1
|
Fruhwirth V, Berger L, Gattringer T, Fandler-Höfler S, Kneihsl M, Eppinger S, Ropele S, Fink A, Deutschmann H, Reishofer G, Enzinger C, Pinter D. White matter integrity and functional connectivity of the default mode network in acute stroke are associated with cognitive outcome three months post-stroke. J Neurol Sci 2024; 462:123071. [PMID: 38850772 DOI: 10.1016/j.jns.2024.123071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/27/2024] [Accepted: 05/29/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Knowledge about factors that are associated with post-stroke cognitive outcome is important to identify patients with high risk for impairment. We therefore investigated the associations of white matter integrity and functional connectivity (FC) within the brain's default-mode network (DMN) in acute stroke patients with cognitive outcome three months post-stroke. METHODS Patients aged between 18 and 85 years with an acute symptomatic MRI-proven unilateral ischemic middle cerebral artery infarction, who had received reperfusion therapy, were invited to participate in this longitudinal study. All patients underwent brain MRI within 24-72 h after symptom onset, and participated in a neuropsychological assessment three months post-stroke. We performed hierarchical regression analyses to explore the incremental value of baseline white matter integrity and FC beyond demographic, clinical, and macrostructural information for cognitive outcome. RESULTS The study cohort comprised 34 patients (mean age: 64 ± 12 years, 35% female). The initial median National Institutes of Health Stroke Scale (NIHSS) score was 10, and significantly improved three months post-stroke to a median NIHSS = 1 (p < .001). Nonetheless, 50% of patients showed cognitive impairment three months post-stroke. FC of the non-lesioned anterior cingulate cortex of the affected hemisphere explained 15% of incremental variance for processing speed (p = .007), and fractional anisotropy of the non-lesioned cingulum of the affected hemisphere explained 13% of incremental variance for cognitive flexibility (p = .033). CONCLUSIONS White matter integrity and functional MRI markers of the DMN in acute stroke explain incremental variance for post-stroke cognitive outcome beyond demographic, clinical, and macrostructural information.
Collapse
Affiliation(s)
- Viktoria Fruhwirth
- Department of Neurology, Medical University of Graz, Graz, Austria; Department of Neurology, Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Graz, Austria; Institute of Psychology, Department of Biological Psychology, University of Graz, Graz, Austria
| | - Lisa Berger
- Institute of Psychology, Department of Neuropsychology - Neuroimaging, University of Graz, Graz, Austria
| | - Thomas Gattringer
- Department of Neurology, Medical University of Graz, Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | | | - Markus Kneihsl
- Department of Neurology, Medical University of Graz, Graz, Austria
| | | | - Stefan Ropele
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Andreas Fink
- Institute of Psychology, Department of Biological Psychology, University of Graz, Graz, Austria
| | - Hannes Deutschmann
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Gernot Reishofer
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Christian Enzinger
- Department of Neurology, Medical University of Graz, Graz, Austria; Department of Neurology, Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Daniela Pinter
- Department of Neurology, Medical University of Graz, Graz, Austria; Department of Neurology, Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Graz, Austria.
| |
Collapse
|
2
|
Zhi Z, Liang X, Huang M, Wu L, Zhou F. The association between glymphatic system dysfunction and alterations in cerebral function and structure in patients with white matter hyperintensities. Neuroreport 2024; 35:476-485. [PMID: 38597326 DOI: 10.1097/wnr.0000000000002031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
The objective of this study is to explore the relationship between the glymphatic system and alterations in the structure and function of the brain in white matter hyperintensity (WMH) patients. MRI data were collected from 27 WMH patients and 23 healthy controls. We calculated the along perivascular space (ALPS) indices, the anterior corner distance of the lateral ventricle, and the width of the third ventricle for each subject. The DPABISurf tool was used to calculate the cortical thickness and cortical area. In addition, data processing assistant for resting-state fMRI was used to calculate regional homogeneity, degree centrality, amplitude low-frequency fluctuation (ALFF), fractional amplitude of low-frequency fluctuation (fALFF), and voxel-mirrored homotopic connectivity (VMHC). In addition, each WMH patient was evaluated on the Fazekas scale. Finally, the correlation analysis of structural indicators and functional indicators with bilateral ALPS indices was investigated using Spearman correlation analysis. The ALPS indices of WMH patients were lower than those of healthy controls (left: t = -4.949, P < 0.001; right: t = -3.840, P < 0.001). This study found that ALFF, fALFF, regional homogeneity, degree centrality, and VMHC values in some brain regions of WMH patients were alternated (AlphaSim corrected, P < 0.005, cluster size > 26 voxel, rmm value = 5), and the cortical thickness and cortical area of WMH patients showed trend changes (P < 0.01, cluster size > 20 mm2, uncorrected). Interestingly, we found significantly positive correlations between the left ALPS indices and degree centrality values in the superior temporal gyrus (r = 0.494, P = 0.009, P × 5 < 0.05, Bonferroni correction). Our results suggest that glymphatic system impairment is related to the functional centrality of local connections in patients with WMH. This provides a new perspective for understanding the pathological mechanisms of cognitive impairment in the WMH population.
Collapse
Affiliation(s)
- Zhang Zhi
- Department of Radiology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University
- Department of Radiology, Jiangxi Province Medical Imaging Research Institute
- Department of Radiology, Clinical Research Center for Medical Imaging
| | - Xiao Liang
- Department of Radiology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University
- Department of Radiology, Jiangxi Province Medical Imaging Research Institute
- Department of Radiology, Clinical Research Center for Medical Imaging
| | - Muhua Huang
- Department of Intervention, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Lin Wu
- Department of Radiology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University
- Department of Radiology, Jiangxi Province Medical Imaging Research Institute
- Department of Radiology, Clinical Research Center for Medical Imaging
| | - Fuqing Zhou
- Department of Radiology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University
- Department of Radiology, Jiangxi Province Medical Imaging Research Institute
- Department of Radiology, Clinical Research Center for Medical Imaging
| |
Collapse
|
3
|
Fu X, Sun P, Zhang X, Zhu D, Qin Q, Lu J, Wang J. GABA in the anterior cingulate cortex mediates the association of white matter hyperintensities with executive function: a magnetic resonance spectroscopy study. Aging (Albany NY) 2024; 16:4282-4298. [PMID: 38441529 DOI: 10.18632/aging.205585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/24/2024] [Indexed: 03/22/2024]
Abstract
White matter hyperintensities (WMH) and gamma-aminobutyric acid (GABA) are associated with executive function. Multiple studies suggested cortical alterations mediate WMH-related cognitive decline. The aim of this study was to investigate the crucial role of cortical GABA in the WMH patients. In the 87 WMH patients (46 mild and 41 moderate to severe) examined in this study, GABA levels in the anterior cingulate cortex (ACC) and posterior cingulate cortex (PCC) assessed by the Meshcher-Garwood point resolved spectroscopy (MEGA-PRESS) sequence, WMH volume and executive function were compared between the two groups. Partial correlation and mediation analyses were carried out to examine the GABA levels in mediating the association between WMH volume and executive function. Patients with moderate to severe WMH had lower GABA+/Cr in the ACC (p = 0.034) and worse executive function (p = 0.004) than mild WMH patients. In all WMH cases, the GABA+/Cr levels in the ACC mediated the negative correlation between WMH and executive function (ab: effect = -0.020, BootSE = 0.010, 95% CI: -0.042 to -0.004). This finding suggested GABA+/Cr levels in the ACC might serve as a protective factor or potential target for preventing the occurrence and progression of executive function decline in WMH people.
Collapse
Affiliation(s)
- Xiaona Fu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430030, China
| | - Peng Sun
- Clinical and Technical Support, Philips Healthcare, Beijing 100600, China
| | - Xinli Zhang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430030, China
| | - Dongyong Zhu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430030, China
| | - Qian Qin
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430030, China
| | - Jue Lu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430030, China
| | - Jing Wang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430030, China
| |
Collapse
|
4
|
Mu S, Lu W, Yu G, Zheng L, Qiu J. Deep learning-based grading of white matter hyperintensities enables identification of potential markers in multi-sequence MRI data. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2024; 243:107904. [PMID: 37924768 DOI: 10.1016/j.cmpb.2023.107904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 10/06/2023] [Accepted: 10/27/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND White matter hyperintensities (WMHs) are widely-seen in the aging population, which are associated with cerebrovascular risk factors and age-related cognitive decline. At present, structural atrophy and functional alterations coexisted with WMHs lacks comprehensive investigation. This study developed a WMHs risk prediction model to evaluate WHMs according to Fazekas scales, and to locate potential regions with high risks across the entire brain. METHODS We developed a WMHs risk prediction model, which consisted of the following steps: T2 fluid attenuated inversion recovery (T2-FLAIR) image of each participant was firstly segmented into 1000 tiles with the size of 32 × 32 × 1, features from the tiles were extracted using the ResNet18-based feature extractor, and then a 1D convolutional neural network (CNN) was used to score all tiles based on the extracted features. Finally, a multi-layer perceptron (MLP) was constructed to predict the Fazekas scales based on the tile scores. The proposed model was trained using T2-FLAIR images, we selected tiles with abnormal scores in the test set after prediction, and evaluated their corresponding gray matter (GM) volume, white matter (WM) volume, fractional anisotropy (FA), mean diffusivity (MD), and cerebral blood flow (CBF) via longitudinal and multi-sequence Magnetic Resonance Imaging (MRI) data analysis. RESULTS The proposed WMHs risk prediction model could accurately predict the Fazekas ratings based on the tile scores from T2-FLAIR MRI images with accuracy of 0.656, 0.621 in training data set and test set, respectively. The longitudinal MRI validation revealed that most of the high-risk tiles predicted by the WMHs risk prediction model in the baseline images had WMHs in the corresponding positions in the longitudinal images. The validation on multi-sequence MRI demonstrated that WMHs were associated with GM and WM atrophies, WM micro-structural and perfusion alterations in high-risk tiles, and multi-modal MRI measures of most high-risk tiles showed significant associations with Mini Mental State Examination (MMSE) score. CONCLUSION Our proposed WMHs risk prediction model can not only accurately evaluate WMH severities according to Fazekas scales, but can also uncover potential markers of WMHs across modalities. The WMHs risk prediction model has the potential to be used for the early detection of WMH-related alterations in the entire brain and WMH-induced cognitive decline.
Collapse
Affiliation(s)
- Si Mu
- College of Mechanical and Electronic Engineering, Shandong Agricultural University, Tai'an, Shandong, 271000, China
| | - Weizhao Lu
- Department of Radiology, the Second Affiliated Hospital of Shandong First Medical University, Tai'an, Shandong, 271000, China
| | - Guanghui Yu
- Department of Radiology, the Second Affiliated Hospital of Shandong First Medical University, Tai'an, Shandong, 271000, China
| | - Lei Zheng
- Department of Radiology, Rushan Hospital of Chinese Medicine, Rushan, Shandong, 264500, China.
| | - Jianfeng Qiu
- School of Radiology, Shandong First Medical University & Shandong Academy of Medicine Sciences, Tai'an, Shandong, 271000, China; Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250000, China.
| |
Collapse
|
5
|
Zhu X, Zhou Y, Zhong W, Li Y, Wang J, Chen Y, Zhang R, Sun J, Sun Y, Lou M. Higher Functional Connectivity of Ventral Attention and Visual Network to Maintain Cognitive Performance in White Matter Hyperintensity. Aging Dis 2023:AD.2022.1206. [PMID: 37163435 PMCID: PMC10389834 DOI: 10.14336/ad.2022.1206] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/06/2022] [Indexed: 05/12/2023] Open
Abstract
Ventral attention network (VAN), associated with cognitive performance, is one of the functional networks that are most vulnerable in white matter hyperintensity (WMH). Considering the global interaction of networks for cognitive performance, we hypothesized that VAN-related between-network connectivity might play a role in maintaining cognition in patients with WMH. We included 139 participants for both cross-sectional and longitudinal analysis from CIRCLE study (ClinicalTrials.gov ID: NCT03542734) between January 2014 and January 2021. Differences of VAN-related between-network connectivity were compared between normal-cognition (NC) and cognitive-impairment (CI) groups cross-sectionally, and between cognitive-decline (CD) and cognitive non-decline (CND) groups longitudinally by using t-test. False Discovery Rate was used for multiple comparison correction. The relationship between the network connectivity and WMH was tested on linear and quadratic models. Subgroup analysis of different WMH burdens were performed to test the difference of network connectivity between NC and CI groups. Among VAN-related between-network connectivity, only VAN-Visual Network (VN) connectivity was higher both in NC (n = 106) and CND (n = 113) groups versus CI (n = 33) and CD groups (n = 26), respectively. There was an inverted U-shaped relation between periventricular WMH (PWMH) burden and VAN-VN connectivity. Normal-cognition participants had higher VAN-VN connectivity among high, but not low PWMH burden subgroups. These findings suggest that the VAN-VN connectivity plays an important role in maintaining cognitive performance in WMH patients. It may serve as a unique marker for cognitive prediction and a potential target for intervention to prevent cognitive decline in WMH patients.
Collapse
Affiliation(s)
- Xiao Zhu
- Department of Neurology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Ying Zhou
- Department of Neurology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Wansi Zhong
- Department of Neurology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Yifei Li
- Department of Neurology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Junjun Wang
- Department of Neurology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
- Department of Neurology, Zhejiang Hospital, Hangzhou, China
| | - Yuping Chen
- Department of Neurology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Ruoxia Zhang
- Department of Neurology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Jianzhong Sun
- Department of Radiology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Yu Sun
- Key Laboratory for Biomedical Engineering of Ministry of Education of China, Zhejiang University, Zhejiang, China
| | - Min Lou
- Department of Neurology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| |
Collapse
|
6
|
Huang C, Zhou X, Ren M, Zhang W, Wan K, Yin J, Li M, Li Z, Zhu X, Sun Z. Altered dynamic functional network connectivity and topological organization variance in patients with white matter hyperintensities. J Neurosci Res 2023; 101:1711-1727. [PMID: 37469210 DOI: 10.1002/jnr.25230] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 06/14/2023] [Accepted: 07/01/2023] [Indexed: 07/21/2023]
Abstract
White matter hyperintensities (WMHs) of presumed vascular origin are important imaging biomarkers of cerebral small vessel disease (CSVD). Previous studies have verified abnormal functional brain networks in CSVD. However, most of these studies rely on static functional connectivity, and only a few focus on the varying severity of the WMHs. Hence, our study primarily explored the disrupted dynamic functional network connectivity (dFNC) and topological organization variance in patients with WMHs. This study included 38 patients with moderate WMHs, 47 with severe WMHs, and 68 healthy controls (HCs). Ten independent components were chosen using independent component analysis based on resting-state functional magnetic resonance imaging. The dFNC of each participant was estimated using sliding windows and k-means clustering. We identified three reproducible dFNC states. Among them, patients with WMHs had a significantly higher occurrence in the sparsely connected State 1, but a lower occurrence and shorter duration in the positive and stronger connected State 3. Regarding topological organization variance, patients with WMHs showed higher variance in local efficiency but not global efficiency compared to HCs. Among the WMH subgroups, patients with severe WMHs showed similar but more obvious alterations than those with moderate WMHs. These altered network characteristics indicated an imbalance between the functional segregation and integration of brain networks, which was correlated with global cognition, memory, executive functions, and visuospatial abilities. Our study confirmed aberrant dFNC state metrics and topological organization variance in patients with moderate-to-severe WMHs; thus, it might provide a new pathway for exploring the pathogenesis of cognitive impairment.
