Magnetic resonance spectroscopy study of cognitive impairment associated with cerebral small vessel disease

This study aimed to examine the association between cognitive decline and brain substance metabolism, as well as the risk factors in cerebral small vessel disease(CSVD) patients.

The CSVD patients were divided into a simple CSVD group and a CSVD-related cognitive impairment group according to the Montreal Cognitive Assessment (MoCA) score. Healthy patients were selected as the normal control group. Magnetic Resonance Imaging (MRI) was used to scan the frontal lobe, hippocampus, and semioval center of the dominant hemisphere of all subjects. The N-acetylaspartic acid (NAA), creatine (Cr), and choline (Cho) were measured.

There were statistically significant differences in visual space, executive function, naming, and abstract thinking between simple CSVD group and CSVD-related cognitive dysfunction group. A history of hypertension, triglycerides, low-density lipoprotein and Homocysteine (Hcy) levels were risk factors for CSVD-related cognitive impairment. The frontal lobe NAA/Cr ratio decreased in the simple CSVD group, the frontal lobe NAA/Cho ratio decreased in the CSVD-related cognitive impairment group, and the semiovale center NAA/Cr ratio decreased. NAA/Cho in the dominant hemisphere of the hippocampus was positively correlated with MoCA scores, frontal NAA/Cr was positively correlated with MoCA scores, and NAA/Cr in the center of the semioval was negatively correlated with MoCA scores.

Hypertension, abnormal blood lipid metabolism and high levels of Hcy are risk factors for CSVD-related cognitive dysfunction. The patients with CSVD-related cognitive dysfunction have visual space and executive function deficiency. Poor abstract thinking may be related to metabolic abnormalities in the frontal lobe and hippocampus.NAA/Cho and NAA/Cr can be used as sensitive indicators of cognitive dysfunction.