Functional plasticity in lateral hypothalamus and its prediction of cognitive impairment in patients with diffuse axonal injury: evidence from a resting-state functional connectivity study

Abstract

Objective Diffuse axonal injury (DAI) is a common pathological process after traumatic brain injury, which may cause survivors severe functional disorders, including cognitive impairment and physical disability. Recent literature indicated lateral hypothalamus and medial hypothalamus damage during DAI. Thus, we aim to investigate whether there is imaging evidence of hypothalamic injury in patients with DAI and its clinical association.Methods Twenty-four patients with diagnosed DAI and 26 age and sex-matched healthy controls underwent resting-state functional MRI. We assessed the lateral hypothalamus and medial hypothalamus functional connectivity with seed-based analysis in DAI. Furthermore, a partial correlation was used to measure its clinical association. The prediction of the severity of DAI from the altered lateral hypothalamus and medial hypothalamus connectivity was conducted using a general linear model. ResultsCompared with healthy control, the DAI group showed significantly decreased lateral hypothalamus functional connectivity with the basal ganglia and cingulate gyrus, which was positively correlated with minimental state examination scores (Bonferroni correction at P < 0.0125). Importantly, this disrupted functional connectivity can be used to predict the patients' cognitive state reliably (P = 0.006; P = 0.009, respectively) in DAI. Moreover, we also observed increased connectivity of medial hypothalamus with the superior temporal gyrus and the regions around the operculum. Furthermore, there was a trend of negative correlation between the medial hypothalamus functional connectivity changes to the right superior temporal gyrus and the disability rating scale scores in the DAI group. ConclusionOur results suggest that there are alterations of medial hypothalamus and lateral hypothalamus connectivity in DAI and further understand its clinical symptoms, including related cognitive impairment.

The effects of androgen deprivation on working memory and quality of life in prostate cancer patients: The roles of hypothalamic connectivity

“…26 Patients with diffuse axonal injury showed reduction in hypothalamic--basal ganglia and cingulate gyrus rsFC in association with cognitive impairment. 27 In rodents the formation of object recognition memory was regulated via hypothalamic circuits. 28 These findings implicate the hypothalamus in learning and memory through mechanisms beyond those involved in energy homeostasis.…”

“…In healthy individuals, physiological responses to trauma and stress were associated with hypothalamic activity and functional connectivity 26 . Patients with diffuse axonal injury showed reduction in hypothalamic––basal ganglia and cingulate gyrus rsFC in association with cognitive impairment 27 . In rodents the formation of object recognition memory was regulated via hypothalamic circuits 28 .…”

Cognitive impairment in diffuse axonal injury patients with favorable outcome

“…Severe cognitive impairment and physical disability were caused by lateral hypothalamus and medial hypothalamus damage during DAI ( Wang et al, 2021 ). HVLT, TMT, and Rey–Osterrieth Complex Figure test were performed by Macruz et al (2022) to reveal the impairment and recovery of episodic verbal memory, attention, and executive function of DAI patients.…”

Disrupted hypothalamic functional connectivity related to cognitive impairment after diffuse axonal injury: Retraction

“…After an investigation into reader concerns, the Editorial Office found that passages had been directly plagiarized and/or slightly modified from “Functional plasticity in lateral hypothalamus and its prediction of cognitive impairment in patients with diffuse axonal injury: evidence from a resting-state functional connectivity study”. [ 2 ]…”