Collapse
Affiliation(s)
- Chaojuan Huang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xia Zhou
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Mengmeng Ren
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Wei Zhang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ke Wan
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jiabin Yin
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Mingxu Li
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Zhiwei Li
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiaoqun Zhu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Zhongwu Sun
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| |
Collapse
|
7
|
Ali DG, Bahrani AA, El Khouli RH, Gold BT, Jiang Y, Zachariou V, Wilcock DM, Jicha GA. White matter hyperintensities influence distal cortical β-amyloid accumulation in default mode network pathways. Brain Behav 2023; 13:e3209. [PMID: 37534614 PMCID: PMC10570488 DOI: 10.1002/brb3.3209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 07/19/2023] [Accepted: 07/22/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND AND PURPOSE Cerebral small vessel disease (SVD) has been suggested to contribute to the pathogenesis of Alzheimer's disease (AD). Yet, the role of SVD in potentially contributing to AD pathology is unclear. The main objective of this study was to test the hypothesis that WMHs influence amyloid β (Aβ) levels within connected default mode network (DMN) tracts and cortical regions in cognitively unimpaired older adults. METHODS Regional standard uptake value ratios (SUVr) from Aβ-PET and white matter hyperintensity (WMH) volumes from three-dimensional magnetic resonance imaging FLAIR images were analyzed across a sample of 72 clinically unimpaired (mini-mental state examination ≥26), older adults (mean age 74.96 and standard deviation 8.13) from the Alzheimer's Disease Neuroimaging Initiative (ADNI3). The association of WMH volumes in major fiber tracts projecting from cortical DMN regions and Aβ-PET SUVr in the connected cortical DMN regions was analyzed using linear regression models adjusted for age, sex, ApoE, and total brain volumes. RESULTS The regression analyses demonstrate that increased WMH volumes in the superior longitudinal fasciculus were associated with increased regional SUVr in the inferior parietal lobule (p = .011). CONCLUSION The findings suggest that the relation between Aβ in parietal cortex is associated with SVD in downstream white matter (WM) pathways in preclinical AD. The biological relationships and interplay between Aβ and WM microstructure alterations that precede overt WMH development across the continuum of AD progression warrant further study.
Collapse
Affiliation(s)
- Doaa G. Ali
- Sanders‐Brown Center on Aging, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
- Department of Behavioral Science, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
| | - Ahmed A. Bahrani
- Sanders‐Brown Center on Aging, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
- Department of Neurology, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
| | - Riham H. El Khouli
- Department of Radiology, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
| | - Brian T. Gold
- Sanders‐Brown Center on Aging, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
- Department of Neuroscience, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
| | - Yang Jiang
- Sanders‐Brown Center on Aging, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
- Department of Behavioral Science, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
| | - Valentinos Zachariou
- Department of Neuroscience, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
| | - Donna M. Wilcock
- Sanders‐Brown Center on Aging, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
- Department of Physiology, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
| | - Gregory A. Jicha
- Sanders‐Brown Center on Aging, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
- Department of Behavioral Science, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
- Department of Neurology, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
| |
Collapse
|
8
|
Chen H, Xu J, Lv W, Hu Z, Ke Z, Qin R, Xu Y. Altered static and dynamic functional network connectivity related to cognitive decline in individuals with white matter hyperintensities. Behav Brain Res 2023; 451:114506. [PMID: 37230298 DOI: 10.1016/j.bbr.2023.114506] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/08/2023] [Accepted: 05/22/2023] [Indexed: 05/27/2023]
Abstract
White matter hyperintensities (WMH) of assumed vascular origin are common in elderly individuals and are closely associated with cognitive decline. However, the underlying neural mechanisms of WMH-related cognitive impairment remain unclear. After strict screening, 59 healthy controls (HC, n = 59), 51 patients with WMH and normal cognition (WMH-NC, n = 51) and 68 patients with WMH and mild cognitive impairment (WMH-MCI, n = 68) were included in the final analyses. All individuals underwent multimodal magnetic resonance imaging (MRI) and cognitive evaluations. We investigated the neural mechanism underlying WMH-related cognitive impairment based on static and dynamic functional network connectivity (sFNC and dFNC) approaches. Finally, the support vector machine (SVM) method was performed to identify WMH-MCI individuals. The sFNC analysis indicated that functional connectivity within the visual network (VN) could mediate the impairment of information processing speed related to WMH (indirect effect: 0.24; 95% CI: 0.03, 0.88 and indirect effect: 0.05; 95% CI: 0.001, 0.14). WMH may regulate the dFNC between the higher-order cognitive network and other networks and enhance the dynamic variability between the left frontoparietal network (lFPN) and the VN to compensate for the decline in high-level cognitive functions. The SVM model achieved good prediction ability for WMH-MCI patients based on the above characteristic connectivity patterns. Our findings shed light on the dynamic regulation of brain network resources to maintain cognitive processing in individuals with WMH. Crucially, dynamic reorganization of brain networks could be regarded as a potential neuroimaging biomarker for identifying WMH-related cognitive impairment.
Collapse
Affiliation(s)
- Haifeng Chen
- Department of Neurology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China; Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China; Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China; Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China; Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Jingxian Xu
- Department of Neurology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Weiping Lv
- Nanjing Drum Tower Hospital Clinical College of Jiangsu University, Nanjing, China
| | - Zheqi Hu
- Department of Neurology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Zhihong Ke
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Ruomeng Qin
- Department of Neurology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China; Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China; Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China; Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Yun Xu
- Department of Neurology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China; Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China; Nanjing Drum Tower Hospital Clinical College of Jiangsu University, Nanjing, China; Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China; Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China; Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China; Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China.
| |
Collapse
|
9
|
Jiang R, Calhoun VD, Noble S, Sui J, Liang Q, Qi S, Scheinost D. A functional connectome signature of blood pressure in >30 000 participants from the UK biobank. Cardiovasc Res 2023; 119:1427-1440. [PMID: 35875865 PMCID: PMC10262183 DOI: 10.1093/cvr/cvac116] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/07/2022] [Accepted: 07/01/2022] [Indexed: 11/12/2022] Open
Abstract
AIMS Elevated blood pressure (BP) is a prevalent modifiable risk factor for cardiovascular diseases and contributes to cognitive decline in late life. Despite the fact that functional changes may precede irreversible structural damage and emerge in an ongoing manner, studies have been predominantly informed by brain structure and group-level inferences. Here, we aim to delineate neurobiological correlates of BP at an individual level using machine learning and functional connectivity. METHODS AND RESULTS Based on whole-brain functional connectivity from the UK Biobank, we built a machine learning model to identify neural representations for individuals' past (∼8.9 years before scanning, N = 35 882), current (N = 31 367), and future (∼2.4 years follow-up, N = 3 138) BP levels within a repeated cross-validation framework. We examined the impact of multiple potential covariates, as well as assessed these models' generalizability across various contexts.The predictive models achieved significant correlations between predicted and actual systolic/diastolic BP and pulse pressure while controlling for multiple confounders. Predictions for participants not on antihypertensive medication were more accurate than for currently medicated patients. Moreover, the models demonstrated robust generalizability across contexts in terms of ethnicities, imaging centres, medication status, participant visits, gender, age, and body mass index. The identified connectivity patterns primarily involved the cerebellum, prefrontal, anterior insula, anterior cingulate cortex, supramarginal gyrus, and precuneus, which are key regions of the central autonomic network, and involved in cognition processing and susceptible to neurodegeneration in Alzheimer's disease. Results also showed more involvement of default mode and frontoparietal networks in predicting future BP levels and in medicated participants. CONCLUSION This study, based on the largest neuroimaging sample currently available and using machine learning, identifies brain signatures underlying BP, providing evidence for meaningful BP-associated neural representations in connectivity profiles.
Collapse
Affiliation(s)
- Rongtao Jiang
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT 06510, USA
| | - Vince D Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia Institute of Technology, Emory University and Georgia State University, Atlanta, GA 30303, USA
| | - Stephanie Noble
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT 06510, USA
| | - Jing Sui
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia Institute of Technology, Emory University and Georgia State University, Atlanta, GA 30303, USA
| | - Qinghao Liang
- Department of Biomedical Engineering, Yale University, New Haven, CT 06520, USA
| | - Shile Qi
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia Institute of Technology, Emory University and Georgia State University, Atlanta, GA 30303, USA
| | - Dustin Scheinost
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT 06510, USA
- Department of Biomedical Engineering, Yale University, New Haven, CT 06520, USA
- Interdepartmental Neuroscience Program, Yale University, New Haven, CT 06520, USA
- Department of Statistics & Data Science, Yale University, New Haven, CT 06520, USA
- Child Study Center, Yale School of Medicine, New Haven, CT 06510, USA
| |
Collapse
|
10
|
Yang D, Li J, Ke Z, Qin R, Mao C, Huang L, Mo Y, Hu Z, Lv W, Huang Y, Zhang B, Xu Y. Subsystem mechanisms of default mode network underlying white matter hyperintensity-related cognitive impairment. Hum Brain Mapp 2023; 44:2365-2379. [PMID: 36722495 PMCID: PMC10028636 DOI: 10.1002/hbm.26215] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 02/02/2023] Open
Abstract
Functional changes of default mode network (DMN) have been proven to be closely associated with white matter hyperintensity (WMH) related cognitive impairment (CI). However, subsystem mechanisms of DMN underlying WMH-related CI remain unclear. The present study recruited WMH patients (n = 206) with mild CI and normal cognition, as well as healthy controls (HC, n = 102). Static/dynamic functional connectivity (FC) of the DMN's three subsystems were calculated using resting-state functional MRI. K-means clustering analyses were performed to extract distinct dynamic connectivity states. Compared with the WMH-NC group, the WMH-MCI group displayed lower static FC within medial temporal lobe (MTL) and core subsystem, between core-MTL subsystem, as well as between core and dorsal medial prefrontal cortex subsystem. All these static alterations were positively associated with information processing speed (IPS). Regarding dynamic FC, the WMH-MCI group exhibited higher dynamic FC within MTL subsystem than the HC and WMH-NC groups. Altered dynamic FC within MTL subsystem mediated the relationship between WMH and memory span (indirect effect: -0.2251, 95% confidence interval [-0.6295, -0.0267]). Additionally, dynamic FCs of DMN subsystems could be clustered into two recurring states. For dynamic FCs within MTL subsystem, WMH-MCI subjects exhibited longer mean dwell time (MDT) and higher reoccurrence fraction (RF) in a sparsely connected state (State 2). Altered MDT and RF in State 2 were negatively associated with IPS. Taken together, these findings indicated static/dynamic FC of DMN subsystems can provide relevant information on cognitive decline from different aspects, which provides a comprehensive view of subsystem mechanisms of DMN underlying WMH-related CI.
Collapse
Affiliation(s)
- Dan Yang
- Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Jiangnan Li
- Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Zhihong Ke
- Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Ruomeng Qin
- Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
| | - ChengLu Mao
- Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
| | - Lili Huang
- Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
| | - Yuting Mo
- Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
| | - Zheqi Hu
- Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
| | - Weiping Lv
- Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
| | - Yanan Huang
- Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
| | - Bing Zhang
- Department of Radiology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Yun Xu
- Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
- Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
- Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
- Nanjing Neurology Clinic Medical Center, Nanjing, China
| |
Collapse
|
11
|
Chuang KC, Ramakrishnapillai S, Madden K, St Amant J, McKlveen K, Gwizdala K, Dhullipudi R, Bazzano L, Carmichael O. Brain effective connectivity and functional connectivity as markers of lifespan vascular exposures in middle-aged adults: The Bogalusa Heart Study. Front Aging Neurosci 2023; 15:1110434. [PMID: 36998317 PMCID: PMC10043334 DOI: 10.3389/fnagi.2023.1110434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/22/2023] [Indexed: 03/16/2023] Open
Abstract
IntroductionEffective connectivity (EC), the causal influence that functional activity in a source brain location exerts over functional activity in a target brain location, has the potential to provide different information about brain network dynamics than functional connectivity (FC), which quantifies activity synchrony between locations. However, head-to-head comparisons between EC and FC from either task-based or resting-state functional MRI (fMRI) data are rare, especially in terms of how they associate with salient aspects of brain health.MethodsIn this study, 100 cognitively-healthy participants in the Bogalusa Heart Study aged 54.2 ± 4.3years completed Stroop task-based fMRI, resting-state fMRI. EC and FC among 24 regions of interest (ROIs) previously identified as involved in Stroop task execution (EC-task and FC-task) and among 33 default mode network ROIs (EC-rest and FC-rest) were calculated from task-based and resting-state fMRI using deep stacking networks and Pearson correlation. The EC and FC measures were thresholded to generate directed and undirected graphs, from which standard graph metrics were calculated. Linear regression models related graph metrics to demographic, cardiometabolic risk factors, and cognitive function measures.ResultsWomen and whites (compared to men and African Americans) had better EC-task metrics, and better EC-task metrics associated with lower blood pressure, white matter hyperintensity volume, and higher vocabulary score (maximum value of p = 0.043). Women had better FC-task metrics, and better FC-task metrics associated with APOE-ε4 3–3 genotype and better hemoglobin-A1c, white matter hyperintensity volume and digit span backwards score (maximum value of p = 0.047). Better EC rest metrics associated with lower age, non-drinker status, and better BMI, white matter hyperintensity volume, logical memory II total score, and word reading score (maximum value of p = 0.044). Women and non-drinkers had better FC-rest metrics (value of p = 0.004).DiscussionIn a diverse, cognitively healthy, middle-aged community sample, EC and FC based graph metrics from task-based fMRI data, and EC based graph metrics from resting-state fMRI data, were associated with recognized indicators of brain health in differing ways. Future studies of brain health should consider taking both task-based and resting-state fMRI scans and measuring both EC and FC analyses to get a more complete picture of functional networks relevant to brain health.
Collapse
Affiliation(s)
- Kai-Cheng Chuang
- Department of Physics & Astronomy, Louisiana State University, Baton Rouge, LA, United States
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
- *Correspondence: Kai-Cheng Chuang,
| | - Sreekrishna Ramakrishnapillai
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
- Department of Electrical and Computer Engineering, Louisiana State University, Baton Rouge, LA, United States
| | - Kaitlyn Madden
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Julia St Amant
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Kevin McKlveen
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Kathryn Gwizdala
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | | | - Lydia Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Owen Carmichael
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| |
Collapse
|
12
|
Deng S, Shu S, Zhai L, Xia S, Cao X, Li H, Bao X, Liu P, Xu Y. Optogenetic Stimulation of mPFC Alleviates White Matter Injury-Related Cognitive Decline after Chronic Ischemia through Adaptive Myelination. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2202976. [PMID: 36529961 PMCID: PMC9929132 DOI: 10.1002/advs.202202976] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 09/08/2022] [Indexed: 06/07/2023]
Abstract
White matter injury (WMI), which reflects myelin loss, contributes to cognitive decline or dementia caused by cerebral vascular diseases. However, because pharmacological agents specifically for WMI are lacking, novel therapeutic strategies need to be explored. It is recently found that adaptive myelination is required for homeostatic control of brain functions. In this study, adaptive myelination-related strategies are applied to explore the treatment for ischemic WMI-related cognitive dysfunction. Here, bilateral carotid artery stenosis (BCAS) is used to model ischemic WMI-related cognitive impairment and uncover that optogenetic and chemogenetic activation of glutamatergic neurons in the medial prefrontal cortex (mPFC) promote the differentiation of oligodendrocyte precursor cells (OPCs) in the corpus callosum, leading to improvements in myelin repair and working memory. Mechanistically, these neuromodulatory techniques exert a therapeutic effect by inducing the secretion of Wnt2 from activated neuronal axons, which acts on oligodendrocyte precursor cells and drives oligodendrogenesis and myelination. Thus, this study suggests that neuromodulation is a promising strategy for directing myelin repair and cognitive recovery through adaptive myelination in the context of ischemic WMI.
