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• Clinical Articles •
Topological characteristics of cerebral blood flow networks based on regional CBF morphological similarity in patent foramen ovale and their associations with cognitive function
YANG Dan  LIANG Yanni  YUE Songhong  ZHANG Ning  MA Xiaoyang  WANG Jun  LI Shilan  LIU Guangyao  ZHANG Jing 

Cite this article as YANG D, LIANG Y N, YUE S H, et al. Topological characteristics of cerebral blood flow networks based on regional CBF morphological similarity in patent foramen ovale and their associations with cognitive function[J]. Chin J Magn Reson Imaging, 2026, 17(8): 33-41, 106. DOI:10.12015/issn.1674-8034.2026.08.002.


[Abstract] Objective To construct a cerebral blood flow (CBF) functional network based on arterial spin labeling (ASL) and to investigate alterations in network topological properties in patients with patent foramen ovale (PFO) and their associations with cognitive function.Materials and Methods A total of 52 patients with PFO and 48 age- and sex-matched healthy controls were prospectively enrolled. CBF was quantified using ASL. The cerebral cortex was parcellated into 200 regions of interest according to the Schaefer atlas. The probability distribution of CBF in each region was estimated using kernel density estimation, and Jensen-Shannon divergence (JSD) was applied to quantify distributional similarity and construct the CBF functional network. Global and nodal topological properties, including global efficiency, clustering coefficient, degree centrality, and nodal efficiency, were calculated. Between-group differences were assessed using independent-samples t-tests. Partial correlation analyses controlling for age, sex, and years of education were further performed to investigate the relationships between abnormal network topological properties and cognitive function. Specifically, we examined correlations with Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) scores, as well as with PFO anatomical parameters and right-to-left shunt (RLS) grades.Results (1) Global properties: Compared with healthy controls, patients with PFO showed a statistically significant difference in global efficiency at the uncorrected level (P < 0.05), but the difference was not statistically significant after Bonferroni correction. (2) Nodal properties: Compared with the HC group, patients with PFO exhibited significant nodal topological alterations across multiple functional networks. In the default mode network (DMN), the degree centrality (Dc) and nodal efficiency (Ne) of the left precuneus were significantly decreased, while the Ne and nodal local efficiency (NLe) of the left dorsal prefrontal cortex were reduced. The left posterior cingulate cortex showed decreased Dc and Ne, with increased nodal clustering coefficient (NCp) and NLe. In the right posterior cingulate cortex, betweenness centrality (Bc), Dc, and Ne were decreased, while nodal shortest path length (NLp) was increased. In the fronto-parietal control network (FPN), the right dorsolateral prefrontal cortex showed decreased Bc, Dc, and Ne, whereas NCp and NLe were increased. In the somatomotor network (SMN), the left somatomotor area showed increased Bc, Dc, and Ne, along with decreased NLp. The right somatomotor area demonstrated increased Bc, Dc, and Ne, whereas the right secondary somatosensory cortex showed decreased Bc, Dc, and Ne. In the ventral attention network (VAN), the right inferior parietal lobule exhibited decreased Ne, accompanied by increased NLe and NLp (FDR corrected P < 0.05). (3) Correlation analysis: In the right posterior cingulate cortex, Bc and Dc were positively correlated with MoCA scores, while Ne and Dc were positively correlated with MMSE scores. In the left precuneus, Ne was positively correlated with MoCA scores. In the left posterior cingulate cortex, Dc, NCp, and NLe were positively correlated with MoCA scores, while Ne, Dc, NCp, and NLe were positively correlated with MMSE scores (FDR corrected P < 0.05).Conclusions Patients with PFO exhibit significant topological reorganization at the nodal level of the CBF network, primarily involving key functional networks such as the default mode network, fronto-parietal control network, and somatomotor network, and these alterations are correlated with cognitive scores. These findings may reveal potential neural mechanisms underlying PFO-related cognitive changes, provide preliminary insights into the relationship between nodal-level network topological changes and cognitive function, and offer an additional neuroimaging perspective for the assessment of cognitive function in patients with PFO.
[Keywords] patent foramen ovale；magnetic resonance imaging；brain network；cerebral blood flow；arterial spin labeling；graph theory analysis；cognitive function

YANG Dan1, 2, 3   LIANG Yanni1, 2, 3   YUE Songhong1, 2, 3   ZHANG Ning1, 2, 3   MA Xiaoyang1, 2, 3   WANG Jun1, 2, 3   LI Shilan1, 2, 3   LIU Guangyao1, 2, 3   ZHANG Jing1, 2, 3*  

1 Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou 730030, China

2 Second Clinical School, Lanzhou University, Lanzhou 730030, China

3 Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, 730030, China

Corresponding author: ZHANG J, E-mail: ery_zhangjing@lzu.edu.cn

Conflicts of interest   None.

Received  2026-02-28
Accepted  2026-07-14
DOI: 10.12015/issn.1674-8034.2026.08.002
Cite this article as YANG D, LIANG Y N, YUE S H, et al. Topological characteristics of cerebral blood flow networks based on regional CBF morphological similarity in patent foramen ovale and their associations with cognitive function[J]. Chin J Magn Reson Imaging, 2026, 17(8): 33-41, 106. DOI:10.12015/issn.1674-8034.2026.08.002.

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