Disrupted functional and structural connectivity within default mode network contribute to WMH-related cognitive impairment
Disrupted functional and structural connectivity within default mode network contribute to WMH-related cognitive impairment
复制标题
默认模式网络内的功能和结构连接中断会导致与 WMH 相关的认知障碍。
DOI：
10.1016/j.nicl.2019.102088
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发表时间：
2019-01-01
影响因子：
4.2
通讯作者：
Xu Yun
中科院分区：
文献类型：
--
作者：
Chen Xin;Huang Lili;Xu Yun
目的：随着年龄的增长，白质高强度（WMH）的患病率急剧上升。WMH的发展和默认模式网络（DMN）模式的改变都与认知功能密切相关。本研究假设DMN功能连通性和结构连通性的改变与WMH相关的认知障碍有关。方法：选取南京大学鼓楼医院脑血管病登记册116例患者，按Fazekas量表分为三类：ⅰ型脑血管病（n = 57）、ⅱ型脑血管病（n = 34）、ⅲ型脑血管病（n = 25）。所有参与者都进行了神经心理测试和多模态MRI扫描，包括扩散张量成像和静息状态fMRI成像。进一步探讨DMN内功能连通性和结构连通性的变化。结果：年龄和高血压是WMH进展的危险因素。WMH负荷较高的受试者，内侧额回DMN功能连通性较高，而丘脑DMN功能连通性较低。在对年龄、性别和受教育程度进行调整后，内侧额回DMN功能连通性的增加，以及海马和后扣带皮层之间白质束平均弥散性的增加是记忆表现较差的独立指标。此外，丘脑DMN功能连通性下降和丘脑与后扣带皮层之间白质束平均弥漫性增加是处理速度减慢的独立危险因素。结论：WMH进展导致的DMN内功能连通性和结构连通性的改变是认知障碍发生的重要原因。
Aims: The prevalence of white matter hyperintensities (WMH) rises dramatically with aging. Both the progression of WMH and changing patterns of default mode network (DMN) have been proven to be closely associated with cognitive function. The present study hypothesized that changes in functional connectivity and structural connectivity of DMN contributed to WMH related cognitive impairment.Methods: A total of 116 subjects were enrolled from the Cerebral Small Vessel Disease Register in Drum Tower Hospital of Nanjing University, and were distributed across three categories according to Fazekas rating scale: WMH I (n = 57), WMH II (n = 34), and WMH III(n = 25). All participants underwent neuropsychological tests and multimodal MRI scans, including diffusion tensor imaging and resting-state fMRI imaging. The alterations of functional connectivity and structural connectivity within the DMN were further explored.Results: Age and hypertension were risk factors for WMH progression. Subjects with a higher WMH burden displayed higher DMN functional connectivity in the medial frontal gyrus, while lower DMN functional connectivity in the thalamus. After adjusting for aging, gender, and education, the increased DMN functional connectivity in the medial frontal gyrus, and the increased mean diffusivity of the white matter tracts between the hippocampus and posterior cingulate cortex were independent indicators of worse performance in memory. Moreover, the decreased DMN functional connectivity in the thalamus and increased mean diffusivity of the white matter tracts between the thalamus and posterior cingulate cortex were independent risk factors for a slower processing speed.Conclusion: The changes in functional connectivity and structural connectivity within the DMN attributed to WMH progression were responsible for the development of cognitive impairment.