Collapse
Affiliation(s)
- Shiji Deng
- Department of NeurologyDrum Tower HospitalMedical School and The State Key Laboratory of Pharmaceutical BiotechnologyInstitute of Translational Medicine for Brain Critical DiseasesNanjing UniversityNanjing210008China
| | - Shu Shu
- Department of NeurologyDrum Tower HospitalMedical School and The State Key Laboratory of Pharmaceutical BiotechnologyInstitute of Translational Medicine for Brain Critical DiseasesNanjing UniversityNanjing210008China
| | - Lili Zhai
- Department of NeurologyDrum Tower HospitalMedical School and The State Key Laboratory of Pharmaceutical BiotechnologyInstitute of Translational Medicine for Brain Critical DiseasesNanjing UniversityNanjing210008China
| | - Shengnan Xia
- Department of NeurologyDrum Tower HospitalMedical School and The State Key Laboratory of Pharmaceutical BiotechnologyInstitute of Translational Medicine for Brain Critical DiseasesNanjing UniversityNanjing210008China
| | - Xiang Cao
- Department of NeurologyDrum Tower HospitalMedical School and The State Key Laboratory of Pharmaceutical BiotechnologyInstitute of Translational Medicine for Brain Critical DiseasesNanjing UniversityNanjing210008China
| | - Huiya Li
- Department of NeurologyDrum Tower HospitalMedical School and The State Key Laboratory of Pharmaceutical BiotechnologyInstitute of Translational Medicine for Brain Critical DiseasesNanjing UniversityNanjing210008China
| | - Xinyu Bao
- Department of NeurologyDrum Tower HospitalMedical School and The State Key Laboratory of Pharmaceutical BiotechnologyInstitute of Translational Medicine for Brain Critical DiseasesNanjing UniversityNanjing210008China
| | - Pinyi Liu
- Department of NeurologyDrum Tower HospitalMedical School and The State Key Laboratory of Pharmaceutical BiotechnologyInstitute of Translational Medicine for Brain Critical DiseasesNanjing UniversityNanjing210008China
| | - Yun Xu
- Department of NeurologyDrum Tower HospitalMedical School and The State Key Laboratory of Pharmaceutical BiotechnologyInstitute of Translational Medicine for Brain Critical DiseasesNanjing UniversityNanjing210008China
- Jiangsu Key Laboratory for Molecular MedicineMedical School of Nanjing UniversityNanjing210008China
- Jiangsu Provincial Key Discipline of NeurologyNanjing210008China
- Nanjing Neurology Medical CenterNanjing210008China
| |
Collapse
|
13
|
Chen X, Luo Y, Zhang S, Yang X, Dong Z, Wang Y, Wu D. Deep medullary veins: a promising neuroimaging marker for mild cognitive impairment in outpatients. BMC Neurol 2023; 23:3. [PMID: 36604624 PMCID: PMC9814341 DOI: 10.1186/s12883-022-03037-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/19/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND AND PURPOSE Mild cognitive impairment is an age-dependent pre-dementia state caused by varied reasons. Early detection of MCI helps handle dementia. Vascular factors are vital for the occurrence of MCI. This study investigates the correlation between deep medullary veins and multi-dimensional cognitive outcomes. MATERIALS AND METHODS A total of 73 participants with MCI and 32 controls were enrolled. Minimum Mental State Examination and Montreal Cognitive Assessment were used to examine the global cognitive function, and different cognitive domains were measured by specific neuropsychological tests. MRI was used to assess the visibility of the DMV and other neuroimage markers. RESULTS DMV score was statistically significantly higher in the MCI group compared with the control group (P = 0.009) and independently related to MCI (P = 0.007). Linear regression analysis verified that DMV score was linearly related to global cognition, memory, attention, and executive function after adjusting for cerebrovascular risk factors. CONCLUSION DMV score was independently related to the onset of MCI, and correlates with overall cognition, memory, attention, and executive function in outpatients.
Collapse
Affiliation(s)
- Xiuqi Chen
- grid.8547.e0000 0001 0125 2443Department of Neurology, Shanghai Fifth People’s Hospital, Fudan University, No.801, He Qing Road, Minhang District, Shanghai, China
| | - Yufan Luo
- grid.8547.e0000 0001 0125 2443Department of Neurology, Shanghai Fifth People’s Hospital, Fudan University, No.801, He Qing Road, Minhang District, Shanghai, China
| | - Shufan Zhang
- grid.8547.e0000 0001 0125 2443Department of Neurology, Shanghai Fifth People’s Hospital, Fudan University, No.801, He Qing Road, Minhang District, Shanghai, China ,grid.8547.e0000 0001 0125 2443Department of Neurology, Shanghai Jing’an District Central Hospital, Fudan University, Shanghai, China
| | - Xiaoli Yang
- grid.8547.e0000 0001 0125 2443Department of Neurology, Shanghai Fifth People’s Hospital, Fudan University, No.801, He Qing Road, Minhang District, Shanghai, China
| | - Zhiyuan Dong
- grid.8547.e0000 0001 0125 2443Department of Neurology, Shanghai Fifth People’s Hospital, Fudan University, No.801, He Qing Road, Minhang District, Shanghai, China
| | - Yilin Wang
- Georgetown Preparatory School, North Bethesda, MD Washington, USA
| | - Danhong Wu
- grid.8547.e0000 0001 0125 2443Department of Neurology, Shanghai Fifth People’s Hospital, Fudan University, No.801, He Qing Road, Minhang District, Shanghai, China
| |
Collapse
|
14
|
Xu Z, Zhao L, Yin L, Liu Y, Ren Y, Yang G, Wu J, Gu F, Sun X, Yang H, Peng T, Hu J, Wang X, Pang M, Dai Q, Zhang G. MRI-based machine learning model: A potential modality for predicting cognitive dysfunction in patients with type 2 diabetes mellitus. Front Bioeng Biotechnol 2022; 10:1082794. [PMID: 36483770 PMCID: PMC9725113 DOI: 10.3389/fbioe.2022.1082794] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 11/10/2022] [Indexed: 07/27/2023] Open
Abstract
Background: Type 2 diabetes mellitus (T2DM) is a crucial risk factor for cognitive impairment. Accurate assessment of patients' cognitive function and early intervention is helpful to improve patient's quality of life. At present, neuropsychiatric screening tests is often used to perform this task in clinical practice. However, it may have poor repeatability. Moreover, several studies revealed that machine learning (ML) models can effectively assess cognitive impairment in Alzheimer's disease (AD) patients. We investigated whether we could develop an MRI-based ML model to evaluate the cognitive state of patients with T2DM. Objective: To propose MRI-based ML models and assess their performance to predict cognitive dysfunction in patients with type 2 diabetes mellitus (T2DM). Methods: Fluid Attenuated Inversion Recovery (FLAIR) of magnetic resonance images (MRI) were derived from 122 patients with T2DM. Cognitive function was assessed using the Chinese version of the Montréal Cognitive Assessment Scale-B (MoCA-B). Patients with T2DM were separated into the Dementia (DM) group (n = 40), MCI group (n = 52), and normal cognitive state (N) group (n = 30), according to the MoCA scores. Radiomics features were extracted from MR images with the Radcloud platform. The variance threshold, SelectKBest, and least absolute shrinkage and selection operator (LASSO) were used for the feature selection. Based on the selected features, the ML models were constructed with three classifiers, k-NearestNeighbor (KNN), Support Vector Machine (SVM), and Logistic Regression (LR), and the validation method was used to improve the effectiveness of the model. The area under the receiver operating characteristic curve (ROC) determined the appearance of the classification. The optimal classifier was determined by the principle of maximizing the Youden index. Results: 1,409 features were extracted and reduced to 13 features as the optimal discriminators to build the radiomics model. In the validation set, ROC curves revealed that the LR classifier had the best predictive performance, with an area under the curve (AUC) of 0.831 in DM, 0.883 in MIC, and 0.904 in the N group, compared with the SVM and KNN classifiers. Conclusion: MRI-based ML models have the potential to predict cognitive dysfunction in patients with T2DM. Compared with the SVM and KNN, the LR algorithm showed the best performance.
Collapse
Affiliation(s)
- Zhigao Xu
- Department of Radiology, Radiology-Based AI Innovation Workroom, The Third People’s Hospital of Datong, Datong, China
| | - Lili Zhao
- Department of Radiology, Radiology-Based AI Innovation Workroom, The Third People’s Hospital of Datong, Datong, China
| | - Lei Yin
- Graduate School, Changzhi Medical College, Changzhi, China
| | - Yan Liu
- Department of Endocrinology, The Third People’s Hospital of Datong, Datong, China
| | - Ying Ren
- Department of Materials Science and Engineering, Henan University of Technology, Zhengzhou, China
| | - Guoqiang Yang
- College of Medical Imaging, Shanxi Medical University, Taiyuan, China
- Department of Radiology, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Jinlong Wu
- Department of Radiology, Radiology-Based AI Innovation Workroom, The Third People’s Hospital of Datong, Datong, China
| | - Feng Gu
- Department of Radiology, Radiology-Based AI Innovation Workroom, The Third People’s Hospital of Datong, Datong, China
| | - Xuesong Sun
- Medical Department, The Third People’s Hospital of Datong, Datong, China
| | - Hui Yang
- Department of Radiology, Radiology-Based AI Innovation Workroom, The Third People’s Hospital of Datong, Datong, China
| | - Taisong Peng
- Department of Radiology, The Second People’s Hospital of Datong, Datong, China
| | - Jinfeng Hu
- Department of Radiology, The Second People’s Hospital of Datong, Datong, China
| | - Xiaogeng Wang
- Department of Radiology, Affiliated Hospital of Datong University, Datong, China
| | - Minghao Pang
- Department of Radiology, The People’s Hospital of Yunzhou District, Datong, China
| | - Qiong Dai
- Huiying Medical Technology (Beijing) Co. Ltd, Beijing, China
| | - Guojiang Zhang
- Department of Cardiovasology, Department of Science and Education, The Third People’s Hospital of Datong, Datong, China
| |
Collapse
|
15
|
Li Y, Liu X, Jia X, Li H, Jia X, Yang Q. Structural and functional alterations in cerebral small vessel disease: an ALE-based meta-analysis. Cereb Cortex 2022; 33:5484-5492. [PMID: 36376927 DOI: 10.1093/cercor/bhac435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/01/2022] [Accepted: 10/02/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Cerebral small vessel disease (CSVD) is one of the most important causes of stroke and dementia. Although increasing studies have reported alterations of brain structural or neuronal functional activity exhibited in patients with CSVD, it is still unclear which alterations are reliable. Here, we performed a meta-analysis to establish which brain structural or neuronal functional activity changes in those studies were consistent. Activation likelihood estimation revealed that changes in neuronal functional activity in the left angular gyrus, bilateral anterior cingulate cortex/left medial prefrontal cortex, right rolandic operculum, and alterations of gray structure in the left insular cortex/superior temporal gyrus/claustrum were reliable in sporadic CSVD. Decreased neuronal functional activity in the caudate head, anterior cingulate cortex, and reduced gray matter volume in the insular cortex/superior temporal gyrus/claustrum were associated with CSVD-related cognitive impairment. Furthermore, unlike sporadic CSVD, the reliable alterations of neuronal functional activity in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy were concentrated in the left parahippocampal gyrus. The current study presents stable brain structural and neuronal functional abnormalities within the brain, which can help further understand the pathogenesis of CSVD and CSVD-cognitive impairment and provide an index to evaluate the effectiveness of treatment protocols.
Highlights
• Default mode network and salience network are reliable networks affected in sporadic CSVD in resting-state.
• Altered corticostriatal circuitry is associated with cognitive decline.
• Decreased gray matter volume in the insular cortex is stable “remote effects” of sporadic CSVD.
• The parahippocampal gyrus may be a reliable affected brain region in CADASIL.
Collapse
Affiliation(s)
- Yingying Li
- Beijing Chaoyang Hospital, Capital Medical University Department of Radiology, , No.8 Gongti South Road, Chaoyang District, Beijing 100020 , China
- Ministry of Education Key Lab of Medical Engineering for Cardiovascular Disease, , Beijing 100020 , China
| | - Xin Liu
- Beijing Chaoyang Hospital, Capital Medical University Department of Radiology, , No.8 Gongti South Road, Chaoyang District, Beijing 100020 , China
- Ministry of Education Key Lab of Medical Engineering for Cardiovascular Disease, , Beijing 100020 , China
| | - Xuejia Jia
- Beijing Chaoyang Hospital, Capital Medical University Department of Radiology, , No.8 Gongti South Road, Chaoyang District, Beijing 100020 , China
- Ministry of Education Key Lab of Medical Engineering for Cardiovascular Disease, , Beijing 100020 , China
| | - Haoyuan Li
- Beijing Chaoyang Hospital, Capital Medical University Department of Radiology, , No.8 Gongti South Road, Chaoyang District, Beijing 100020 , China
- Ministry of Education Key Lab of Medical Engineering for Cardiovascular Disease, , Beijing 100020 , China
| | - Xiuqin Jia
- Beijing Chaoyang Hospital, Capital Medical University Department of Radiology, , No.8 Gongti South Road, Chaoyang District, Beijing 100020 , China
- Ministry of Education Key Lab of Medical Engineering for Cardiovascular Disease, , Beijing 100020 , China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Capital Medical University , No.10 Xitoutiao, Fengtai District, Beijing 100069 , China
| | - Qi Yang
- Beijing Chaoyang Hospital, Capital Medical University Department of Radiology, , No.8 Gongti South Road, Chaoyang District, Beijing 100020 , China
- Ministry of Education Key Lab of Medical Engineering for Cardiovascular Disease, , Beijing 100020 , China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Capital Medical University , No.10 Xitoutiao, Fengtai District, Beijing 100069 , China
| |
Collapse
|
16
|
Ma J, Hua XY, Zheng MX, Wu JJ, Huo BB, Xing XX, Gao X, Zhang H, Xu JG. Brain Metabolic Network Redistribution in Patients with White Matter Hyperintensities on MRI Analyzed with an Individualized Index Derived from 18F-FDG-PET/MRI. Korean J Radiol 2022; 23:986-997. [PMID: 36098344 PMCID: PMC9523232 DOI: 10.3348/kjr.2022.0320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Whether metabolic redistribution occurs in patients with white matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) is unknown. This study aimed 1) to propose a measure of the brain metabolic network for an individual patient and preliminarily apply it to identify impaired metabolic networks in patients with WMHs, and 2) to explore the clinical and imaging features of metabolic redistribution in patients with WMHs. MATERIALS AND METHODS This study included 50 patients with WMHs and 70 healthy controls (HCs) who underwent 18F-fluorodeoxyglucose-positron emission tomography/MRI. Various global property parameters according to graph theory and an individual parameter of brain metabolic network called "individual contribution index" were obtained. Parameter values were compared between the WMH and HC groups. The performance of the parameters in discriminating between the two groups was assessed using the area under the receiver operating characteristic curve (AUC). The correlation between the individual contribution index and Fazekas score was assessed, and the interaction between age and individual contribution index was determined. A generalized linear model was fitted with the individual contribution index as the dependent variable and the mean standardized uptake value (SUVmean) of nodes in the whole-brain network or seven classic functional networks as independent variables to determine their association. RESULTS The means ± standard deviations of the individual contribution index were (0.697 ± 10.9) × 10-3 and (0.0967 ± 0.0545) × 10-3 in the WMH and HC groups, respectively (p < 0.001). The AUC of the individual contribution index was 0.864 (95% confidence interval, 0.785-0.943). A positive correlation was identified between the individual contribution index and the Fazekas scores in patients with WMHs (r = 0.57, p < 0.001). Age and individual contribution index demonstrated a significant interaction effect on the Fazekas score. A significant direct association was observed between the individual contribution index and the SUVmean of the limbic network (p < 0.001). CONCLUSION The individual contribution index may demonstrate the redistribution of the brain metabolic network in patients with WMHs.
