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Published on: January 4, 2013
Relationship between cerebral perfusion and cognition in white matter hyperintensities of presumed vascular origin: A
Fanhua Meng1,2, Guangwei Jin3, Ying Yang4
1Department of Radiology, Peking University Third Hospital, Haidian District, Beijing, China.
Abstract:
White matter hyperintensities of presumed vascular origin (WMH) are known imaging markers of cerebral small vessel disease and have been associated with future stroke risk, cognitive decline, and other adverse outcomes. However, the pathogenesis of WMH and its correlation with cerebral perfusion and cognitive impairment remain unclear. In this prospective study, we included 128 participants, each of whom underwent cognitive assessments and a three-dimensional pseudo-continuous arterial spin labeling sequence, using post-labeling delay values of 1525 and 2525 ms. The magnetic resonance imaging results of all participants were categorized into 4 groups based on the Fazekas visual rating scale. Variance analyses were conducted among the 4 groups of cerebral blood flow (CBF), and partial correlation analyses were performed between CBF and cognitive function. No clusters with a CBF1525ms difference were identified among the 4 groups. Three clusters with the CBF2525ms differences were identified among the 4 groups. The CBF2525ms of the brain regions with perfusion differences among the 4 groups showed an increasing trend with increasing Fazekas grades. A negative correlation was observed between CBF2525ms in the left lenticular nucleus and the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores (r = -0.306, P < .001, and r = -0.269, P = .002). The CBF2525ms of the right lenticular nucleus was negatively correlated with the MMSE and MoCA scores (r = -0.177, P = .047, and r = -0.179, P = .045). The CBF2525ms of the left thalamus/hippocampus was negatively correlated with the MMSE and MoCA scores (r = -0.226, P = .011, and r = -0.220, P = .013). This indicates that more severe WMH may increase perfusion through collateral circulation in certain brain regions, and their CBF is negatively correlated with cognitive function. This study further unveiled mechanisms behind WMH-related cognitive decline, which has a positive effect on the prevention and treatment of cognitive impairment in patients with WMH.
Insights
White matter hyperintensities (WMH) are linked to cognitive decline. This study found that reduced cerebral blood flow (CBF) in specific brain regions correlates with lower cognitive scores, suggesting a mechanism for WMH-related impairment.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- White matter hyperintensities (WMH) are imaging markers of cerebral small vessel disease.
- WMH are associated with stroke risk, cognitive decline, and adverse outcomes.
- The precise pathogenesis of WMH and its link to cerebral perfusion and cognitive impairment require further elucidation.
Purpose of the Study:
- To investigate the correlation between WMH severity, cerebral blood flow (CBF), and cognitive function.
- To explore potential mechanisms underlying WMH-related cognitive decline.
Main Methods:
- Prospective study including 128 participants.
- Cognitive assessments (MMSE, MoCA) and 3D pseudo-continuous arterial spin labeling MRI.
- WMH severity categorized using the Fazekas visual rating scale.
- Variance and partial correlation analyses performed between CBF and cognitive scores.
Main Results:
- No significant CBF differences at 1525ms post-labeling delay were found across WMH severity groups.
- Significant CBF differences at 2525ms post-labeling delay were identified among the groups, showing an increasing trend with higher Fazekas grades.
- Negative correlations were observed between CBF2525ms in the lenticular nucleus and thalamus/hippocampus and cognitive scores (MMSE, MoCA).
Conclusions:
- More severe WMH may be associated with increased perfusion via collateral circulation in specific brain regions.
- Reduced CBF in these regions is negatively correlated with cognitive function.
- This study provides insights into the mechanisms of WMH-related cognitive decline, aiding in prevention and treatment strategies.
