Disrupted topological properties of the structural brain network in patients with cerebellar infarction on different sides are associated with cognitive impairment

Wang, Duohao; Yao, Qun; Lin, Xingjian; Hu, Jun; Shi, Jingping · 2022 · DOAJ

DOI: 10.3389/fneur.2022.982630

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Summary

This study investigates the relationship between disrupted structural brain network topology and cognitive impairment in patients with acute unilateral cerebellar infarction. While the cerebellum is traditionally associated with motor control, recent evidence suggests its involvement in higher cognitive functions through cerebrocerebellar loops. The authors aimed to characterize changes in brain structural networks following left or right posterior cerebellar infarction and determine how these topological alterations correlate with specific cognitive deficits. The study included 37 patients with acute unilateral posterior cerebellar infarction (19 with left-sided and 18 with right-sided lesions) and 27 healthy controls matched for age, sex, and education. Participants underwent diffusion magnetic resonance imaging (DTI) and a battery of neuropsychological tests assessing general mental status, episodic memory, attention, executive function, language, and visual-spatial abilities. Brain structural networks were constructed using fractional anisotropy values and graph theory metrics, including clustering coefficient, shortest path length, global and local efficiency, and nodal efficiency. Statistical analyses compared network properties across groups and correlated them with cognitive scores. Results indicated that both left and right cerebellar infarction groups exhibited significantly lower scores on the Mini-Mental Status Examination, Montreal Cognitive Assessment, and Rey Auditory Verbal Learning Test compared to controls. The right infarction group showed significantly longer Trail Making Test times than the left group, indicating more severe executive dysfunction, while the left group had lower Digit Span Test scores, reflecting impaired attention. Topologically, both patient groups displayed abnormal network properties, including altered clustering coefficients, path lengths, and efficiencies. Specifically, unilateral cerebellar infarction led to decreased nodal efficiency in bilateral cerebral regions, such as the precuneus, cingulate gyri, and temporal poles. Correlation analyses revealed that decreased processing speed in left infarction patients correlated with reduced efficiency of right cerebral nodes, whereas executive dysfunction in right infarction patients correlated with decreased efficiency of left cerebral nodes. The findings demonstrate that unilateral cerebellar infarction disrupts the topological properties of the structural brain network, particularly reducing the efficiency of key bilateral cerebral regions. These network disruptions are closely associated with specific cognitive impairments, suggesting a contralateral or bilateral impact on cerebral processing despite unilateral cerebellar damage. The study provides evidence for the neural mechanisms underlying cerebellar cognitive affective syndrome and suggests that brain topological network properties may serve as potential imaging markers for evaluating cognitive impairment in cerebellar stroke patients.

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• cognitive impairment