Collapse
Affiliation(s)
- Jie Ma
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xu-Yun Hua
- Department of Traumatology and Orthopedics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mou-Xiong Zheng
- Department of Traumatology and Orthopedics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jia-Jia Wu
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bei-Bei Huo
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiang-Xin Xing
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xin Gao
- Panoramic Medical Imaging Diagnostic Center, Shanghai, China
| | - Han Zhang
- School of Biomedical Engineering, ShanghaiTech University, Shanghai, China.
| | - Jian-Guang Xu
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China.
| |
Collapse
|
17
|
Shao P, Li X, Qin R, Xu H, Sheng X, Huang L, Ma J, Cheng Y, Chen H, Zhang B, Zhao H, Xu Y. Altered local gyrification and functional connectivity in type 2 diabetes mellitus patients with mild cognitive impairment: A pilot cross-sectional small-scale single center study. Front Aging Neurosci 2022; 14:934071. [PMID: 36204559 PMCID: PMC9530449 DOI: 10.3389/fnagi.2022.934071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 08/26/2022] [Indexed: 11/17/2022] Open
Abstract
Aims This research aimed to explore alterations in the local gyrification index (GI) and resting-state functional connectivity (RSFC) in type 2 diabetes mellitus (T2DM) patients with mild cognitive impairment (MCI). Methods In this study, 126 T2DM patients with MCI (T2DM-MCI), 154 T2DM patients with normal cognition (T2DM-NC), and 167 healthy controls (HC) were recruited. All subjects underwent a battery of neuropsychological tests. A multimodal approach combining surface-based morphometry (SBM) and seed-based RSFC was used to determine the structural and functional alterations in patients with T2DM-MCI. The relationships among the GI, RSFC, cognitive ability, and clinical variables were characterized. Results Compared with the T2DM-NC group and HC group, T2DM-MCI patients showed significantly reduced GI in the bilateral insular cortex. Decreased RSFC was found between the left insula and right precuneus, and the right superior frontal gyrus (SFG). The altered GI was correlated with T2DM duration, global cognition, and episodic memory. The mediation effects of RSFC on the association between GI and cognition were not statistically significant. Conclusion Our results suggest that GI may serve as a novel neuroimaging biomarker to predict T2DM-related MCI and help us to improve the understanding of the neuropathological effects of T2DM-related MCI.
Collapse
Affiliation(s)
- Pengfei Shao
- Department of Neurology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
| | - Xin Li
- Department of Radiology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Ruomeng Qin
- Department of Neurology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
| | - Hengheng Xu
- Department of Neurology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
| | - Xiaoning Sheng
- Department of Neurology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
| | - Lili Huang
- Department of Neurology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
| | - Junyi Ma
- Department of Neurology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
| | - Yue Cheng
- Department of Neurology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Haifeng Chen
- Department of Neurology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Bing Zhang
- Department of Radiology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Hui Zhao
- Department of Neurology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
- Department of Neurology, Affiliated Taikang Xianlin Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
- *Correspondence: Hui Zhao
| | - Yun Xu
- Department of Neurology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
- Yun Xu
| |
Collapse
|
18
|
The negative affectivity dimension of Type D personality associated with increased risk for acute ischemic stroke and white matter hyperintensity. J Psychosom Res 2022; 160:110973. [PMID: 35749831 DOI: 10.1016/j.jpsychores.2022.110973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 05/24/2022] [Accepted: 06/13/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study was conducted to examine the relationship among type D personality, acute ischemic stroke (AIS), and white matter hyperintensity (WMH). METHODS In a cross-sectional study conducted between September 2020 and June 2021, 235 patients aged 50-85 years with first-ever ischemic cerebrovascular disease, including 146 males and 89 females, were enrolled. All participants underwent the Type D Scale-14 test containing negative affectivity (NA) and social inhibition (SI) subscales. Clinical and laboratory data were also collected for analysis. The patients were divided into the AIS group (n = 148) and the transient ischemic attack (TIA) group (n = 87) according to whether there was an acute lesion. RESULTS Patients with type D personality had a higher frequency of AIS and LAA and a higher level of WMH. Multiple logistic regression showed that the NA score was related to a 1.11-fold increase in the odds of AIS (95% CI: 1.03-1.19). Neither NA nor SI showed a clear association with a higher frequency of LAA. Higher scores of NA (OR = 1.07, 95% CI: 1.01-1.15), SI (OR = 1.11, 95% CI: 1.03-1.19), and the interaction between the two dimensions (OR = 1.03, 95% CI: 1.01-1.05) were independently associated with an increased load of WMH. CONCLUSION Type D personality was related to AIS and WMH. In particular, it was NA, not SI, affected the occurrence of AIS. Our findings may provide new insights regarding behavioral vulnerability for the development of cerebrovascular disorders.
Collapse
|
19
|
Godet A, Fortier A, Bannier E, Coquery N, Val-Laillet D. Interactions between emotions and eating behaviors: Main issues, neuroimaging contributions, and innovative preventive or corrective strategies. Rev Endocr Metab Disord 2022; 23:807-831. [PMID: 34984602 DOI: 10.1007/s11154-021-09700-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/29/2021] [Indexed: 12/13/2022]
Abstract
Emotional eating is commonly defined as the tendency to (over)eat in response to emotion. Insofar as it involves the (over)consumption of high-calorie palatable foods, emotional eating is a maladaptive behavior that can lead to eating disorders, and ultimately to metabolic disorders and obesity. Emotional eating is associated with eating disorder subtypes and with abnormalities in emotion processing at a behavioral level. However, not enough is known about the neural pathways involved in both emotion processing and food intake. In this review, we provide an overview of recent neuroimaging studies, highlighting the brain correlates between emotions and eating behavior that may be involved in emotional eating. Interaction between neural and neuro-endocrine pathways (HPA axis) may be involved. In addition to behavioral interventions, there is a need for a holistic approach encompassing both neural and physiological levels to prevent emotional eating. Based on recent imaging, this review indicates that more attention should be paid to prefrontal areas, the insular and orbitofrontal cortices, and reward pathways, in addition to regions that play a major role in both the cognitive control of emotions and eating behavior. Identifying these brain regions could allow for neuromodulation interventions, including neurofeedback training, which deserves further investigation.
Collapse
Affiliation(s)
- Ambre Godet
- Nutrition Metabolisms and Cancer (NuMeCan), INRAE, INSERM, Univ Rennes, St Gilles, France
| | - Alexandra Fortier
- Nutrition Metabolisms and Cancer (NuMeCan), INRAE, INSERM, Univ Rennes, St Gilles, France
| | - Elise Bannier
- CRNS, INSERM, IRISA, INRIA, Univ Rennes, Empenn Rennes, France
- Radiology Department, Rennes University Hospital, Rennes, France
| | - Nicolas Coquery
- Nutrition Metabolisms and Cancer (NuMeCan), INRAE, INSERM, Univ Rennes, St Gilles, France
| | - David Val-Laillet
- Nutrition Metabolisms and Cancer (NuMeCan), INRAE, INSERM, Univ Rennes, St Gilles, France.
| |
Collapse
|
20
|
da Silva PHR, Paschoal AM, Secchinatto KF, Zotin MCZ, Dos Santos AC, Viswanathan A, Pontes-Neto OM, Leoni RF. Contrast agent-free state-of-the-art magnetic resonance imaging on cerebral small vessel disease - Part 2: Diffusion tensor imaging and functional magnetic resonance imaging. NMR IN BIOMEDICINE 2022; 35:e4743. [PMID: 35429070 DOI: 10.1002/nbm.4743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 04/04/2022] [Indexed: 06/14/2023]
Abstract
Cerebral small vessel disease (cSVD) has been widely studied using conventional magnetic resonance imaging (MRI) methods, although the association between MRI findings and clinical features of cSVD is not always concordant. We assessed the additional contribution of contrast agent-free, state-of-the-art MRI techniques, particularly diffusion tensor imaging (DTI) and functional magnetic resonance imaging (fMRI), to understand brain damage and structural and functional connectivity impairment related to cSVD. We performed a review following the PICOS worksheet and Search Strategy, including 152 original papers in English, published from 2000 to 2022. For each MRI method, we extracted information about their contributions regarding the origins, pathology, markers, and clinical outcomes in cSVD. In general, DTI studies have shown that changes in mean, radial, and axial diffusivity measures are related to the presence of cSVD. In addition to the classical deficit in executive functions and processing speed, fMRI studies indicate connectivity dysfunctions in other domains, such as sensorimotor, memory, and attention. Neuroimaging metrics have been correlated with the diagnosis, prognosis, and rehabilitation of patients with cSVD. In short, the application of contrast agent-free, state-of-the-art MRI techniques has provided a complete picture of cSVD markers and tools to explore questions that have not yet been clarified about this clinical condition. Longitudinal studies are desirable to look for causal relationships between image biomarkers and clinical outcomes.
Collapse
Affiliation(s)
| | - André Monteiro Paschoal
- Department of Physics, FFCLRP, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Maria Clara Zanon Zotin
- Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- J Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Antônio Carlos Dos Santos
- Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Anand Viswanathan
- J Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Octavio M Pontes-Neto
- Department of Neurosciences and Behavioral Science, Ribeirão Preto Medical School, University of Sao Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Renata Ferranti Leoni
- Department of Physics, FFCLRP, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| |
Collapse
|
21
|
Wang S, Zhang F, Huang P, Hong H, Jiaerken Y, Yu X, Zhang R, Zeng Q, Zhang Y, Kikinis R, Rathi Y, Makris N, Lou M, Pasternak O, Zhang M, O'Donnell LJ. Superficial white matter microstructure affects processing speed in cerebral small vessel disease. Hum Brain Mapp 2022; 43:5310-5325. [PMID: 35822593 PMCID: PMC9812245 DOI: 10.1002/hbm.26004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 06/10/2022] [Accepted: 06/15/2022] [Indexed: 01/15/2023] Open
Abstract
White matter hyperintensities (WMH) are a typical feature of cerebral small vessel disease (CSVD), which contributes to about 50% of dementias worldwide. Microstructural alterations in deep white matter (DWM) have been widely examined in CSVD. However, little is known about abnormalities in superficial white matter (SWM) and their relevance for processing speed, the main cognitive deficit in CSVD. In 141 CSVD patients, processing speed was assessed using Trail Making Test Part A. White matter abnormalities were assessed by WMH burden (volume on T2-FLAIR) and diffusion MRI measures. SWM imaging measures had a large contribution to processing speed, despite a relatively low SWM WMH burden. Across all imaging measures, SWM free water (FW) had the strongest association with processing speed, followed by SWM mean diffusivity (MD). SWM FW was the only marker to significantly increase between two subgroups with the lowest WMH burdens. When comparing two subgroups with the highest WMH burdens, the involvement of WMH in the SWM was accompanied by significant differences in processing speed and white matter microstructure. Mediation analysis revealed that SWM FW fully mediated the association between WMH volume and processing speed, while no mediation effect of MD or DWM FW was observed. Overall, results suggest that the SWM has an important contribution to processing speed, while SWM FW is a sensitive imaging marker associated with cognition in CSVD. This study extends the current understanding of CSVD-related dysfunction and suggests that the SWM, as an understudied region, can be a potential target for monitoring pathophysiological processes.
Collapse
Affiliation(s)
- Shuyue Wang
- Department of Radiologythe Second Affiliated Hospital of Zhejiang University School of MedicineChina,Brigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Fan Zhang
- Brigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Peiyu Huang
- Department of Radiologythe Second Affiliated Hospital of Zhejiang University School of MedicineChina
| | - Hui Hong
- Department of Radiologythe Second Affiliated Hospital of Zhejiang University School of MedicineChina
| | - Yeerfan Jiaerken
- Department of Radiologythe Second Affiliated Hospital of Zhejiang University School of MedicineChina
| | - Xinfeng Yu
- Department of Radiologythe Second Affiliated Hospital of Zhejiang University School of MedicineChina
| | - Ruiting Zhang
- Department of Radiologythe Second Affiliated Hospital of Zhejiang University School of MedicineChina
| | - Qingze Zeng
- Department of Radiologythe Second Affiliated Hospital of Zhejiang University School of MedicineChina
| | - Yao Zhang
- Department of Radiologythe Second Affiliated Hospital of Zhejiang University School of MedicineChina
| | - Ron Kikinis
- Brigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Yogesh Rathi
- Brigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Nikos Makris
- Brigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA,Center for Morphometric AnalysisMassachusetts General Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Min Lou
- Department of Neurologythe Second Affiliated Hospital of Zhejiang University School of MedicineChina
| | - Ofer Pasternak
- Brigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Minming Zhang
- Department of Radiologythe Second Affiliated Hospital of Zhejiang University School of MedicineChina
| | | |
Collapse
|
22
|
Meng F, Yang Y, Jin G. Research Progress on MRI for White Matter Hyperintensity of Presumed Vascular Origin and Cognitive Impairment. Front Neurol 2022; 13:865920. [PMID: 35873763 PMCID: PMC9301233 DOI: 10.3389/fneur.2022.865920] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 06/14/2022] [Indexed: 11/17/2022] Open
Abstract
White matter hyperintensity of presumed vascular origin (WMH) is a common medical imaging manifestation in the brains of middle-aged and elderly individuals. WMH can lead to cognitive decline and an increased risk of cognitive impairment and dementia. However, the pathogenesis of cognitive impairment in patients with WMH remains unclear. WMH increases the risk of cognitive impairment, the nature and severity of which depend on lesion volume and location and the patient's cognitive reserve. Abnormal changes in microstructure, cerebral blood flow, metabolites, and resting brain function are observed in patients with WMH with cognitive impairment. Magnetic resonance imaging (MRI) is an indispensable tool for detecting WMH, and novel MRI techniques have emerged as the key approaches for exploring WMH and cognitive impairment. This article provides an overview of the association between WMH and cognitive impairment and the application of dynamic contrast-enhanced MRI, structural MRI, diffusion tensor imaging, 3D-arterial spin labeling, intravoxel incoherent motion, magnetic resonance spectroscopy, and resting-state functional MRI for examining WMH and cognitive impairment.
