sibmedСибирский научный медицинский журналСибирский научный медицинский журнал2410-25122410-2520ИЦиГ СО РАН10.18699/SSMJ20260106sibmed-2717Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯRESEARCH ARTICLESДинамика функциональных сетей головного мозга в ранний восстановительный период ишемического инсульта по данным МРТStudy of the dynamics of changes in functional brain networks in the early recovery period of ischemic stroke according to MRI datahttps://orcid.org/0009-0000-7074-0838ЗудилинаО. В.ZudilinaO. V.

Зудилина Ольга Викторовна

630090, Новосибирск, ул. Институтская, 3а; 630090, Новосибирск, ул. Пирогова, 1

Olga V. Zudilina

630090, Novosibirsk, Institutskaya st., 3a; 630090, Novosibirsk, Pirogova st., 1

ozudilina@inbox.ruhttps://orcid.org/0000-0003-3082-2315ПоповВ. В.PopovV. V.

Попов Владимир Владимирович

630090, Новосибирск, ул. Институтская, 3а; 630090, Новосибирск, ул. Пирогова, 1

Vladimir V. Popov

630090, Novosibirsk, Institutskaya st., 3a; 630090, Novosibirsk, Pirogova st., 1

v.popov1@g.nsu.ruhttps://orcid.org/0000-0003-4325-4062ПетровскийЕ. Д.PetrovskiyE. D.

Петровский Евгений Дмитриевич

630090, Новосибирск, ул. Институтская, 3а

Evgeniy D. Petrovskiy

630090, Novosibirsk, Institutskaya st., 3a

petrovskiy@tomo.nsc.ruhttps://orcid.org/0000-0002-7959-5160СтанкевичЮ. А.StankevichYu. A.

Станкевич Юлия Александровна - к.м.н.

630090, Новосибирск, ул. Институтская, 3а; 630090, Новосибирск, ул. Пирогова, 1

Yulia A. Stankevich - candidate of medical sciences.

630090, Novosibirsk, Institutskaya st., 3a; 630090, Novosibirsk, Pirogova st., 1

stankevich@tomo.nsc.ruhttps://orcid.org/0000-0002-1277-4113ТулуповА. А.TulupovA. A.

Тулупов Андрей Александрович - д.м.н, проф., чл.-корр. РАН.

630090, Новосибирск, ул. Институтская, 3а; 630090, Новосибирск, ул. Пирогова, 1

Andrey A. Tulupov - doctor of medical sciences, professor, corresponding member of RAS.

630090, Novosibirsk, Institutskaya st., 3a; 630090, Novosibirsk, Pirogova st., 1

taa@tomo.nsc.ruИнститут «Международный томографический центр» СО РАН; Новосибирский государственный университетРоссияInternational Tomography Center of SB RAS; Novosibirsk State UniversityRussian FederationИнститут «Международный томографический центр» СО РАНРоссияInternational Tomography Center of SB RASRussian Federation2026190320264617181Copyright © Зудилина О.В., Попов В.В., Петровский Е.Д., Станкевич Ю.А., Тулупов А.А., 20262026Зудилина О.В., Попов В.В., Петровский Е.Д., Станкевич Ю.А., Тулупов А.А.Zudilina O.V., Popov V.V., Petrovskiy E.D., Stankevich Y.A., Tulupov A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://sibmed.elpub.ru/jour/article/view/2717

Цель исследования – оценить динамику изменений функциональных нейронных сетей головного мозга (default mode network, DMN, и sensorimotor network, SMN) в раннем восстановительном периоде ишемического инсульта с учетом объема ишемического поражения по данным МРТ. Материал и методы. На МР-томографе 3,0 Тл проведено динамическое МРТ-исследование головного мозга 137 пациентов на 1–3-и сутки, 7–10-е сутки, 3–4-й месяц после манифестации острого нарушения мозгового кровообращения по рутинному протоколу (DWI-EPI, FLAIR-SPIR, T2-WI, T1W-TFE), дополненному методикой функциональной МРТ покоя. Дополнительно выполнено тестирование с использованием Монреальской шкалы оценки когнитивных функций (MoCA-тест) и модифицированной шкалы Рэнкина. Выборка составила 36 пациентов с диагнозом острый ишемический инсульт супратенториальной локализации, прошедших исследование не менее двух раз. Результаты и их обсуждение. Отмечена тенденция (p > 0,05) к увеличению функциональных связей между регионами DMN и SMN от первого к третьему исследованию. Результаты теста MoCA (p < 0,05 для второго и третьего исследования по сравнению с 1-м) в динамике показали улучшение когнитивных функций, соответствующие клинической картине. Наиболее значимый результат корреляционного анализа – прямая корреляционная связь между DMN и SMN в первом наблюдении (R = 0,57; p = 0,006). Выявлено статистически значимое влияние большего объема на динамику восстановления связности между регионами DMN (R = 0,83; p = 0,04). Заключение. Получена сонаправленная динамика внутрисетевой связности DMN и SMN, что свидетельствует о системной функциональной перестройке головного мозга при остром нарушении мозгового кровообращения. В раннем восстановительном периоде в динамике отмечается увеличение связности DMN и SMN по данным функциональной МРТ наряду с восстановлением когнитивных функций по результатам когнитивного теста. Требуются дополнительные исследования с целью поиска закономерностей восстановления DMN и SMN, влияния объема и локализации очага поражения на восстановление функциональной коннективности исследуемых нейронных сетей.

Aim of the study was to evaluate the dynamics of changes in functional brain networks (default mode network, DMN, and sensorimotor network, SMN) during the early recovery period following ischemic stroke, taking into account the volume of ischemic lesions according to MRI data. Material and methods. A dynamic MRI study of the brain was performed on a 3.0 T scanner in 137 patients at 1–3 days, 7–10 days, and 3–4 months after the onset of acute cerebrovascular accident, using a routine protocol (DWI-EPI, FLAIR-SPIR, T2-WI, T1W-TFE) supplemented with resting-state functional MRI. Additional assessment included the Montreal Cognitive Assessment (MoCA) and the modified Rankin scale. The study cohort comprised 36 patients diagnosed with acute ischemic supratentorial stroke who underwent at least two MRI examinations. Results and discussion. A trend (p > 0.05) towards increased functional connectivity between DMN and SMN regions was observed from the first to the third examination. The MoCA results (p < 0.05 for 2nd and 3rd study compared to 1st) showed improvement in cognitive functions over time, consistent with the clinical course. The most significant finding of the correlation analysis was a direct correlation between DMN and SMN connectivity at the first observation (R = 0.57; p = 0.006). Lesion volume was found to influence functional connectivity, with a significant effect of larger lesion size on DMN recovery dynamics (R = 0.83; p = 0.04). Conclusions. A parallel increase in intra-network connectivity of the DMN and SMN was demonstrated, indicating systemic functional reorganization of the brain following acute stroke. During the early recovery period, resting-state functional MRI revealed progressive restoration of DMN and SMN connectivity, accompanied by cognitive improvement as assessed by MoCA. Further research is required to clarify the mechanisms of DMN and SMN recovery, as well as the role of lesion volume and localization in functional network reorganization.

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The authors declare that there are no conflicts of interest present.