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Co-analysis of Brain Structure and Function using fMRI and Diffusion-weighted Imaging
Published on: November 8, 2012
Diffuse Tract Damage Correlates With Global Cognitive Impairment in Cerebral Autosomal Dominant Arteriopathy With
Qi Zhang1, Dongdong Wang, Shiman Wu
1From the Department of Radiology, Huashan Hospital, Fudan University, Shanghai, P.R. China.
Insights
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) patients exhibit widespread white matter abnormalities. These microstructural changes significantly correlate with cognitive impairment, highlighting their role in the disease.
Area of Science:
- Neuroimaging
- Neurology
- White Matter Diseases
Background:
- Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a common genetic arteriopathy causing stroke, migraine, and depression.
- The precise mechanisms underlying cognitive dysfunction in CADASIL remain unclear.
Purpose of the Study:
- To investigate the spatial distribution of brain microstructural changes in CADASIL using diffusion tensor imaging (DTI) and tract-based spatial statistics (TBSS).
- To elucidate the neuropsychopathological mechanisms of cognitive impairment in CADASIL.
Main Methods:
- Magnetic resonance imaging (MRI) was performed on 12 CADASIL patients and 11 healthy controls.
- DTI-derived indices including fractional anisotropy (FA), mode of anisotropy (MO), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were analyzed using TBSS.
Main Results:
- CADASIL patients displayed widespread reductions in FA and MO, and increases in RD, AD, and MD in white matter regions compared to controls.
- These microstructural alterations in white matter were significantly correlated with cognitive assessment scores (Montreal Cognitive Assessment) and Scheltens scores.
- Specifically, decreased FA and MO correlated positively with cognitive scores, while increased AD, RD, and MD correlated negatively.
Conclusions:
- TBSS revealed extensive white matter abnormalities in CADASIL patients.
- The severity of microstructural changes correlated with T2 hyperintensity.
- White matter tract damage is a significant contributor to cognitive impairment in CADASIL.
Purpose:
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common familial arteriopathy characterized by recurrent lacunar stroke, migraine, and depression. The mechanism of cognitive dysfunction in CADASIL is still uncertain. The aim of this study was to use tract-based spatial statistics (TBSS) to map voxelwise the spatial distribution of brain microstructural change revealed by DTI-derived indices in patients with CADASIL to further study the underlying neuropsychopathological mechanism of CADASIL.
Method:
Twelve patients with CADASIL and 11 age-, sex-matched healthy controls underwent magnetic resonance imaging at 3 T. Then we evaluated DTI-derived indices (fractional anisotropy [FA], mode of anisotropy [MO], mean diffusivity [MD], axial diffusivity [AD] and radial diffusivity [RD]) of brain white matter (WM) between CADASIL patients and healthy subjects through TBSS.
Results:
Compared with healthy controls, patients with CADASIL showed extensive decreased FA, MO and increased RD, AD, and MD throughout the entire brain (mainly the WM of the temporal poles, inferior and superior longitudinal fasciculus, inferior fronto-occipital fasciculus, corpus callosum, uncinate fasciculus, internal capsule, external capsule, corona radiata, thalamic radiation, and cingulum). Furthermore, these WM microstructural alterations were significantly correlated with cognitive scores and Scheltens scores. Decreased FA values and MO values were positively correlated with Montreal Cognitive Assessment scores in CADASIL patients. Increased AD, RD, and MD values were significantly negatively correlated with Montreal Cognitive Assessment scores.
Conclusions:
Widespread WM abnormalities were clearly shown in CADASIL by using TBSS. Severity of microstructural changes correlates significantly with extension of T2 hyperintensity. Moreover, WM microstructural damage and cognitive impairment were significantly correlated. This study indicated that WM tract damage plays an important role in cognitive impairment in CADASIL.