Collapse
Affiliation(s)
- Fanhua Meng
- North China University of Science and Technology, Tangshan, China
| | - Ying Yang
- Department of Radiology, China Emergency General Hospital, Beijing, China
| | - Guangwei Jin
- Department of Radiology, China Emergency General Hospital, Beijing, China
- *Correspondence: Guangwei Jin
| |
Collapse
|
23
|
Zhu H, Qin R, Cheng Y, Huang L, Shao P, Xu H, Xu Y, Ye Q. The Enhanced Interhemispheric Functional Connectivity in the Striatum Is Related to the Cognitive Impairment in Individuals With White Matter Hyperintensities. Front Neurosci 2022; 16:899473. [PMID: 35837117 PMCID: PMC9273905 DOI: 10.3389/fnins.2022.899473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 06/09/2022] [Indexed: 11/23/2022] Open
Abstract
Objective The cognitive performance of individuals with white matter hyperintensities (WMH) tends to vary considerably. This study aimed to explore the relationship of the synchronous spontaneous activities in homotopic areas across hemispheres, named as voxel-mirrored homotopic connectivity (VMHC), with the cognitive performance of individuals with WMH. Materials and Methods Eighty-two WMH subjects without cognitive impairment (CI), 56 WMH subjects with CI, and 92 healthy subjects (HS) underwent neuropsychological tests and multimodal magnetic resonance imaging scans. VMHC maps were analyzed among the three groups. Correlative analyses were performed between VMHC values and cognitive function. Results No significant difference in WMH volume, brain volume, or gray matter atrophy rate was shown between WMH subjects with and without CI. In contrast, those with CI displayed lower VMHC in the bilateral cuneus and calcarine and higher VMHC in the lentiform nucleus and caudate nucleus (LNCN) than those without CI. Furthermore, the VMHC in the LNCN was negatively associated with the global function and the memory function in WMH subjects. Conclusion The enhanced VMHC in the LNCN was associated with the development of CI in individuals with WMH. This finding may contribute to the exploration of surrogate markers for the CI caused by WMH.
Collapse
Affiliation(s)
- Huahong Zhu
- Department of Neurology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, China
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
- Institute for Brain Sciences, Nanjing University, Nanjing, China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
- Nanjing Neurology Clinic Medical Center, Nanjing, China
| | - Ruomeng Qin
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
- Institute for Brain Sciences, Nanjing University, Nanjing, China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
- Nanjing Neurology Clinic Medical Center, Nanjing, China
| | - Yue Cheng
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
- Institute for Brain Sciences, Nanjing University, Nanjing, China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
- Nanjing Neurology Clinic Medical Center, Nanjing, China
| | - Lili Huang
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
- Institute for Brain Sciences, Nanjing University, Nanjing, China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
- Nanjing Neurology Clinic Medical Center, Nanjing, China
| | - Pengfei Shao
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
- Institute for Brain Sciences, Nanjing University, Nanjing, China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
- Nanjing Neurology Clinic Medical Center, Nanjing, China
| | - Hengheng Xu
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
- Institute for Brain Sciences, Nanjing University, Nanjing, China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
- Nanjing Neurology Clinic Medical Center, Nanjing, China
| | - Yun Xu
- Department of Neurology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, China
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
- Institute for Brain Sciences, Nanjing University, Nanjing, China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
- Nanjing Neurology Clinic Medical Center, Nanjing, China
- *Correspondence: Yun Xu,
| | - Qing Ye
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
- Institute for Brain Sciences, Nanjing University, Nanjing, China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
- Nanjing Neurology Clinic Medical Center, Nanjing, China
- Qing Ye,
| |
Collapse
|
24
|
Yin W, Zhou X, Li C, You M, Wan K, Zhang W, Zhu W, Li M, Zhu X, Qian Y, Sun Z. The Clustering Analysis of Time Properties in Patients With Cerebral Small Vessel Disease: A Dynamic Connectivity Study. Front Neurol 2022; 13:913241. [PMID: 35795790 PMCID: PMC9251301 DOI: 10.3389/fneur.2022.913241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/27/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeThis study aimed to investigate the dynamic functional connectivity (DFC) pattern in cerebral small vessel disease (CSVD) and explore the relationships between DFC temporal properties and cognitive impairment in CSVD.MethodsFunctional data were collected from 67 CSVD patients, including 35 patients with subcortical vascular cognitive impairment (SVCI) and 32 cognitively unimpaired (CU) patients, as well as 35 healthy controls (HCs). The DFC properties were estimated by k-means clustering analysis. DFC strength analysis was used to explore the regional functional alterations between CSVD patients and HCs. Correlation analysis was used for DFC properties with cognition and SVD scores, respectively.ResultsThe DFC analysis showed three distinct connectivity states (state I: sparsely connected, state II: strongly connected, state III: intermediate pattern). Compared to HCs, CSVD patients exhibited an increased proportion in state I and decreased proportion in state II. Besides, CSVD patients dwelled longer in state I while dwelled shorter in state II. CSVD subgroup analyses showed that state I frequently occurred and dwelled longer in SVCI compared with CSVD-CU. Also, the internetwork (frontal-parietal lobe, frontal-occipital lobe) and intranetwork (frontal lobe, occipital lobe) functional activities were obviously decreased in CSVD. Furthermore, the fractional windows and mean dwell time (MDT) in state I were negatively correlated with cognition in CSVD but opposite to cognition in state II.ConclusionPatients with CSVD accounted for a higher proportion and dwelled longer mean time in the sparsely connected state, while presented lower proportion and shorter mean dwell time in the strongly connected state, which was more prominent in SVCI. The changes in the DFC are associated with altered cognition in CSVD. This study provides a better explanation of the potential mechanism of CSVD patients with cognitive impairment from the perspective of DFC.
Collapse
Affiliation(s)
- Wenwen Yin
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xia Zhou
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Chenchen Li
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Mengzhe You
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ke Wan
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Wei Zhang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Wenhao Zhu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Mingxu Li
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiaoqun Zhu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yinfeng Qian
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Zhongwu Sun
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- *Correspondence: Zhongwu Sun
| |
Collapse
|
25
|
Ye Q, Zhu H, Chen H, Liu R, Huang L, Chen H, Cheng Y, Qin R, Shao P, Xu H, Ma J, Xu Y. Effects of cognitive reserve proxies on cognitive function and frontoparietal control network in subjects with white matter hyperintensities: A cross-sectional functional magnetic resonance imaging study. CNS Neurosci Ther 2022; 28:932-941. [PMID: 35274485 PMCID: PMC9062549 DOI: 10.1111/cns.13824] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 02/16/2022] [Accepted: 02/21/2022] [Indexed: 12/01/2022] Open
Abstract
Aims This study aimed to analyze the potential association between cognition reserve (CR) components, including education, working activity, and leisure time activity, and cognitive function in subjects with white matter hyperintensities (WMH). The study also explored the role of the frontoparietal control network (FPCN) in such association. Methods White matter hyperintensities subjects with and without cognitive impairment (CI) were evaluated with multimodal magnetic resonance imaging, neuropsychological testing, and CR survey. FPCN patterns were assessed with dorsolateral prefrontal cortex seed‐based functional connectivity analysis. Results Education was positively associated with cognitive function in WMH subjects with or without CI, whereas working activity and leisure time activity were positively associated with cognitive function only in those without CI. Similarly, education was associated with bilateral FPCN in both WMH groups, whereas working activity and leisure time activity were associated with bilateral FPCN mainly in the group without CI. Furthermore, FPCN partially mediated the association between education and cognitive function in both WMH groups. Conclusion Education showed a positive impact on cognitive function in WMH subjects regardless of their cognitive status, whereas working activity and leisure time activity exhibited beneficial effects only in those without CI. The FPCN mediated the beneficial effect of education on cognitive function.
Collapse
Affiliation(s)
- Qing Ye
- Department of Neurology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.,The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China.,Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Huahong Zhu
- Department of Neurology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.,The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China.,Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Huiping Chen
- Department of Neurology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.,The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Renyuan Liu
- Department of Radiology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Lili Huang
- Department of Neurology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.,The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Haifeng Chen
- Department of Neurology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.,The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Yue Cheng
- Department of Neurology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.,The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Ruomeng Qin
- Department of Neurology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.,The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Pengfei Shao
- Department of Neurology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.,The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Hengheng Xu
- Department of Neurology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.,The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Junyi Ma
- Department of Neurology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.,The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Yun Xu
- Department of Neurology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.,The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China.,Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| |
Collapse
|
26
|
Wang Y, Liu X, Hu Y, Yu Z, Wu T, Wang J, Liu J, Liu J. Impaired functional network properties contribute to white matter hyperintensity related cognitive decline in patients with cerebral small vessel disease. BMC Med Imaging 2022; 22:40. [PMID: 35264145 PMCID: PMC8908649 DOI: 10.1186/s12880-022-00769-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 02/28/2022] [Indexed: 12/14/2022] Open
Abstract
Background White matter hyperintensity (WMH) is one of the typical neuroimaging manifestations of cerebral small vessel disease (CSVD), and the WMH correlates closely to cognitive impairment (CI). CSVD patients with WMH own altered topological properties of brain functional network, which is a possible mechanism that leads to CI. This study aims to identify differences in the characteristics of some brain functional network among patients with different grades of WMH and estimates the correlations between these different brain functional network characteristics and cognitive assessment scores. Methods 110 CSVD patients underwent 3.0 T Magnetic resonance imaging scans and neuropsychological cognitive assessments. WMH of each participant was graded on the basis of Fazekas grade scale and was divided into two groups: (A) WMH score of 1–2 points (n = 64), (B) WMH score of 3–6 points (n = 46). Topological indexes of brain functional network were analyzed using graph-theoretical method. T-test and Mann–Whitney U test was used to compare the differences in topological properties of brain functional network between groups. Partial correlation analysis was applied to explore the relationship between different topological properties of brain functional networks and overall cognitive function. Results Patients with high WMH scores exhibited decreased clustering coefficient values, global and local network efficiency along with increased shortest path length on whole brain level as well as decreased nodal efficiency in some brain regions on nodal level (p < 0.05). Nodal efficiency in the left lingual gyrus was significantly positively correlated with patients' total Montreal Cognitive Assessment (MoCA) scores (p < 0.05). No significant difference was found between two groups on the aspect of total MoCA and Mini-mental State Examination (MMSE) scores (p > 0.05). Conclusion Therefore, we come to conclusions that patients with high WMH scores showed less optimized small-world networks compared to patients with low WMH scores. Global and local network efficiency on the whole-brain level, as well as nodal efficiency in certain brain regions on the nodal level, can be viewed as markers to reflect the course of WMH. Supplementary Information The online version contains supplementary material available at 10.1186/s12880-022-00769-7.
Collapse
Affiliation(s)
- Yifan Wang
- Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, China
| | - Xiao Liu
- School of Computer and Information Technology, Beijing Jiaotong University, Beijing, China
| | - Ying Hu
- Institute of Medical Imaging Engineering, School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, 200093, China
| | - Zekuan Yu
- Academy for Engineering and Technology, Fudan University, Yangpu District, No. 539 Handan Road, Shanghai, 200433, China. .,Key Laboratory of Industrial Dust Prevention and Control & Occupational Health and Safety, Ministry of Education, Beijing, China. .,Anhui Province Engineering Laboratory of Occupational Health and Safety, Huainan, China. .,Laboratory of Industrial Dust Deep Reduction and Occupational Health and Safety of Anhui Higher Education Institutes, Hefei, China.
| | - Tianhao Wu
- Department of Radiology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 XianXia Road, Shanghai, 200050, China
| | - Junjie Wang
- Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Jie Liu
- School of Computer and Information Technology, Beijing Jiaotong University, No. 3, Shangyuan Village, Haidian District, Beijing, 100089, China.
| | - Jun Liu
- Department of Radiology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 XianXia Road, Shanghai, 200050, China.
| |
Collapse
|
27
|
Yang D, Qin R, Chu L, Xu H, Ni L, Ma J, Shao P, Huang L, Zhang B, Zhang M, Xu Y. Abnormal Cerebrovascular Reactivity and Functional Connectivity Caused by White Matter Hyperintensity Contribute to Cognitive Decline. Front Neurosci 2022; 16:807585. [PMID: 35310084 PMCID: PMC8930816 DOI: 10.3389/fnins.2022.807585] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/10/2022] [Indexed: 11/16/2022] Open
Abstract
Aims This study aimed to investigate the relationships of impaired cerebrovascular reactivity (CVR) and abnormal functional connectivity (FC) with white matter hyperintensity (WMH)-related cognitive decline. Methods A total of 233 WMH subjects were recruited and categorized into WMH-I (n = 106), WMH-II (n = 72), and WMH-III (n = 55) groups according to Fazekas visual rating scale. All participants underwent neuropsychological tests and multimodal MRI scans, including 3D-T1, and resting-state functional magnetic resonance imaging (rs-fMRI). The alterations of CVR maps and FC were further explored. Results Subjects with a higher WMH burden displayed a lower CVR in the left medial occipital gyrus (MOG). The FC analysis using MOG as a seed revealed that the FC of the left insula, left inferior parietal lobule, and thalamus changed abnormally as WMH aggravated. After adjusting for age, gender, and education years, the serial mediation analysis revealed that periventricular white matter hyperintensity contributes indirectly to poorer Mini-Mental State Examination (MMSE) scores (indirect effect: β = −0.1248, 95% CI: −0.4689, −0188), poorer Montreal Cognitive Assessment (MoCA) (indirect effect: β = −0.1436, 95% CI: −0.4584, −0.0292) scores, and longer trail making tests A (TMT-A) (indirect effect: β = 0.1837, 95% CI: 0.0069, 0.8273) times, specifically due to the lower CVR of the left MOG and the higher FC of the left insula-MOG. Conclusion The CVR decline of the left MOG and the abnormal FC of the left insula-MOG attributed to WMH progression were responsible for the poor general cognition (MMSE and MoCA) and information processing speed (TMT-A). The left MOG may act as a connection, which is involved in the processing of cognitive biases by connecting with the left insula-cortical regions in WMH individuals.
Collapse
Affiliation(s)
- Dan Yang
- Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
| | - Ruomeng Qin
- Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
| | - Lan Chu
- Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Hengheng Xu
- Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
| | - Ling Ni
- Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
| | - Junyi Ma
- Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
| | - Pengfei Shao
- Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
| | - Lili Huang
- Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
| | - Bing Zhang
- Department of Radiology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Meijuan Zhang
- Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
- Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
- Nanjing Neurology Clinic Medical Center, Nanjing, China
- *Correspondence: Meijuan Zhang,
| | - Yun Xu
- Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
- Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
- Nanjing Neurology Clinic Medical Center, Nanjing, China
- Yun Xu,
| |
Collapse
|
28
|
Ni L, Sun W, Yang D, Huang L, Shao P, Wang C, Xu Y. The Cerebrovascular Reactivity-Adjusted Spontaneous Brain Activity Abnormalities in White Matter Hyperintensities Related Cognitive Impairment: A Resting-State Functional MRI Study. J Alzheimers Dis 2022; 86:691-701. [PMID: 35124642 DOI: 10.3233/jad-215216] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The BOLD signal is regulated by neuronal activity and vascular physiology. The evolution pattern of brain activities after modulating the vascular factors in white matter hyperintensities (WMHs) related cognitive impairment (CI) was unknown. OBJECTIVE To explore the "pure" low-frequency fluctuation (ALFF) alterations after adjusting the cerebrovascular reactivity (CVR) factor. METHODS In this study, 111 WMHs subjects including 55 with CI (WMH-CI) and 56 without CI (WMH-no-CI), and 72 normal controls (NCs) underwent resting-state fMRI. The CVR and ALFF maps were derived using BOLD data. A voxel-wise Pearson analysis was performed to detect the relationship between CVR and ALFF maps. The ANCOVA analysis with and without CVR as a covariate was conducted to explore the effect of CVR on ALFF analysis. Correlation between the ALFF alterations and cognitive performance was conducted in WMH-CI subjects. The receiver operating characteristic curve was constructed to assess the diagnostic performance of ALFF indexes to determine the occurrence of CI. RESULTS There was a significant widespread correlation between the CVR and ALFF maps. The ALFF alterations between the WMH groups and NC group with CVR as covariate were more than those without CVR as covariate. WMH-CI subjects showed further ALFF alterations when compared with WMH-no-CI subjects. The abnormal ALFF values were significantly associated with poor performance. The combination of inferior frontal gyrus and middle frontal gyrus to PCC provided an incremental contribution to the occurrence of CI. CONCLUSION More areas with abnormal ALFF values which were specific to the WMHs related cognitive dysfunction were detected when considering the impact of CVR.
