Abnormal Functional and Structural networks in Rectal Cancer with Depressive risk: A Graph Theory Analysis

Abstract

Background: Surgery and chemotherapy can cause depressive risk in patients with rectal cancer (RC). However, few comprehensive studies are conducted on RC patients associated alterations induced by emotional disorders in the topological organization of structural and functional networks. Methods: Resting-state functional MRI and Diffusion tensor imaging data were collected from 36 RC patients with surgery and chemotherapy and 32 healthy controls (HC). Functional network (FN) was constructed from extracting average time courses for 246 regions of interest (ROI) and structural network (SN) was established by deterministic tractography. Graph theoretical analysis was used to calculate small-worldness property, clustering coefficients, shortest path length and network efficiency. Additionally, we assess network resilient on FN and SN. Results: Abnormal small-worldness property of FN and SN were found in RC patients. The FN and SN exhibited increased local efficiency and global efficiency respectively in RC patients.The increased nodal efficiency in RC patients were mainly found in the frontal lobe, parietal lobe and limbic lobe for FN and SN, while the decreased nodal efficiency were distributed in subcortical nuclei, parietal lobe and limbic lobe only for SN. In network resilient analysis, the RC patients showed less resilient to targeted or random node deletion in both networks compared with HC. Moreover, FN is more robust than SN for all participants. Conclusions: This study revealed that topological organizations of the FN and SN may be disrupted in RC patients. Brain network reorganization is a compensation mechanism to alleviate the depressive risk in RC patients after surgery and chemotherapy.