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Aberrant microstructural integrity of white matter in mild and severe orthostatic hypotension: A NODDI study

Yingzhe Cheng1,2,3,4, Lin Lin1,2,3,4, Shaofan Jiang5,6

  • 1Department of Neurology, Center for Cognitive Neurology, Fujian Medical University Union Hospital, Fuzhou City, China.

CNS Neuroscience & Therapeutics
|February 29, 2024
PubMed
Abstract

Insights

Abnormal white matter (WM) microstructure is linked to cognitive decline in orthostatic hypotension (OH). These changes appear early in mild OH (MOH) and correlate with cognitive function and biomarkers.

Area of Science:

  • Neuroscience
  • Neurology
  • Medical Imaging

Background:

  • Orthostatic hypotension (OH) is associated with cognitive impairment, but the underlying white matter (WM) microstructural changes are not well understood.
  • Investigating WM integrity in mild OH (MOH) and severe OH (SOH) is crucial for understanding cognitive deficits.

Purpose of the Study:

  • To investigate the association between WM microstructure and cognitive performance in patients with MOH and SOH.
  • To evaluate the relationship between abnormal WM microstructure, cognitive domains, and plasma biomarkers.

Main Methods:

  • Neurite orientation dispersion and density imaging (NODDI) was used to analyze WM integrity in 72 non-OH (NOH), 17 MOH, and 11 SOH participants.
  • Nonparametric tests and post hoc models identified differences in WM microstructure.
  • Spearman's correlation analysis assessed associations between WM microstructure, cognitive function, and plasma biomarkers.

Main Results:

  • Abnormal WM microstructure was localized in MOH and widespread in SOH patients (p < 0.05).
  • Reduced neurite density in the left cingulate gyrus correlated with lower levels of amyloid β-40, glial fibrillary acidic protein, neurofilament light chain, and phospho-tau181, but higher global cognitive function, memory, attention, language, and Aβ40/Aβ42 ratio (p < 0.05).
  • Other WM microstructural abnormalities in OH were associated with various cognitive domains and biomarkers.

Conclusions:

  • Abnormal WM microstructures are present even in the early stages of MOH.
  • These structural changes are significantly associated with cognitive function and related plasma biomarkers in OH patients.
Keywords:
MOHNODDISOHWM integritycognitionplasma biomarker

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