Table_2_The Effect of Abnormal Regional Homogeneity and Spontaneous Low-Frequency Brain Activity on Lower Cognitive Ability: A Cross-Sectional Study on Postoperative Children With Tetralogy of Fallot.docx

Despite intracardiac malformation correction, children with Tetralogy of Fallot (TOF) may still suffer from brain injury. This cross-sectional study was primarily designed to determine the relationship between blood oxygenation level-dependent (BOLD) signal changes after surgery and cognition in school-aged children with TOF. To evaluate the differences between TOF children (n = 9) and healthy children (n = 9), resting-state functional magnetic resonance imaging (rs-fMRI) and the Wechsler Intelligence Scale for Children–Chinese revised edition (WISC-CR) were conducted in this study. The results showed that TOF children had a lower full-scale intelligence quotient (FSIQ, 95.444 ± 5.354, p = 0.022) and verbal intelligence quotient (VIQ, 92.444 ± 4.708, p = 0.003) than healthy children (FSIQ = 118.500 ± 4.330;VIQ = 124.250 ± 4.404), and that significant differences in regional homogeneity (ReHo) and amplitude of low-frequency fluctuation (ALFF) existed between the two groups. Besides, VIQ had significantly positive correlations with the decreased ALFF value of the middle inferior occipital gyrus (MIOG, beta = 0.908, p = 0.012) after fully adjusting for all covariates. In addition, elevated ReHo values of the left and right precuneus were positively related to ALFF in the MIOG. This study revealed that brain injury substantially influences neural activity and cognition in postoperative TOF children, providing direct evidence of an association between BOLD signal changes and the VIQ and prompting further attention to language development in TOF children.

尽管接受了心内畸形矫正术，法洛四联症（Tetralogy of Fallot, TOF）患儿仍可能遭受脑损伤。本项横断面研究旨在探究法洛四联症术后学龄儿童的血氧水平依赖（blood oxygenation level-dependent, BOLD）信号变化与认知功能之间的关联。为对比法洛四联症患儿（n=9）与健康儿童（n=9）的差异，本研究对所有受试者开展了静息态功能磁共振成像（resting-state functional magnetic resonance imaging, rs-fMRI）检测，并采用韦氏儿童智力量表中国修订版（Wechsler Intelligence Scale for Children–Chinese revised edition, WISC-CR）进行认知评估。研究结果显示，法洛四联症患儿的总智商（full-scale intelligence quotient, FSIQ，95.444±5.354，p=0.022）与言语智商（verbal intelligence quotient, VIQ，92.444±4.708，p=0.003）均显著低于健康儿童（健康儿童FSIQ=118.500±4.330；VIQ=124.250±4.404），且两组受试者的局部一致性（regional homogeneity, ReHo）与低频振幅（amplitude of low-frequency fluctuation, ALFF）存在显著组间差异。此外，在对所有协变量进行充分校正后，言语智商与枕中下回（middle inferior occipital gyrus, MIOG）降低的低频振幅值呈显著正相关（beta=0.908，p=0.012）。同时，左右两侧楔前叶的局部一致性升高与枕中下回的低频振幅呈正相关。本研究表明，脑损伤可显著影响法洛四联症术后患儿的神经活动与认知功能，为血氧水平依赖信号变化与言语智商之间的关联提供了直接证据，并提示需进一步关注法洛四联症患儿的语言发育状况。