Collapse
Affiliation(s)
- Ling Ni
- Department of Neurology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, China.,Department of Radiology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Wenshan Sun
- Department of Neurology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, China
| | - Dan Yang
- Department of Neurology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Lili Huang
- Department of Neurology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Pengfei Shao
- Department of Neurology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Chong Wang
- Department of Neurology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yun Xu
- Department of Neurology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, China.,Department of Neurology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| |
Collapse
|
29
|
Progressive cortical and sub-cortical alterations in patients with anti-N-methyl-D-aspartate receptor encephalitis. J Neurol 2022; 269:389-398. [PMID: 34297178 DOI: 10.1007/s00415-021-10643-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Advanced structural analyses are increasingly being highly valued to uncover pathophysiological understanding of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. Therefore, we aimed to explore whether and how antibody-mediated NMDAR dysfunction affected cortical and sub-cortical brain morphology and their relationship with clinical symptoms. METHODS We performed surface-based morphometry analyses, hippocampal segmentation, and correlational analyses in 24 patients with anti-NMDAR encephalitis after acute disease stage and 30 normal controls (NC) in this case-control study. RESULTS Patients showed significantly decreased cortical alterations mainly in language network (LN) and default mode network (DMN), as well as decreased gray matter volume in left cornu ammonis 1 (CA1) body of hippocampus. Further correlation analyses showed that the decreased cortical thickness in the right superior frontier gyrus was associated with decreased cognitive scores, the decreased cortical volume in the right pars triangulari and decreased surface area in the right pars operculari were associated with decreased memory scores, whereas decreased gray matter volume in the left CA1 body was significantly correlated with longer time between first symptom and imaging in the patients. CONCLUSION These results suggested that cognitive impairments resulted from long-term sequelae of the encephalitis were mainly associated with cortical alterations in LN and DMN and sub-cortical atrophy of left CA1 body, which can be served as effective features to assess disease progression in clinical routine examination.
Collapse
|
30
|
Huang H, Zhao K, Zhu W, Li H, Zhu W. Abnormal Cerebral Blood Flow and Functional Connectivity Strength in Subjects With White Matter Hyperintensities. Front Neurol 2021; 12:752762. [PMID: 34744987 PMCID: PMC8564178 DOI: 10.3389/fneur.2021.752762] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 09/13/2021] [Indexed: 11/16/2022] Open
Abstract
White matter hyperintensities (WMHs) are common neuroimaging findings in the aging population and are associated with various clinical symptoms, especially cognitive impairment. Abnormal global cerebral blood flow (CBF) and specific functional connections have been reported in subjects with higher WMH loads. Nevertheless, the comprehensive functional mechanisms underlying WMH are yet to be established. In this study, by combining resting-state functional magnetic resonance imaging and arterial spin labeling, we investigated the neurovascular dysfunction in subjects with WMH in CBF, functional connectivity strength (FCS), and CBF–FCS coupling. The whole-brain alterations of all these measures were explored among non-dementia subjects with different WMH loads using a fine-grained Human Brainnetome Atlas. In addition, exploratory mediation analyses were conducted to further determine the relationships between these neuroimaging indicators, WMH load, and cognition. The results showed that subjects with higher WMH loads displayed decreased CBF and FCS mainly in regions involving the cognitive- and emotional-related brain networks, including the default mode network, salience network, and central executive network. Notably, subjects with higher WMH loads also showed an abnormal regional CBF–FCS coupling in several regions of the thalamus, posterior cingulate cortex, and parahippocampal gyrus involving the default mode network. Furthermore, regional CBF in the right inferior temporal gyrus and right dorsal caudate may mediate the relationship between WMH load and cognition in WMH subjects. These findings indicated characteristic changes in cerebral blood supply, brain activity, and neurovascular coupling in regions involving specific brain networks with the development of WMH, providing further information on pathophysiology underpinnings of the WMH and related cognitive impairment.
Collapse
Affiliation(s)
- Hao Huang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kun Zhao
- School of Biological Science & Medical Engineering, Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China
| | - Wenzhen Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hui Li
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenhao Zhu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
31
|
Wang SM, Kim NY, Um YH, Kang DW, Na HR, Lee CU, Lim HK. Default mode network dissociation linking cerebral beta amyloid retention and depression in cognitively normal older adults. Neuropsychopharmacology 2021; 46:2180-2187. [PMID: 34158614 PMCID: PMC8505502 DOI: 10.1038/s41386-021-01072-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/12/2021] [Indexed: 11/09/2022]
Abstract
Cerebral beta amyloid (Aβ) deposition and late-life depression (LLD) are known to be associated with the trajectory of Alzheimer's disease (AD). However, their neurobiological link is not clear. Previous studies showed aberrant functional connectivity (FC) changes in the default mode network (DMN) in early Aβ deposition and LLD, but its mediating role has not been elucidated. This study was performed to investigate the distinctive association pattern of DMN FC linking LLD and Aβ retention in cognitively normal older adults. A total of 235 cognitively normal older adults with (n = 118) and without depression (n = 117) underwent resting-state functional magnetic resonance imaging and 18F-flutemetamol positron emission tomography to investigate the associations between Aβ burden, depression, and DMN FC. Independent component analysis showed increased anterior DMN FC and decreased posterior DMN FC in the depression group compared with the no depression group. Global cerebral Aβ retention was positively correlated with anterior and negatively correlated with posterior DMN FC. Anterior DMN FC was positively correlated with severity of depression, whereas posterior DMN FC was negatively correlated with cognitive function. In addition, the effects of global cerebral Aβ retention on severity of depression were mediated by subgenual anterior cingulate FC. Our results of anterior and posterior DMN FC dissociation pattern may be pivotal in linking cerebral Aβ pathology and LLD in the course of AD progression. Further longitudinal studies are needed to confirm the causal relationships between cerebral Aβ retention and LLD.
Collapse
Affiliation(s)
- Sheng-Min Wang
- grid.411947.e0000 0004 0470 4224Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Nak-Young Kim
- Department of Psychiatry, Geyo Hospital, Uiwang, South Korea
| | - Yoo Hyun Um
- grid.411947.e0000 0004 0470 4224Department of Psychiatry, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Dong Woo Kang
- grid.411947.e0000 0004 0470 4224Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hae-Ran Na
- grid.411947.e0000 0004 0470 4224Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Chang Uk Lee
- grid.411947.e0000 0004 0470 4224Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
| |
Collapse
|
32
|
Xing Y, Yang J, Zhou A, Wang F, Tang Y, Jia J. Altered brain activity mediates the relationship between white matter hyperintensity severity and cognition in older adults. Brain Imaging Behav 2021; 16:899-908. [PMID: 34671890 DOI: 10.1007/s11682-021-00564-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2021] [Indexed: 11/26/2022]
Abstract
White matter hyperintensities (WMHs) on magnetic resonance imaging are commonly found in older adults. The mechanisms underpinning the dose-dependent association between WMH severity and cognition are not well understood. This study aimed to investigate how brain activity changes with WMH severity, and if altered brain activity mediates the relationship between WMH and cognitive function. A total of 35 participants with moderate to severe WMHs (Fazekas grade 2 or 3) and 34 participants with mild WMHs (Fazekas grade 1), who were cognitively normal, were included. Resting-state brain function was analyzed using the amplitude of low-frequency fluctuation (ALFF). A mean fractional anisotropy (FA) value of 20 tract-specific regions of interest was calculated. Mediation analysis was used to assess whether ALFF values mediated the relationship between WMH and cognition. The results showed that compared to those with mild WMHs, participants with confluent WMHs had worse memory and naming ability and also had increased ALFF in the right middle frontal gyrus and decreased ALFF in the left middle occipital gyrus. After controlling for age, gender, education and apolipoprotein E (ApoE) ε4 status, increased ALFF in the right prefrontal cortex was associated with worse immediate recall and recognition, and ALFF values mediated the relationships between both Fazekas scores and FA values and memory. In conclusion, our study suggests that cognitively normal adults with high WMH load exhibit subclinical cognitive dysfunction and altered spontaneous brain activity. The mediating effects of brain activity help to shed light on our understanding of the relationship between WMHs and cognition.
Collapse
Affiliation(s)
- Yi Xing
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, National Clinical Research Center for Geriatric Disorders, Capital Medical University, 45 Changchun Street, Beijing, 100053, China
- Key Laboratory of Neurodegenerative Diseases, Ministry of Education of the People's Republic of China, Beijing, China
| | - Jianwei Yang
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, National Clinical Research Center for Geriatric Disorders, Capital Medical University, 45 Changchun Street, Beijing, 100053, China
- Key Laboratory of Neurodegenerative Diseases, Ministry of Education of the People's Republic of China, Beijing, China
| | - Aihong Zhou
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, National Clinical Research Center for Geriatric Disorders, Capital Medical University, 45 Changchun Street, Beijing, 100053, China
- Key Laboratory of Neurodegenerative Diseases, Ministry of Education of the People's Republic of China, Beijing, China
| | - Fen Wang
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, National Clinical Research Center for Geriatric Disorders, Capital Medical University, 45 Changchun Street, Beijing, 100053, China
- Key Laboratory of Neurodegenerative Diseases, Ministry of Education of the People's Republic of China, Beijing, China
| | - Yi Tang
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, National Clinical Research Center for Geriatric Disorders, Capital Medical University, 45 Changchun Street, Beijing, 100053, China.
- Key Laboratory of Neurodegenerative Diseases, Ministry of Education of the People's Republic of China, Beijing, China.
| | - Jianping Jia
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, National Clinical Research Center for Geriatric Disorders, Capital Medical University, 45 Changchun Street, Beijing, 100053, China.
- Key Laboratory of Neurodegenerative Diseases, Ministry of Education of the People's Republic of China, Beijing, China.
| |
Collapse
|
33
|
Snyder B, Simone SM, Giovannetti T, Floyd TF. Cerebral Hypoxia: Its Role in Age-Related Chronic and Acute Cognitive Dysfunction. Anesth Analg 2021; 132:1502-1513. [PMID: 33780389 DOI: 10.1213/ane.0000000000005525] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Postoperative cognitive dysfunction (POCD) has been reported with widely varying frequency but appears to be strongly associated with aging. Outside of the surgical arena, chronic and acute cerebral hypoxia may exist as a result of respiratory, cardiovascular, or anemic conditions. Hypoxia has been extensively implicated in cognitive impairment. Furthermore, disease states associated with hypoxia both accompany and progress with aging. Perioperative cerebral hypoxia is likely underdiagnosed, and its contribution to POCD is underappreciated. Herein, we discuss the various disease processes and forms in which hypoxia may contribute to POCD. Furthermore, we outline hypoxia-related mechanisms, such as hypoxia-inducible factor activation, cerebral ischemia, cerebrovascular reserve, excitotoxicity, and neuroinflammation, which may contribute to cognitive impairment and how these mechanisms interact with aging. Finally, we discuss opportunities to prevent and manage POCD related to hypoxia.
Collapse
Affiliation(s)
- Brina Snyder
- From the Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Tania Giovannetti
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | - Thomas F Floyd
- From the Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas.,Department of Cardiothoracic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| |
Collapse
|
34
|
Cao S, Nie J, Zhang J, Chen C, Wang X, Liu Y, Mo Y, Du B, Hu Y, Tian Y, Wei Q, Wang K. The Cerebellum Is Related to Cognitive Dysfunction in White Matter Hyperintensities. Front Aging Neurosci 2021; 13:670463. [PMID: 34248601 PMCID: PMC8261068 DOI: 10.3389/fnagi.2021.670463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 05/03/2021] [Indexed: 11/13/2022] Open
Abstract
Objective White matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) is frequently presumed to be secondary to cerebral small vessel disease (CSVD) and associated with cognitive decline. The cerebellum plays a key role in cognition and has dense connections with other brain regions. Thus, the aim of this study was to investigate if cerebellar abnormalities could occur in CSVD patients with WMHs and the possible association with cognitive performances. Methods A total of 104 right-handed patients with WMHs were divided into the mild WMHs group (n = 39), moderate WMHs group (n = 37), and severe WMHs group (n = 28) according to the Fazekas scale, and 36 healthy controls were matched for sex ratio, age, education years, and acquired resting-state functional MRI. Analysis of voxel-based morphometry of gray matter volume (GMV) and seed-to-whole-brain functional connectivity (FC) was performed from the perspective of the cerebellum, and their correlations with neuropsychological variables were explored. Results The analysis revealed a lower GMV in the bilateral cerebellum lobule VI and decreased FC between the left- and right-sided cerebellar lobule VI with the left anterior cingulate gyri in CSVD patients with WMHs. Both changes in structure and function were correlated with cognitive impairment in patients with WMHs. Conclusion Our study revealed damaged GMV and FC in the cerebellum associated with cognitive impairment. This indicates that the cerebellum may play a key role in the modulation of cognitive function in CSVD patients with WMHs.
Collapse
Affiliation(s)
- Shanshan Cao
- The School of Mental Health and Psychological Sciences, Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Jiajia Nie
- The School of Mental Health and Psychological Sciences, Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Jun Zhang
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Chen Chen
- The School of Mental Health and Psychological Sciences, Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Xiaojing Wang
- The School of Mental Health and Psychological Sciences, Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Yuanyuan Liu
- The School of Mental Health and Psychological Sciences, Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Yuting Mo
- The School of Mental Health and Psychological Sciences, Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Baogen Du
- The School of Mental Health and Psychological Sciences, Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Yajuan Hu
- The School of Mental Health and Psychological Sciences, Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Yanghua Tian
- The School of Mental Health and Psychological Sciences, Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China
| | - Qiang Wei
- The School of Mental Health and Psychological Sciences, Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Kai Wang
- The School of Mental Health and Psychological Sciences, Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China
| |
Collapse
|
35
|
Coelho A, Fernandes HM, Magalhães R, Moreira PS, Marques P, Soares JM, Amorim L, Portugal‐Nunes C, Castanho T, Santos NC, Sousa N. Reorganization of brain structural networks in aging: A longitudinal study. J Neurosci Res 2021; 99:1354-1376. [PMID: 33527512 PMCID: PMC8248023 DOI: 10.1002/jnr.24795] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 12/31/2020] [Indexed: 12/12/2022]
Abstract
Normal aging is characterized by structural and functional changes in the brain contributing to cognitive decline. Structural connectivity (SC) describes the anatomical backbone linking distinct functional subunits of the brain and disruption of this communication is thought to be one of the potential contributors for the age-related deterioration observed in cognition. Several studies already explored brain network's reorganization during aging, but most focused on average connectivity of the whole-brain or in specific networks, such as the resting-state networks. Here, we aimed to characterize longitudinal changes of white matter (WM) structural brain networks, through the identification of sub-networks with significantly altered connectivity along time. Then, we tested associations between longitudinal changes in network connectivity and cognition. We also assessed longitudinal changes in topological properties of the networks. For this, older adults were evaluated at two timepoints, with a mean interval time of 52.8 months (SD = 7.24). WM structural networks were derived from diffusion magnetic resonance imaging, and cognitive status from neurocognitive testing. Our results show age-related changes in brain SC, characterized by both decreases and increases in connectivity weight. Interestingly, decreases occur in intra-hemispheric connections formed mainly by association fibers, while increases occur mostly in inter-hemispheric connections and involve association, commissural, and projection fibers, supporting the last-in-first-out hypothesis. Regarding topology, two hubs were lost, alongside with a decrease in connector-hub inter-modular connectivity, reflecting reduced integration. Simultaneously, there was an increase in the number of provincial hubs, suggesting increased segregation. Overall, these results confirm that aging triggers a reorganization of the brain structural network.
