Altered Resting-State Connectivity within Executive Networks after Aneurysmal Subarachnoid Hemorrhage

• Published in: PloS one Vol. 10; no. 7; p. e0130483
• Main Authors: Maher, Monica, Churchill, Nathan W, de Oliveira Manoel, Airton Leonardo, Graham, Simon J, Macdonald, R Loch, Schweizer, Tom A
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 14.07.2015; Public Library of Science (PLoS)
• Subjects: Adolescent; Adult; Aged; Aneurysm; Atrophy; Brain; Brain mapping; Brain research; Cognition; Cognitive ability; Connectivity analysis; Cortex; Executive Function; Female; Functional magnetic resonance imaging; Hemorrhage; Hospitals; Humans; Intracranial Aneurysm - complications; Magnetic resonance; Magnetic resonance imaging; Male; Memory; Middle Aged; Mood; Morphometry; Mortality; Nerve Net - pathology; Nerve Net - physiopathology; Neural networks; Neuroimaging; Neurosciences; Neurosurgery; NMR; Nuclear magnetic resonance; Organ Size; Patients; Prefrontal Cortex - pathology; Prefrontal Cortex - physiopathology; Quality of Life; Rest; Stroke; Studies; Subarachnoid hemorrhage; Subarachnoid Hemorrhage - complications; Subarachnoid Hemorrhage - pathology; Subarachnoid Hemorrhage - physiopathology; Traumatic brain injury; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0130483

Aneurysmal subarachnoid hemorrhage (aSAH) is associated with significant mortality rates, and most survivors experience significant cognitive deficits across multiple domains, including executive function. It is critical to determine the neural basis for executive deficits in aSAH, in order to better understand and improve patient outcomes. This study is the first examination of resting-state functional Magnetic Resonance Imaging in a group of aSAH patients, used to characterize changes in functional connectivity of the frontoparietal network. We scanned 14 aSAH patients and 14 healthy controls, and divided patients into "impaired" and "unimpaired" groups based on a composite executive function score. Impaired patients exhibited significantly lower quality of life and neuropsychological impairment relative to controls, across multiple domains. Seed-based functional connectivity analysis demonstrated that unimpaired patients were not significantly different from controls, but impaired patients had increased frontoparietal connectivity. Patients evidenced increased frontoparietal connectivity as a function of decreased executive function and decreased mood (i.e. quality of life). In addition, T1 morphometric analysis demonstrated that these changes are not attributable to local cortical atrophy among aSAH patients. These results establish significant, reliable changes in the endogenous brain dynamics of aSAH patients, that are related to cognitive and mood outcomes.