Cerebral Perfusion Patterns of Anxiety State in Patients With Pulmonary Nodules: A Study of Cerebral Blood Flow Based on Arterial Spin Labeling

Abstract

Background and PurposeThe proportion of patients with somatic diseases associated with anxiety is increasing each year, and pulmonary nodules have become a non-negligible cause of anxiety, the mechanism of which is unclear. The study focus on the cerebral blood flow (CBF) of anxiety in patients with pulmonary nodules to explore the cerebral perfusion pattern of anxiety associated with pulmonary nodules, blood perfusion status and mode of pulmonary nodule induced anxiety state.Materials and MethodsPatients with unconfirmed pulmonary nodules were evaluated by Hamilton Anxiety Scale (HAMA). The total score > 14 was defined as anxiety group, and the total score ≤ 14 points was defined as non-anxiety group. A total of 38 patients were enrolled, of which 19 patients were the anxiety group and 19 were the non-anxiety group. All subjects underwent arterial spin labeling imaging using a 3.0 T MRI. A two-sample t-test was performed to compare the CBF between the two groups. The CBF was extracted in brain regions with difference, and Spearman correlation was used to analyze the correlation between CBF and HAMA scores; ROC was used to analyze the performance of CBF to distinguish between the anxiety group and the non-anxiety group.ResultsThe CBF in the right insula/Heschl’s cortex of the anxiety group decreased (cluster = 109, peak t = 4.124, and P < 0.001), and the CBF in the right postcentral gyrus increased (cluster = 53, peak t = −3.912, and P < 0.001) in the anxiety group. But there was no correlation between CBF and HAMA score. The ROC analysis of the CBF of the right insula/Heschl’s cortex showed that the AUC was 0.856 (95%CI, 0.729, 0.983; P < 0.001), the optimal cutoff value of the CBF was 50.899, with the sensitivity of 0.895, and specificity of 0.789. The ROC analysis of CBF in the right postcentral gyrus showed that the AUC was 0.845 (95%CI, 0.718, 0.972; P < 0.001), the optimal cutoff value of CBF was 43.595, with the sensitivity of 0.737, and specificity of 0.842.ConclusionThe CBF of the right insula/Heschl’s cortex decreased and the CBF of the right postcentral gyrus increased in patients with pulmonary nodules under anxiety state, and the CBF of the aforementioned brain regions can accurately distinguish the anxiety group from the non-anxiety group.

Cerebral blood flow in adolescents with drug-naive, first-episode major depressive disorder: An arterial spin labeling study based on voxel-level whole-brain analysis

“…Voxel-based whole-brain analysis was performed based on arterial spin labeling imaging for calculating rCBF ( Wang et al, 2022 ). Compared with the traditional fMRI data analysis, ASL provides quantitative and reproducible whole-brain measures that are closely related to neural activity for local cerebral blood flow.…”

“…Emerging arterial spin labeling (ASL) perfusion magnetic resonance imaging (MRI) is a technique that applies magnetically labeled arterial blood water as an endogenous tracer to quantitatively assess rCBF ( Ma et al, 2017 ; Zheng et al, 2019 ; Momosaka et al, 2020 ; Wang et al, 2022 ). This approach not only provides results which are consistent with PET and SPECT ( Chen et al, 2011 ; Boscolo Galazzo et al, 2016 ; Tosun et al, 2016 ; Verclytte et al, 2016 ), but it also enables absolute quantification of rCBF ( Detre et al, 2009 ; Bokkers et al, 2010 ), thus presenting ASL as a reliable physiological marker of neural activity ( Akgoren et al, 1994 ; Hoge and Pike, 2001 ; Lauritzen, 2001 ).…”

Application of pseudocontinuous arterial spin labeling perfusion imaging in children with autism spectrum disorders

“…Arterial Spin Labeling is based on magnetically labeled endogenous water in the blood and using it as a tracer ( Ohnishi et al, 2000 ; Zheng et al, 2019 ; Wang et al, 2022 ). This approach enables the quantification of CBF without radiation exposure ( Hernandez-Garcia et al, 2019 ).…”