Collapse
Affiliation(s)
- Ana Coelho
- Life and Health Sciences Research Institute (ICVS), School of MedicineUniversity of MinhoBragaPortugal
- ICVS/3B’s, PT Government Associate LaboratoryBraga/GuimarãesPortugal
- Clinical Academic Center – BragaBragaPortugal
| | - Henrique M. Fernandes
- Center for Music in the Brain (MIB)Aarhus UniversityAarhusDenmark
- Department of PsychiatryUniversity of OxfordOxfordUK
| | - Ricardo Magalhães
- Life and Health Sciences Research Institute (ICVS), School of MedicineUniversity of MinhoBragaPortugal
- ICVS/3B’s, PT Government Associate LaboratoryBraga/GuimarãesPortugal
- Clinical Academic Center – BragaBragaPortugal
| | - Pedro S. Moreira
- Life and Health Sciences Research Institute (ICVS), School of MedicineUniversity of MinhoBragaPortugal
- ICVS/3B’s, PT Government Associate LaboratoryBraga/GuimarãesPortugal
- Clinical Academic Center – BragaBragaPortugal
| | - Paulo Marques
- Life and Health Sciences Research Institute (ICVS), School of MedicineUniversity of MinhoBragaPortugal
- ICVS/3B’s, PT Government Associate LaboratoryBraga/GuimarãesPortugal
- Clinical Academic Center – BragaBragaPortugal
| | - José M. Soares
- Life and Health Sciences Research Institute (ICVS), School of MedicineUniversity of MinhoBragaPortugal
- ICVS/3B’s, PT Government Associate LaboratoryBraga/GuimarãesPortugal
- Clinical Academic Center – BragaBragaPortugal
| | - Liliana Amorim
- Life and Health Sciences Research Institute (ICVS), School of MedicineUniversity of MinhoBragaPortugal
- ICVS/3B’s, PT Government Associate LaboratoryBraga/GuimarãesPortugal
- Clinical Academic Center – BragaBragaPortugal
| | - Carlos Portugal‐Nunes
- Life and Health Sciences Research Institute (ICVS), School of MedicineUniversity of MinhoBragaPortugal
- ICVS/3B’s, PT Government Associate LaboratoryBraga/GuimarãesPortugal
- Clinical Academic Center – BragaBragaPortugal
| | - Teresa Castanho
- Life and Health Sciences Research Institute (ICVS), School of MedicineUniversity of MinhoBragaPortugal
- ICVS/3B’s, PT Government Associate LaboratoryBraga/GuimarãesPortugal
- Clinical Academic Center – BragaBragaPortugal
| | - Nadine Correia Santos
- Life and Health Sciences Research Institute (ICVS), School of MedicineUniversity of MinhoBragaPortugal
- ICVS/3B’s, PT Government Associate LaboratoryBraga/GuimarãesPortugal
- Clinical Academic Center – BragaBragaPortugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of MedicineUniversity of MinhoBragaPortugal
- ICVS/3B’s, PT Government Associate LaboratoryBraga/GuimarãesPortugal
- Clinical Academic Center – BragaBragaPortugal
| |
Collapse
|
36
|
Wu X, Bai F, Wang Y, Zhang L, Liu L, Chen Y, Li H, Zhang T. Circadian Rhythm Disorders and Corresponding Functional Brain Abnormalities in Young Female Nurses: A Preliminary Study. Front Neurol 2021; 12:664610. [PMID: 33995261 PMCID: PMC8120025 DOI: 10.3389/fneur.2021.664610] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 04/08/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Shift work is associated with a decrease in melatonin level and perturbation of the circadian rhythm; however, it is unknown if these lead to functional brain changes. In this study, we investigated whether circadian rhythm disorders caused by shift work are related to changes in brain functional connectivity (FC) and regional homogeneity (ReHo) using whole-brain resting-state functional magnetic resonance imaging (fMRI). Methods: This prospective case-control study included nine female night shift nurses and nine age-matched female day work nurses with normal sleep rhythms. To assess sleep quality and mood, participants were asked to complete questionnaires. Serum melatonin and cortisol levels were measured. ReHo of whole-brain resting-state function and seed-based FC of the bilateral hypothalamus were compared between groups. Variables that differed significantly between groups were used to examine the association between questionnaire scores and hormone levels and fMRI data. Results: The night shift nurses had significantly lower sleep quality and melatonin levels; lower ReHo activation in the bilateral cerebellar hemisphere and higher ReHo in the bilateral occipital lobe and left parietal lobe; and higher FC from the hypothalamus to the right cingulate gyrus, right putamen, and vermis than did the day shift nurses. Activation of the right cerebellar hemisphere left superior parietal gyrus, and the right superior occipital gyrus was correlated with sleep quality scores. Moreover, activation of the right cerebellar hemisphere (r = 0.583, P = 0.011) was correlated with melatonin levels, and higher sleepiness scores were associated with stronger FC between the hypothalamus and vermis (r = 0.501, P = 0.034). Conclusions: Circadian rhythm disorder caused by night shift work can lead to a decrease in sleep quality and melatonin level, as well as a series of changes in brain FC and ReHo.
Collapse
Affiliation(s)
- Xiaoli Wu
- Department of Neurorehabilitation, Rehabilitation Medicine of Capital Medical University, China Rehabilitation Research Centre, Beijing, China
| | - Fan Bai
- China Rehabilitation Science Institute of China Rehabilitation Research Centre, Beijing, China.,Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, China
| | - Yunlei Wang
- China Rehabilitation Science Institute of China Rehabilitation Research Centre, Beijing, China.,Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, China
| | - Lu Zhang
- Department of Neurorehabilitation, Rehabilitation Medicine of Capital Medical University, China Rehabilitation Research Centre, Beijing, China
| | - Lixu Liu
- Department of Neurorehabilitation, Rehabilitation Medicine of Capital Medical University, China Rehabilitation Research Centre, Beijing, China
| | - Yudong Chen
- Department of Neurorehabilitation, Rehabilitation Medicine of Capital Medical University, China Rehabilitation Research Centre, Beijing, China
| | - Hanzhi Li
- Department of Neurorehabilitation, Rehabilitation Medicine of Capital Medical University, China Rehabilitation Research Centre, Beijing, China
| | - Tong Zhang
- Department of Neurorehabilitation, Rehabilitation Medicine of Capital Medical University, China Rehabilitation Research Centre, Beijing, China.,China Rehabilitation Science Institute of China Rehabilitation Research Centre, Beijing, China.,Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, China
| |
Collapse
|
37
|
Kang SH, Park YH, Kim JP, Kim JS, Kim CH, Jang H, Kim HJ, Koh SB, Na DL, Chin J, Seo SW. Cortical neuroanatomical changes related to specific neuropsychological deficits in subcortical vascular cognitive impairment. NEUROIMAGE-CLINICAL 2021; 30:102685. [PMID: 34215155 PMCID: PMC8102616 DOI: 10.1016/j.nicl.2021.102685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 04/06/2021] [Accepted: 04/18/2021] [Indexed: 11/30/2022]
Abstract
Poor performances in neuropsychological tests were associated with cortical atrophy. Neural substrates in Aβ (−) SVCI differed from those in ADCI. Neural substrate of episodic memory was frontal regions in Aβ (−) SVCI. Neural substrates of three neuropsychological tests showed laterality.
Objective Neuropsychological test-specific neural substrates in subcortical vascular cognitive impairment (SVCI) are expected to differ from those in Alzheimer’s disease-related cognitive impairment (ADCI) but the details are unclear. To determine neural substrates related to cerebral small vessel disease, we investigated the correlations between cognitive dysfunctions measured by standardized neuropsychological tests and cortical thickness in a large sample of participants with amyloid negative (Aβ (−)) SVCI. Methods One hundred ninety-eight participants with Aβ (−) SVCI were recruited from the memory clinic between November 2007 to August 2018. To acquire neural substrates, we performed linear regression using the scores of each neuropsychological test as a predictor, cortical thickness as an outcome, and age, sex, education years, intracranial volume and white matter hyperintensity (WMH) as confounders. Results Poor performances in each neuropsychological test were associated with cortical atrophy in certain brain regions regardless of WMH. Especially, not the medial temporal but the frontal and posterior cingulate regions with cortical atrophy were mainly associated with memory impairment. Poor performance in animal fluency was more likely to be associated with cortical atrophy in the left hemisphere, while poor performance in the visuospatial memory test was more likely to be associated with cortical atrophy in the right hemisphere. Conclusions Our findings suggested that cortical atrophy was an important factor of cognitive impairment in Aβ (−) SVCI regardless of WMH. Furthermore, our findings might give clinicians a better understanding of specific neural substrates of neuropsychological deficits in patients with SVCI.
Collapse
Affiliation(s)
- Sung Hoon Kang
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea; Neuroscience Center, Samsung Medical Center, Seoul 06351, South Korea; Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Yu Hyun Park
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea; Neuroscience Center, Samsung Medical Center, Seoul 06351, South Korea; Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea; Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, South Korea
| | - Jun Pyo Kim
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea; Neuroscience Center, Samsung Medical Center, Seoul 06351, South Korea
| | - Ji-Sun Kim
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea; Neuroscience Center, Samsung Medical Center, Seoul 06351, South Korea
| | - Chi Hun Kim
- Department of Neurology, Kyungpook National University Chilgok Hospital, Kyungpook National University School of Medicine, Daegu, South Korea; Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Hyemin Jang
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea; Neuroscience Center, Samsung Medical Center, Seoul 06351, South Korea
| | - Hee Jin Kim
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea; Neuroscience Center, Samsung Medical Center, Seoul 06351, South Korea
| | - Seong-Beom Koh
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Duk L Na
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea; Neuroscience Center, Samsung Medical Center, Seoul 06351, South Korea
| | - Juhee Chin
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea; Neuroscience Center, Samsung Medical Center, Seoul 06351, South Korea.
| | - Sang Won Seo
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea; Neuroscience Center, Samsung Medical Center, Seoul 06351, South Korea; Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea; Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, South Korea; Samsung Alzheimer Research Center and Center for Clinical Epidemiology Medical Center, Seoul, South Korea.
| |
Collapse
|
38
|
Liu H, Liu D, Li K, Xue X, Ma X, Bu Q, Ma J, Pan Z, Zhou L. Microstructural changes in the cingulate gyrus of patients with mild cognitive impairment induced by cerebral small vessel disease. Neurol Res 2021; 43:659-667. [PMID: 33825678 DOI: 10.1080/01616412.2021.1910903] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: The purpose of our study was to distinguish the changes in the microstructure of the cingulate cortex in patients with mild cognitive impairment (MCI) induced by cerebral small vessel disease (CSVD).Method: 80 patients were diagnosed with CSVD in this study, including 55 patients with MCI and 25 patients without MCI. Diffusion kurtosis imaging (DKI) and Montreal cognitive assessment (MoCA) were performed in all patients. The anterior cingulate gyrus, posterior cingulate gyrus and middle cingulate gyrus were selected as the regions of interest, and some parameters were recorded.Results: Compared with the non-MCI group, the MCI group mainly showed obviously higher mean diffusion (MD) and radial diffusion (RD) values (P = 0.022 and P = 0.029) but lower fractional anisotropy (FA), axial kurtosis (AK), mean kurtosis (MK) and radial kurtosis (RK) values (P = 0.047, P = 0.001, P < 0.01, and P = 0.001, respectively) in the right anterior cingulate gyrus. Meanwhile, in the right posterior cingulate gyrus, the MCI group also showed higher axial diffusion (AD) and MD (P = 0.027 and P = 0.030) and lower AK (P = 0.014). Additionally, negative correlations of AD, MD, and RD with MoCA scores and positive correlations of FA, AK, MK and RK with MoCA scores were observed in some regions of the cingulate gyrus.Conclusions: DKI is a good method to examine microstructural damage in the cingulate cortex, and some parameters of DKI may be used as imaging biomarkers to detect early MCI in patients with CSVD.
Collapse
Affiliation(s)
- Huilin Liu
- Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Dongtao Liu
- Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Kun Li
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xiaofan Xue
- Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xiangke Ma
- Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Qiao Bu
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Jing Ma
- Department of Echocardiography, Shanghai Xuhui Central Hospital, Zhongshan-xuhui Hospital, Fudan University, Shanghai, China
| | - Zhenyu Pan
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Lichun Zhou
- Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
39
|
Chen C, Wang X, Cao S, Zhang J, Wang Z, Pan W, Yang J, Tian Y, Qiu B, Wei Q, Wang K. Thalamocortical Functional Connectivity in Patients With White Matter Hyperintensities. Front Aging Neurosci 2021; 13:632237. [PMID: 33815090 PMCID: PMC8012554 DOI: 10.3389/fnagi.2021.632237] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 02/23/2021] [Indexed: 01/14/2023] Open
Abstract
Background: White matter hyperintensities (WMH)s is a very common neuroradiological manifestation in the elderly and is an increased risk of dementia and cognitive decline. As we all know, the thalamocortical circuit plays an important part in cognition regulation. However, the role of this circuit in WMHs and its related cognitive deficits is still unclear. Method: Eighty WMH patients and 37 healthy controls (HCs) were enrolled in the current study. WMH patients were divided into a mild WMH group (n = 33) and moderate-severe WMH group (n = 47) according to Fazekas scores. Resting-state functional magnetic resonance imaging (rs-fMRI) data of all participants were collected for thalamocortical functional connectivity (FC) analysis. The analysis was performed in two steps. First, the whole cerebral cortex was divided into six regions of interest (ROIs), which were used as seeds to investigate the changes of FC with the thalamus. Then, the subregion of the thalamus generated in the previous step was used as the seed for FC analysis with the whole brain. Results: In the first step of FC analysis, it was found that precentral gyrus (PrCG)-interthalamic adhesion (ITA) FC values in moderate-severe WMH group were higher than those in HC and mild WMH groups. However, when compared with the HC group, the increase of PrCG-ITA FC values in mild WMH group was not statistically significant. In the second step of FC analysis, the ITA was set as the seed, and compared with the HC group, the results showed that the FC values of the ITA-medial frontal gyrus (MFG) in mild group and moderate-severe WMH groups were significantly increased. In addition, the FC values in moderate-severe group were significantly higher than those in mild group. Finally, it was also found that FC values (PrCG-ITA and ITA-MFG) were significantly correlated with neuropsychological test results for multiple cognitive functions such as memory, execution and attention in WMH patients. Conclusion: Abnormal thalamocortical FC was closely related with cognitive impairments in WMH patients.
