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Microstructural White Matter Abnormalities and Cognitive Dysfunction in Subcortical Ischemic Vascular Disease: an
Lin Lin1, Yunjing Xue, Qing Duan
1Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
Abstract:
Recent studies in subcortical ischemic vascular disease (SIVD) suggest the involvement of white matter (WM) abnormalities underlying the pathogenesis of cognitive function impairment. Here, we performed magnetic resonance diffusion tensor imaging (DTI) on detecting WM damage and to investigate the correlations between DTI measures and cognitive dysfunction in SIVD patients. Fifty right-handed SIVD patients were recruited and divided into vascular cognitive impairment on dementia (VCIND) group and normal cognition (NC) group. Twenty-two VCIND patients and 28 NC patients underwent DTI scanning and neuropsychological assessment. Atlas-based analysis (ABA) was performed on each subject for extracting FA and MD measures from supratentorial tracts. Among VCIND, as compared to NC patients, decreased FA and increased MD were observed in all projection fibers (bilateral anterior, posterior limb, and retrolenticular part of internal capsule, anterior, superior, and posterior corona radiata and posterior thalamic radiation), association fibers (bilateral sagittal stratum, external capsule, cingulum, fornix, and stria terminalis, superior longitudinal fasciculus, superior fronto-occipital fasciculus, and uncinate fasciculus), and commissural fibers (genu, body, splenium, and bilateral tapetum of corpus callosum). Furthermore, we also found that MoCA scores correlated with DTI values in all supratentorial WM tracts. The results suggested that SIVD patients demonstrated abnormal WM connectivity in all supratentorial regions. Moreover, the severity of damage in WM tracts correlated with cognitive dysfunction.
Insights
Subcortical ischemic vascular disease (SIVD) is linked to white matter (WM) damage, impacting cognitive function. Diffusion tensor imaging (DTI) revealed widespread WM abnormalities and their correlation with cognitive decline in SIVD patients.
Area of Science:
- Neuroimaging
- Neurology
- Vascular Dementia Research
Background:
- Subcortical ischemic vascular disease (SIVD) is increasingly recognized for its role in cognitive impairment.
- White matter (WM) abnormalities are implicated in the pathogenesis of cognitive dysfunction in SIVD.
- Diffusion tensor imaging (DTI) offers a method to detect WM microstructural changes.
Purpose of the Study:
- To detect white matter (WM) damage using magnetic resonance diffusion tensor imaging (DTI) in subcortical ischemic vascular disease (SIVD) patients.
- To investigate the correlations between DTI measures and cognitive dysfunction in SIVD.
- To differentiate between SIVD patients with vascular cognitive impairment on dementia (VCIND) and normal cognition (NC).
Main Methods:
- Fifty SIVD patients were divided into VCIND (22) and NC (28) groups.
- Magnetic resonance diffusion tensor imaging (DTI) was performed on all participants.
- Atlas-based analysis (ABA) was used to extract fractional anisotropy (FA) and mean diffusivity (MD) from supratentorial tracts, alongside neuropsychological assessments.
Main Results:
- SIVD patients, particularly those in the VCIND group, exhibited decreased FA and increased MD across all major supratentorial white matter tracts (projection, association, and commissural fibers).
- Montreal Cognitive Assessment (MoCA) scores showed significant correlations with DTI measures in all supratentorial WM tracts.
- These findings indicate widespread white matter connectivity abnormalities in SIVD patients.
Conclusions:
- Subcortical ischemic vascular disease (SIVD) is associated with significant white matter (WM) abnormalities affecting connectivity across all supratentorial regions.
- The degree of white matter damage, as measured by DTI, directly correlates with the severity of cognitive dysfunction in SIVD patients.
- DTI is a valuable tool for assessing WM integrity and its relationship to cognitive impairment in SIVD.
