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White matter abnormalities in metabolic syndrome patients with and without mild cognitive impairment: A diffusion
Wen Shao1, TianTian Zhu2, Xiaoxiao Xiong2
1Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Department of Neurology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, China.
Background:
The presence of metabolic syndrome (MetS) constitutes a significant risk factor for the development of cognitive dysfunction and dementia. MetS can result in damage to the integrity and microstructure of white matter (WM). There may exist certain distinctions in WM between MetS patients with mild cognitive impairment (MCI) and MetS patients with preserved cognitive function. Using diffusion tensor imaging (DTI), we aim to investigate the alterations of the WM in MetS patients with and without MCI.
Methods:
36 MetS patients with MCI (MetS-MCI group), 30 age-, gender-, and education-matched MetS patients with normal cognition (MetS-NC group), and 36 healthy controls (HC) were included in the study. Diffusion data was analyzed using Tract-Based Spatial Statistics (TBSS) analysis and Region of Interest (ROI) quantitative analysis to investigate the differences in fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (λ1), and radial diffusivity (λ23) among these groups. Analyses on WM fiber tracts showed FA reduction or MD elevation in regions related to cognitive functions. Relationship between DTI metrics in these regions and neuropsychological assessments was characterized.
Results:
In the whole-brain TBSS analysis, compared to HC group, MetS-MCI group primarily exhibited an increase in MD, λ1 and λ23. MetS-NC group primarily exhibited an increase in MD and λ1 compared to HC group. Furthermore, compared to MetS-NC group, MetS-MCI group demonstrated significantly elevated MD and λ23. In the ROI quantitative analysis, increased MD values in right posterior thalamic radiation (PTR.R), left external capsule (EC.L), right inferior fronto-occipital fasciculus (IFO.R), left inferior fronto-occipital fasciculus (IFO.L), and right uncinate fasciculus (UF.R), along with decreased FA values in EC.L, right external capsule (EC.R) and left superior corona radiata (SCR.L), were associated with overall cognitive decline. Elevated MD values in EC.L and IFO.L, as well as reduced FA values in EC.L, were linked to poorer executive function. Similarly, higher MD values in EC.L, IFO.L, and UF.R, combined with lower FA values in EC.L, were associated with worse memory performance.
Conclusions:
Our study showed that MetS patients with MCI exhibited more severe WM damage compared to MetS patients without cognitive impairment, and loss of myelin sheath integrity may contribute to the cognitive decline in patients with MetS. Furthermore, our study clarified the association between different cognitive functions and specific WM fiber bundles in MetS patients.
Insights
Metabolic syndrome (MetS) patients with mild cognitive impairment (MCI) show more severe white matter (WM) damage than those without cognitive impairment. Myelin sheath damage likely contributes to cognitive decline in MetS.
Area of Science:
- Neuroimaging
- Neurology
- Metabolic Disorders
Background:
- Metabolic syndrome (MetS) is a risk factor for cognitive dysfunction and dementia.
- MetS can damage white matter (WM) microstructure.
- WM integrity may differ between MetS patients with and without mild cognitive impairment (MCI).
Purpose of the Study:
- Investigate WM alterations in MetS patients with and without MCI using diffusion tensor imaging (DTI).
- Compare WM microstructural differences between MetS patients with MCI, MetS patients with normal cognition (MetS-NC), and healthy controls (HC).
Main Methods:
- Included 36 MetS-MCI patients, 30 MetS-NC patients, and 36 HC.
- Utilized Tract-Based Spatial Statistics (TBSS) and Region of Interest (ROI) analysis of DTI data.
- Assessed fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (λ1), and radial diffusivity (λ23).
Main Results:
- MetS-MCI patients showed increased MD, λ1, and λ23 compared to HC.
- MetS-NC patients showed increased MD and λ1 compared to HC.
- MetS-MCI patients had significantly higher MD and λ23 than MetS-NC patients.
- Specific WM regions (e.g., EC.L, IFO.L, UF.R) showed altered DTI metrics correlated with cognitive decline, executive function, and memory deficits.
Conclusions:
- MetS patients with MCI exhibit more severe WM damage than those without cognitive impairment.
- Loss of myelin sheath integrity is implicated in cognitive decline in MetS patients.
- Specific WM fiber bundles are associated with distinct cognitive functions in MetS patients.
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