Superficial white matter microstructure affects processing speed in cerebral small vessel disease.
Superficial white matter microstructure affects processing speed in cerebral small vessel disease.
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浅层白质微结构影响脑小血管疾病的处理速度
DOI：
10.1002/hbm.26004
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发表时间：
2022-12-01
影响因子：
4.8
通讯作者：
中科院分区：
文献类型：
--
作者：
白质高信号（WMH）是脑小血管疾病（CSVD）的典型特征。全球约 50% 的痴呆症是由这种情况引起的，这是老龄化过程中的巨大健康负担。深部白质 (DWM) 的微观结构改变已在 CSVD 中得到广泛检查。然而，人们对浅层白质 (SWM) 异常及其与处理速度（脑小血管病的主要认知缺陷）的相关性知之甚少。本文对 141 名 CSVD 患者进行了研究。处理速度通过跟踪测试 A 部分的完成时间进行评估。白质异常通过 WMH 负荷（T2-FLAIR 上的病变体积）和扩散 MRI 进行评估，包括 DTI 和自由水 (FW) 成像微观结构测量。我们的研究结果表明，浅层白质可能在脑小血管病认知能力下降中发挥着特别重要的作用。尽管 SWM 中的 WMH 负担相对较小，但 SWM 成像措施对处理速度做出了很大贡献。在所有成像标记中，SWM FW 与处理速度的相关性最强，并且与其他扩散 MRI 测量不同，SWM FW 在 WMH 负担最低（可能代表疾病早期）的两个患者亚组之间显着增加。当比较 WMH 负担最高的两个患者亚组时，SWM 中 WMH 的参与伴随着处理速度和白质微结构的显着差异。鉴于 WMH 容量和区域 FW 对处理速度的显着影响，我们进行了中介分析。研究发现 SWM FW 完全介导 WMH 体积和处理速度之间的关联，而没有观察到 DWM FW 的介导作用。总体而言，我们的研究结果确定了 CSVD 中的 SWM 异常，并表明 SWM 对处理速度有重要贡献。结果表明，SWM 中的 FW 是与 CSVD 认知相关的微观结构变化的敏感标记。这项研究扩展了目前对 CSVD 相关功能障碍的理解，并表明 SWM 作为一个未被研究的区域，可以成为未来研究中监测病理生理过程的潜在目标。
White matter hyperintensities (WMH) are a typical feature of cerebral small vessel disease (CSVD). This condition contributes to about 50% of dementias worldwide, a massive health burden in aging. Microstructural alterations in the deep white matter (DWM) have been widely examined in CSVD. However, little is known about abnormalities in the superficial white matter (SWM) and their relevance for processing speed, the main cognitive deficit in CSVD. In this paper, 141 patients with CSVD were studied. Processing speed was assessed by the completion time of the Trail Making Test Part A. White matter abnormalities were assessed by WMH burden (lesion volume on T2-FLAIR) and diffusion MRI, including DTI and free-water (FW) imaging microstructure measures. The results of our study indicate that the superficial white matter may play a particularly important role in cognitive decline in CSVD. SWM imaging measures resulted in a large contribution to processing speed, despite a relatively small WMH burden in the SWM. SWM FW had the strongest association with processing speed among all imaging markers and, unlike the other diffusion MRI measures, significantly increased between two patient subgroups with the lowest WMH burdens (possibly representing early stages of disease). When comparing two patient subgroups with the highest WMH burdens, the involvement of WMH in the SWM was accompanied by significant differences in processing speed and white matter microstructure. Given significant effects of WMH volume and regional FW on processing speed, we performed a mediation analysis. SWM FW was found to fully mediate the association between WMH volume and processing speed, while no mediation effect of DWM FW was observed. Overall, our findings identify SWM abnormalities in CSVD and suggest that the SWM has an important contribution to processing speed. Results indicate that FW in the SWM is a sensitive marker of microstructural changes associated with cognition in CSVD. This study extends the current understanding of CSVD-related dysfunction and suggests that the SWM, as an understudied region, can be a potential target for monitoring pathophysiological processes in future research.
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DOI：
10.1002/alz.12150
发表时间：
2020-11
期刊：
Alzheimer's & dementia : the journal of the Alzheimer's Association
影响因子：
--
作者：
Finsterwalder S;Vlegels N;Gesierich B;Araque Caballero MÁ;Weaver NA;Franzmeier N;Georgakis MK;Konieczny MJ;Koek HL;Dominantly Inherited Alzheimer Network (DIAN);Karch CM;Graff-Radford NR;Salloway S;Oh H;Allegri RF;Chhatwal JP;DELCODE study group;Jessen F;Düzel E;Dobisch L;Metzger C;Peters O;Incesoy EI;Priller J;Spruth EJ;Schneider A;Fließbach K;Buerger K;Janowitz D;Teipel SJ;Kilimann I;Laske C;Buchmann M;Heneka MT;Brosseron F;Spottke A;Roy N;Ertl-Wagner B;Scheffler K;Alzheimer's Disease Neuroimaging Initiative (ADNI);Utrecht VCI study group;Seo SW;Kim Y;Na DL;Kim HJ;Jang H;Ewers M;Levin J;Schmidt R;Pasternak O;Dichgans M;Biessels GJ;Duering M
通讯作者：
Duering M
影响因子：
5.2
作者：
Cedres, Nira;Ferreira, Daniel;Westman, Eric
通讯作者：
Westman, Eric
影响因子：
5.7
作者：
Gazes Y;Bowman FD;Razlighi QR;O'Shea D;Stern Y;Habeck C
通讯作者：
Habeck C
影响因子：
3.2
作者：
Bigham, Bahare;Zamanpour, Seyed Amir;Zare, Hoda
通讯作者：
Zare, Hoda
影响因子：
14.8
作者：
Bowie, Christopher R.;Harvey, Philip D.
通讯作者：
Harvey, Philip D.