Altered Brain Function and Network Topology in Patients With Acromegaly: Resting-State fMRI Study of Networks Related to Cognitive and Emotional Processing.

CONTEXT: Neurodegenerative diseases are particularly prevalent among patients with acromegaly, but their functional alterations remain poorly understood.

OBJECTIVE

To explore the neurobiological mechanisms of excess growth hormone (GH) on brain functional activity and connectivity in acromegaly.

METHODS

Neuropsychological assessments and resting-state functional magnetic resonance imaging (fMRI) were conducted on 27 patients with acromegaly and 25 healthy controls. The amplitude of low-frequency fluctuations (ALFF), fractional ALFF (fALFF), and regional homogeneity (ReHo) were compared between groups via voxel-based analyses, while graph theory was used to assess brain network topology. T-tests and multikernel support vector machine (MK-SVM) were used to identify discriminative connectome features for classification.

RESULTS

Patients with acromegaly exhibited lower Montreal Cognitive Assessment scores, increased ALFF in the default mode network regions, and decreased fALFF in the frontal-parietal control network areas. ReHo was elevated in the visual network but reduced in the frontal-parietal network. Disruptions were observed in key hub nodes within the default mode and visual networks. The MK-SVM achieved 85.11% accuracy and 80.00% sensitivity in classifying patients.

CONCLUSIONS

Patients with acromegaly exhibited altered brain function and network disruptions. These results offer novel insights into the mechanisms of excess GH in the brain.