Collapse
Affiliation(s)
- Chen Chen
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Xiaojing Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Shanshan Cao
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Jun Zhang
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Zhiqi Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Wen Pan
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Jinying Yang
- Laboratory Center for Information Science and Technology of China, Hefei, China
| | - Yanghua Tian
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Bensheng Qiu
- Hefei National Lab for Physical Sciences at the Microscale and the Centers for Biomedical Engineering, University of Science and Technology of China, Hefei, China
| | - Qiang Wei
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China.,The College of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China
| |
Collapse
|
40
|
Huang L, Chen X, Sun W, Chen H, Ye Q, Yang D, Li M, Luo C, Ma J, Shao P, Xu H, Zhang B, Zhu X, Xu Y. Early Segmental White Matter Fascicle Microstructural Damage Predicts the Corresponding Cognitive Domain Impairment in Cerebral Small Vessel Disease Patients by Automated Fiber Quantification. Front Aging Neurosci 2021; 12:598242. [PMID: 33505302 PMCID: PMC7829360 DOI: 10.3389/fnagi.2020.598242] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 12/07/2020] [Indexed: 11/13/2022] Open
Abstract
Objective: To characterize earlier damage pattern of white matter (WM) microstructure in cerebral small vessel disease (CSVD) and its relationship with cognitive domain dysfunction. Methods: A total of 144 CSVD patients and 100 healthy controls who underwent neuropsychological measurements and diffusion tensor imaging (DTI) examination were recruited. Cognitive function, emotion, and gait were assessed in each participant. The automated fiber quantification (AFQ) technique was used to extract different fiber properties between groups, and partial correlation and general linear regression analyses were performed to assess the relationship between position-specific WM microstructure and cognitive function. Results: Specific segments in the association fibers, commissural WM regions of interest (ROIs), and projection fibers were damaged in the CSVD group [P < 0.05, family-wise error (FWE) correction], and these damaged segments showed interhemispheric symmetry. In addition, the damage to specific tract profiles [including the posteromedial component of the right cingulum cingulate (CC), the occipital lobe portion of the callosum forceps major, the posterior portion of the left superior longitudinal fasciculus (SLF), and the bilateral anterior thalamic radiation (ATR)] was related to the dysfunction in specific cognitive domains. Among these tracts, we found the ATR to be the key set of tracts whose profiles were most associated with cognitive dysfunction. The left ATR was a specific fiber bundle associated with episode memory and language function, whereas the fractional anisotropy (FA) values of the intermediate component of the right ATR were negatively correlated with executive function and gait evaluation. It should be noted that the abovementioned relationships could not survive the Bonferroni correction (p < 0.05/27), so we chose more liberal uncorrected statistical thresholds. Conclusions: Damage to the WM fiber bundles showed extensive interhemispheric symmetry and was limited to particular segments in CSVD patients. Disruption of strategically located fibers was associated with different cognitive deficits, especially the bilateral ATR.
Collapse
Affiliation(s)
- Lili Huang
- Department of Neurology, Drum Tower Hospital, Medical School and the State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neurological Medical Center, Nanjing, China
| | - Xin Chen
- Department of Neurology, Drum Tower Hospital, Medical School and the State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neurological Medical Center, Nanjing, China
| | - Wenshan Sun
- Department of Neurology, Drum Tower Hospital, Medical School and the State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neurological Medical Center, Nanjing, China
| | - Haifeng Chen
- Department of Neurology, Drum Tower Hospital, Medical School and the State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neurological Medical Center, Nanjing, China
| | - Qing Ye
- Department of Neurology, Drum Tower Hospital, Medical School and the State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neurological Medical Center, Nanjing, China
| | - Dan Yang
- Department of Neurology, Drum Tower Hospital, Medical School and the State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neurological Medical Center, Nanjing, China
| | - Mengchun Li
- Department of Neurology, Drum Tower Hospital, Medical School and the State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neurological Medical Center, Nanjing, China
| | - Caimei Luo
- Department of Neurology, Drum Tower Hospital, Medical School and the State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neurological Medical Center, Nanjing, China
| | - Junyi Ma
- Department of Neurology, Drum Tower Hospital, Medical School and the State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neurological Medical Center, Nanjing, China
| | - Pengfei Shao
- Department of Neurology, Drum Tower Hospital, Medical School and the State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neurological Medical Center, Nanjing, China
| | - Hengheng Xu
- Department of Neurology, Drum Tower Hospital, Medical School and the State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neurological Medical Center, Nanjing, China
| | - Bing Zhang
- Department of Radiology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Xiaolei Zhu
- Department of Neurology, Drum Tower Hospital, Medical School and the State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neurological Medical Center, Nanjing, China
| | - Yun Xu
- Department of Neurology, Drum Tower Hospital, Medical School and the State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neurological Medical Center, Nanjing, China
| |
Collapse
|
41
|
Zhou L, Liu G, Luo H, Li H, Peng Y, Zong D, Ouyang R. Aberrant Hippocampal Network Connectivity Is Associated With Neurocognitive Dysfunction in Patients With Moderate and Severe Obstructive Sleep Apnea. Front Neurol 2020; 11:580408. [PMID: 33362692 PMCID: PMC7759642 DOI: 10.3389/fneur.2020.580408] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/11/2020] [Indexed: 01/20/2023] Open
Abstract
Objectives: This work aims to explore the changes of functional connectivity (FC) within the hippocampus network in patients with moderate and severe obstructive sleep apnea (OSA) and its correlation with neurocognitive dysfunction to explore the potential neurophysiological mechanism. Methods: A total of 32 treatment-naïve patients with moderate or severe OSA and 26 healthy controls (HCs), matched in age, gender, and education, underwent the evaluations of Epworth Sleep Scale, neurocognitive function, full-night polysomnography, and resting-state functional magnetic resonance imaging. The FC map of the hippocampus to other brain areas was compared among 15 OSA patients and 15 HCs with little head motion. Finally, the correlation between hippocampus FC strength and respiratory sleep parameters and neurocognitive assessments was analyzed. Results: Compared with HCs, the right hippocampus showed a significantly decreased FC with the bilateral insular lobe, right thalamus, and right anterior cingulate gyrus (ACG) and an increased FC with the right superior and middle temporal gyrus, left posterior cingulate gyrus, and left angular gyrus in the patients with OSA. The left hippocampus presented a significantly decreased FC with the left anterior cerebellum in patients with OSA. In addition, the aberrant right hippocampal FC with the right ACG was significantly correlated with disease severity and disrupted sleep architecture in the OSA group. Furthermore, after adjusting the related confounding factors, the FC strength between the right hippocampus, right insular lobe, and right thalamus was positively associated with the scores of Stroop Color–Word Test (SCWT) or Hopkins Verbal Learning Test—Revised (HVLT-R), while the FC between the right hippocampus and the right middle temporal gyrus was negatively correlated with the scores of HVLT-R. The right hippocampus FC with right superior temporal gyrus, left angular gyrus, and ACG were all negatively related to the scores of the symbol coding test (r = −0.642, p = 0.045; r = −0.638, p = 0.047; r = −0.753, p = 0.012), respectively. The FC between the left hippocampal and the left anterior cerebellar lobe showed a positive relationship with the scores of HVLT-R (r = 0.757, p = 0.011) and CPT-3D (r = −0.801, p = 0.005). Conclusion: The hippocampus presented abnormal FC with the cerebral and cerebellar regions extensively in OSA, and the correlation between abnormal hippocampal network FC and neurocognitive dysfunction in OSA suggests a promising insight to explore the potential biomarker and pathophysiologic mechanism of neurocognitive dysfunction of OSA.
Collapse
Affiliation(s)
- Li Zhou
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Unit of Respiratory Disease, Central South University, Changsha, China.,Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, China
| | - Guiqian Liu
- Hunan Province Prevention and Treatment Institute for Occupational Diseases, Changsha, China
| | - Hong Luo
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Unit of Respiratory Disease, Central South University, Changsha, China.,Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, China
| | - Huabing Li
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yating Peng
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Unit of Respiratory Disease, Central South University, Changsha, China.,Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, China
| | - Dandan Zong
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Unit of Respiratory Disease, Central South University, Changsha, China.,Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, China
| | - Ruoyun Ouyang
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Unit of Respiratory Disease, Central South University, Changsha, China.,Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, China
| |
Collapse
|
42
|
Kumar D, Vipin A, Wong B, Ng KP, Kandiah N. Differential Effects of Confluent and Nonconfluent White Matter Hyperintensities on Functional Connectivity in Mild Cognitive Impairment. Brain Connect 2020; 10:547-554. [PMID: 33050714 DOI: 10.1089/brain.2020.0784] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background: White matter hyperintensities (WMHs) indicate active small vessel disease. Emerging evidence suggests that confluent WMH (C-WMH) results in greater cognitive impairment compared with nonconfluent WMH (NC-WMH) visualized as punctate lesions. However, the mechanism linking C-WMH and early cognitive impairment is not clearly understood. Aims: To investigate the effects of C-WMH and NC-WMH on whole-brain functional connectivity (FC) across 138 regions of interest (ROIs) and cognition in 63 subjects with mild cognitive impairment (MCI). Methods: MCI subjects were classified as C-WMH or NC-WMH using the Staals criteria on the Fazekas WMH scale. Group-level ROI-to-ROI FC trends and differences based on WMH subtypes were computed using standard resting-state functional magnetic resonance imaging analysis. Global cognitive performance was measured with mini-mental state examination (MMSE). Results: Subjects with C-WMH exhibited increased inter-regional FC in the fronto-parietal, fronto-occipital, parieto-occipital, and temporo-parietal regions of the salience, dorsal-attention, default-mode, and visual networks compared with NC-WMH. Increased intra-regional FC was also observed within the frontal and parietal lobes in C-WMH. In addition to widespread increased FC in C-WMH, a few regions in the fronto-temporal and intra-frontal areas demonstrated reduced FC in C-WMH compared with NC-WMH. Analyses of cognitive correlates demonstrated increased parieto-occipital FC to be negatively associated with MMSE in the C-WMH. The increased parieto-occipital FC may be related to loss of higher order inhibitory control in the parieto-occipital regions induced by C-WMH or alternatively a compensatory mechanism to FC alterations induced by C-WMH. Conclusion: C-WMH in subjects with MCI is associated with widespread increase in intra- and inter-regional FC. These findings provide novel insights into divergent FC related to confluence of WMH in MCI. Impact statement White matter hyperintensities (WMHs) have been demonstrated to be a major risk factor for progressive cognitive decline. However, the relationship between structural and functional brain changes related to different types of WMH lesions as well as different stages of WMH progression remains unclear. In this study, we demonstrate that confluent WMH is significantly associated with divergent functional connectivity changes in patients with mild cognitive impairment (MCI). This finding may allow identification of MCI subjects who are adversely affected by WMH and thus provides a window of opportunity to introduce pharmacological and nonpharmacological interventional measures.
Collapse
Affiliation(s)
- Dilip Kumar
- National Neuroscience Institute, Neurology and Research Departments, Singapore, Singapore
| | - Ashwati Vipin
- National Neuroscience Institute, Neurology and Research Departments, Singapore, Singapore
| | - Benjamin Wong
- National Neuroscience Institute, Neurology and Research Departments, Singapore, Singapore
| | - Kok Pin Ng
- National Neuroscience Institute, Neurology and Research Departments, Singapore, Singapore.,Duke-NUS Medical School, Neuroscience Academic Clinical Programme, Singapore, Singapore
| | - Nagaendran Kandiah
- National Neuroscience Institute, Neurology and Research Departments, Singapore, Singapore.,Duke-NUS Medical School, Neuroscience Academic Clinical Programme, Singapore, Singapore.,NTU-Imperial Lee Kong Chian School of Medicine, Faculty, Singapore, Singapore
| |
Collapse
|
43
|
Li M, Huang L, Yang D, Luo C, Qin R, Zhang B, Zhao H, Xu Y. Atrophy patterns of hippocampal subfields in T2DM patients with cognitive impairment. Endocrine 2020; 68:536-548. [PMID: 32172485 PMCID: PMC7308251 DOI: 10.1007/s12020-020-02249-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 02/26/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE To identify the volume changes of hippocampus subfields in T2DM patients with cognitive impairment and to determine how these atrophy patterns associate with impairments in different cognitive domain. METHODS A total of 117 individuals were recruited, including T2DM patients with cognitive impairment (T2DM-CI) (n = 34), T2DM patients without cognitive impairment (T2DM-non-CI) (n = 36) and normal controls (NC) (n = 47). All subjects went through a 3.0 T magnetic resonance (MR) scan and a neuropsychological assessment. Hippocampal subfield volumes were processed using the FreeSurfer 6.0.0 and compared among the three groups. Partial correlation analyses were used to estimate the relationship between cognitive function and hippocampal subfield volume, with age, sex, education, and eTIV (estimated total intracranial volume) as covariants. RESULTS The total hippocampal volume had a reduction trend among the three groups, and the significantly statistical difference only was found between T2DM-CI group and NC group. Regarding the hippocampal subfields, the volumes of left subiculum, left presubiculum, left fimbria, right CA1 and right molecular layer HP decreased significantly in the T2DM-CI group (P < 0.05/12). Partial correlation analyses showed that the volumes of the left subiculum, left fimbria, and left presubiculum were significantly related to executive function. The right hippocampal CA1 volume was significantly correlated with memory in the T2DM-CI group (P < 0.05). But in T2DM-non-CI group, the correlation between the left fimbria volume and the memory, the left subiculum volume and MoCA were different with the T2DM-CI group and NC group (P < 0.05). CONCLUSIONS The smaller the volume of left presubiculum, the worse the executive function, and the atrophy of the right CA1 was related to memory impairment in T2DM-CI group. However the result was the opposite in T2DM-non-CI group. There might be a compensation mechanism of hippocampus of T2DM patients before cognitive impairment.
Collapse
Affiliation(s)
- MengChun Li
- Department of Neurology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
- Nanjing Medicine Center For Neurological and Psychiatric Diseases, Nanjing, China
| | - LiLi Huang
- Department of Neurology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
- Nanjing Medicine Center For Neurological and Psychiatric Diseases, Nanjing, China
| | - Dan Yang
- Department of Neurology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
- Nanjing Medicine Center For Neurological and Psychiatric Diseases, Nanjing, China
| | - CaiMei Luo
- Department of Neurology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
- Nanjing Medicine Center For Neurological and Psychiatric Diseases, Nanjing, China
| | - RuoMeng Qin
- Department of Neurology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
- Nanjing Medicine Center For Neurological and Psychiatric Diseases, Nanjing, China
| | - Bing Zhang
- Department of Neurology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
- Department of Radiology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Hui Zhao
- Department of Neurology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China.
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China.
- Nanjing Medicine Center For Neurological and Psychiatric Diseases, Nanjing, China.
| | - Yun Xu
- Department of Neurology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China.
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China.
- Nanjing Medicine Center For Neurological and Psychiatric Diseases, Nanjing, China.
| |
Collapse
|