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[Correlation between spatial navigation disorder and white matter hyperintensity in patients with mild cognitive
1Department of Radiology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China.
Abstract:
Objective: To investigate the relationship between white matter lesions and spatial navigation ability in patients with mild cognitive impairment (MCI). Methods: A total of 32 MCI patients [age (66±11) years, 16 males and 16 females] who were treated in the Affiliated Drum Tower Hospital of Nanjing University Medical School from January 2015 to February 2018 were selected, and matched with age, gender and education level of 28 healthy controls (NC) [age (70±11) years, 19 males and 9 females] underwent spatial navigation ability test and neuropsychology scale evaluation. In the cross-sectional study, all subjects simultaneously underwent 3.0T magnetic resonance three-dimensional liquid inversion recovery sequence and high-resolution T(1) weighted imaging scan. The Wisconsin White Matter Hyperintensities Segmentation Toolbox (W2MHS) was used to automatically mark and extract the volume of the white matter hyperintensity. Results: The average error distances of egocentric virtual (P=0.002) and allocentric virtual (P=0.039) of MCI patients are greater than that of the control group, but the average error distance of mixed (allocentric-egocentric virtual) navigation had no statistic difference between two groups (P=0.070). The volume of the whole white matter hyperintensity, periventricular white matter hyperintensity, and deep white matter hyperintensity showed no significant differences between two groups (all P>0.05). Partial correlation analysis showed that after controlling for age, gender, education level and whole brain volume, the average error distance of mixed (allocentric-egocentric virtual) navigation in MCI patients was positively correlated to the volume of the whole white matter hyperintensity, deep white matter intensity, and periventricular white matter hyperintensity (r=0.469, 0.434, 0.512, all P<0.05). The average error distance of allocentric virtual navigation is positively correlated with the volume of periventricular white matter hyperintensity (r=0.403, P=0.033). There is no correlation between the average error distance of egocentric virtual navigation and the hyperintensity of white matter. Conclusions: The spatial navigation ability of patients with MCI is related to white matter lesions, which is of great significance for further research on the potential biological mechanisms affecting human spatial navigation ability.
Insights
Mild cognitive impairment (MCI) patients show impaired spatial navigation linked to white matter lesions. These white matter hyperintensities significantly correlate with navigation errors, suggesting a biological basis for cognitive decline.
Area of Science:
- Neuroscience
- Radiology
- Gerontology
Background:
- Mild cognitive impairment (MCI) is a transitional stage between normal aging and dementia.
- Spatial navigation deficits are increasingly recognized as an early symptom of cognitive decline.
- The role of white matter integrity in spatial navigation in MCI requires further elucidation.
Purpose of the Study:
- To investigate the relationship between white matter lesions and spatial navigation abilities in individuals with MCI.
- To quantify white matter hyperintensities and assess spatial navigation performance in MCI patients and healthy controls.
Main Methods:
- A cross-sectional study involving 32 MCI patients and 28 healthy controls (NC).
- Spatial navigation ability tests (egocentric, allocentric, mixed) and neuropsychological evaluations were performed.
- 3.0T MRI scans (3D-FLAIR, high-resolution T1-weighted imaging) were used to quantify white matter hyperintensities (WMH) via the W2MHS toolbox.
Main Results:
- MCI patients exhibited greater average error distances in egocentric and allocentric virtual navigation compared to NC.
- No significant differences in total, periventricular, or deep WMH volume were found between groups.
- Partial correlation analysis revealed positive correlations between mixed navigation error distances and total, deep, and periventricular WMH volumes in MCI patients.
- Allocentric navigation errors correlated positively with periventricular WMH volume in MCI patients.
Conclusions:
- Spatial navigation deficits in MCI are associated with the presence and extent of white matter lesions.
- White matter hyperintensities, particularly in deep and periventricular regions, may contribute to impaired spatial navigation in MCI.
- These findings highlight the potential biological mechanisms underlying navigation difficulties in MCI and warrant further investigation.
