Structural connectivity mediates the relationship between blood oxygenation and cognitive function in sickle cell anemia.
Structural connectivity mediates the relationship between blood oxygenation and cognitive function in sickle cell anemia.
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DOI：
10.1182/bloodadvances.2021006751
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发表时间：
2023-06-13
期刊：
影响因子：
7.5
通讯作者：
Clark, Chris A.
中科院分区：
文献类型：
--
作者：
Clayden, Jonathan D.;Stotesbury, Hanne;Kawadler, Jamie M.;Slee, April;Kolbel, Melanie;Saunders, Dawn E.;Hood, Anna M.;Wilkey, Olu;Layton, Mark;Inusa, Baba;Pelidis, Maria;Chakravorty, Subarna;Rees, David C.;Howard, Jo;Awogbade, Moji;Liossi, Christina;Kirkham, Fenella J.;Clark, Chris A.
与对照组相比，镰状细胞病患者的脑白质连接性减弱。减弱的连接性在患者的血氧饱和度和处理速度之间的关系中起中介作用。在镰状细胞病中，血氧饱和度、脑白质连接性和处理速度在镰状细胞病中，降低的血红蛋白(Hb)和外周血氧饱和度对脑结构的相对重要性仍不确定。我们应用图论分析对弥散磁共振成像数据进行分析，以探讨脑结构连通性对认知功能的影响，以及无症状性脑梗塞的存在与否、数目和体积。在患者中，我们调查了网络特性、血氧和认知(工作记忆和处理速度指数)之间的关系。根据流线计数和各向异性分数，我们在92例镰状细胞病患者(91例HBs[HBs]纯合子，1例HBsβ0地中海贫血杂合子；49名男性；年龄8-38.8岁)中发现了连接减弱的亚网络，并与54名对照组(22名男性；年龄6.7-30.6岁)进行了比较。多元回归分析显示，Hb对全网络边缘密度有显著影响(P<0.05)，外周血氧饱和度对流线加权网络效率有显著影响(P<0.01)。分数各向异性加权的全网络和子网络效率对工作记忆指数有影响(P<0.05)，流线型加权的子网络效率对加工速度指数有影响(P<0.05)。然而，无症状脑梗塞的存在、数目或体积没有影响。流线加权效率随血氧饱和度的降低而逐渐降低，并对加工速度指数产生下游影响。在通径分析中，血氧与认知之间的间接关系由网络特性调节，比直接替代更好地支持，患者低氧饱和度与加工速度指数之间的间接关系由与对照受试者不同的脑子网络结构连接效率调节。我们的发现与认知障碍主要由正常脑白质缺氧缺血效应介导的观点一致，并强调了基于网络的方法在提供镰状细胞疾病患者认知功能障碍的生物标志物方面的有效性。
Patients with sickle cell disease have weakened brain white matter connectivity compared with control subjects. Weakened connectivity mediates the relationship between oxygen saturation and processing speed in patients. Oxygen saturation, brain white matte connectivity and processing speed in sickle cell disease In sickle cell disease, the relative importance of reduced hemoglobin (Hb) and peripheral oxygen saturation on brain structure remains uncertain. We applied graph-theoretical analysis to diffusion magnetic resonance imaging data to investigate the effect of structural brain connectivity on cognitive function, alongside the presence or absence, number, and volume of silent cerebral infarction. In patients, we investigated the relationships between network properties, blood oxygenation, and cognition (working memory and processing speed indices). Based on streamline counts and fractional anisotropy, we identified a subnetwork with weakened connectivity in 92 patients with sickle cell disease (91 homozygous for HbS [HbSS], 1 heterozygote with HbSβ0 thalassemia; 49 males; aged 8.0 to 38.8 y), compared with 54 control subjects (22 males; aged 6.7 to 30.6 y). Multiple regression analyses showed a significant effect of Hb on full-network edge density (P < .05) and of peripheral oxygen saturation on streamline-weighted subnetwork efficiency (P < .01). There were effects of fractional anisotropy-weighted full-network and subnetwork efficiency on working memory index (both P < .05), and of streamline-weighted subnetwork efficiency on processing speed index (P = .05). However, there were no effects of presence, number or volume of silent cerebral infarcts. Streamline-weighted efficiency was progressively lower with lower oxygen saturation, with a downstream effect on the processing speed index. In path analysis, indirect relationships between blood oxygenation and cognition, mediated by network properties, were better supported than direct alternatives, with an indirect relationship between low oxygen saturation and processing speed index in patients, mediated by structural connectivity efficiency in a subnetwork of the brain differing from control subjects. Our findings are consistent with the notion that cognitive impairment is primarily mediated by hypoxic–ischemic effects on normal-appearing white matter and highlight the utility of network-based methods in providing biomarkers of cognitive dysfunction in patients with sickle cell disease.
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影响因子：
3.7
作者：
Colombatti R;Lucchetta M;Montanaro M;Rampazzo P;Ermani M;Talenti G;Baracchini C;Favero A;Basso G;Manara R;Sainati L
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影响因子：
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作者：
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