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• Clinical Articles •
Study on brain functional changes in patients with patent foramen ovale based on graph theory and independent component analysis
CUI Kaige  LIU Liying  ZHAI Yu  JIA Juan  YU Jiaqi  YANG Jiping 

Cite this article as: CUI K G, LIU L Y, ZHAI Y, et al. Study on brain functional changes in patients with patent foramen ovale based on graph theory and independent component analysis[J]. Chin J Magn Reson Imaging, 2026, 17(3): 1-7, 14. DOI:10.12015/issn.1674-8034.2026.03.001.


[Abstract] Objective To explore the abnormal changes in brain functional networks caused by patent foramen ovale (PFO) before the occurrence of structural lesions and the alterations in brain functional networks before and after PFO closure using functional magnetic resonance imaging (fMRI).Materials and Methods This study is a prospective study. Seventy-seven patients with PFO who were eligible for interventional occlusion in the Second Hospital of Hebei Medical University from October 2023 to October 2024 were selected and forty-two age- and gender-matched healthy controls (HC) were recruited from the community. The two groups are the PFO group and the HC group. All of them underwent fMRI examination. After six months of follow-up, twenty-four postoperative patients were collected and named as the postoperative group. The preoperative baseline data of these patients constituted the preoperative group. SPSS 25.0 software was used to analyze the gender, age and scale score data of the two groups. Using graph theory methods, based on the GRETNA software package in MATLAB R2013b, the whole-brain resting-state networks of two groups of patients were constructed and brain network analysis was performed. The results were analyzed by independent sample t test, and the preoperative and postoperative data were analyzed by paired sample t test. Independent component analysis (ICA) method was used to construct the resting-state networks (RSNs) of the whole brain and static functional network connectivity (sFNC) was used to evaluate the network connectivity strength of the whole brain.Results There was no statistically significant difference in gender and age between PFO group and HC group (P > 0.05). The Montreal Cognitive Assessment (MoCA) score of the PFO group was lower than that of the HC group, and the Visual Symptoms and Quality of Life Questionnaire (VSQ) score was higher than that of the HC group. The differences were statistically significant (P < 0.05). The small worldness (σ) and normalized clustering coefficient (γ) of the small world network in the PFO group were higher than those in the HC group. Normalized characteristic path length (λ), clustering coefficient (Cp) and characteristic path length (Lp) were lower than those in the HC group. The differences were statistically significant (P < 0.05). The global efficiency (Eglob) of PFO group was higher than that of HC group. The differences were statistically significant (P < 0.05). There was no statistically significant difference in local efficiency (Eloc) between PFO group and HC group (P > 0.05). Compared with the HC group, the PFO group showed enhanced sFNC in left fronto-parietal networks (LFPN) and sensory-motor network (SMN), and LFPN and dorsal attention network (DAN) (P < 0.05). The sFNC between SMN and VN, DAN and SMN, DAN and default mode network (DMN) decreased (P < 0.05). There was no statistically significant difference in gender and age between the PFO group and the postoperative group (P > 0.05). There was no statistically significant difference in cognitive assessment between the preoperative group and the postoperative group (P > 0.05). The postoperative Visual Analogue Scale (VAS) score of the subjects was lower than the preoperative score and the postoperative VSQ score was also lower than the preoperative score. The differences were statistically significant (P < 0.05). There was no significant difference in the values of brain network properties between the preoperative group and the postoperative group (P > 0.05). The sFNC of DAN-VN increased after closure (P < 0.05).Conclusions The changes of brain network characteristic values in PFO patients indicate that the stability of brain network is impaired, and the dynamic regulation of brain networks tends to increase compensatory communication efficiency. The functional connectivity of brain network in PFO patients is changed, which may be related to cognitive, visual abnormalities or headache symptoms. The enhancement of sFNC in some brain networks after surgery may be related to the recovery of brain function.
[Keywords] patent foramen ovale；closure；magnetic resonance imaging；brain network；brain function

CUI Kaige1, 2   LIU Liying1   ZHAI Yu1   JIA Juan1   YU Jiaqi1   YANG Jiping1*  

1 Department of Medical Imaging, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China

2 Department of Imaging, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China

Corresponding author: YANG J P, E-mail: ran0511@sina.com

Conflicts of interest   None.

Received  2025-09-29
Accepted  2026-03-09
DOI: 10.12015/issn.1674-8034.2026.03.001
Cite this article as: CUI K G, LIU L Y, ZHAI Y, et al. Study on brain functional changes in patients with patent foramen ovale based on graph theory and independent component analysis[J]. Chin J Magn Reson Imaging, 2026, 17(3): 1-7, 14. DOI:10.12015/issn.1674-8034.2026.03.001.

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