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.