied. All 27 patients and HCs performed rs-fMRI examinations. Of 27 cirrhotic patients, 13 patients received LT underwent the repeated rs-fMRI examinations one month after LT. Laboratory and psychometric tests were carried out. The long- and short-range FCD maps derived from degree centrality calculation were compared. Correlations between FCD alteration and laboratory/psychometric changes were evaluated as well.


RESULTS
In cirrhotic patients, most of the brain areas with altered long- and short-range FCD could reverse one month after LT, which was accompanied with cognitive and liver functional improvement. The reduced long-range FCD in right posterior cingulate cortex (PCC) and Left middle frontal gyrus (MFG), and reduced short-range FCD in right precuneus (PCu) persisted in the early period after LT. In addition, one month after LT, the post-LT group showed reduced long-range FCD in right rectus gyrus (REC) and left medial prefrontal cortex (MPFC), and reduced short-range FCD in left middle temporal gyrus (MTG), when compared with the pre-LT group. We found Δdigital symbol test (ΔDST) score positively correlated with long-range ΔFCD in right precentral gyrus (preCG) (r = 0.72, P < 0.01) and right supplementary motor area (SMA) (r = 0.59, P < 0.05).


CONCLUSIONS
LT results in favorable effect on cognitive function in cirrhotic patient, which can be reflected by FCD alteration. However, persistence of PCC/PCu functional connectivity disturbance one month after LT indicates complete cognitive function restoration may need a longer time.
Department of Medical Imaging, Jinling Hospital, Nanjing Clinical School, Southern Medical University, Nanjing 210002, Jiangsu Province, PR China; Department of Radiology, Tianjin First Central Hospital, Clinical School of Tianjin Medical University, Tianjin 300192, PR China; Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, PR China.
Xiao-Dong
XD
Zhang
Department of Radiology, Tianjin First Central Hospital, Clinical School of Tianjin Medical University, Tianjin 300192, PR China.
Yue
Y
Cheng
Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, United States.
Colin S
CS
Poon
Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, PR China.
Rongfeng
R
Qi
Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, PR China.
Qiang
Q
Xu
Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, PR China.
Hui-Juan
HJ
Chen
Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, PR China.
Xiang
X
Kong
Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, PR China.
Guang-Ming
GM
Lu
Department of Radiology, Tianjin First Central Hospital, Clinical School of Tianjin Medical University, Tianjin 300192, PR China.
Wen
W
Shen
Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, PR China. Electronic address: kevinzhlj@163.com.
Long-Jiang
LJ
Zhang
D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D005260:Female; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000503:physiopathology* / Q000601:surgery*; D016031:Liver Transplantation; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000503:physiopathology; D009473:Neuronal Plasticity; D011446:Prospective Studies; D012146:Rest; D012815:Signal Processing, Computer-Assisted; D016896:Treatment Outcome
Cirrhosis; Functional connectivity; Functional magnetic resonance imaging; Liver transplantation; Resting-state