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Diffuse Tract Damage Correlates With Global Cognitive Impairment in Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy: A Tract-Based Spatial Statistics Study.

弥漫性束损伤与常染色体显性遗传性脑动脉病伴皮质下梗死和白质脑病的整体认知障碍相关: 一项基于束的空间统计研究。

  • 影响因子:1.48
  • DOI:10.1097/RCT.0000000000001129
  • 作者列表:"Zhang Q","Wang D","Wu S","Ren Y","Li Y","Zhang J","Feng X
  • 发表时间:2021-03-01
Abstract

PURPOSE:Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common familial arteriopathy characterized by recurrent lacunar stroke, migraine, and depression. The mechanism of cognitive dysfunction in CADASIL is still uncertain. The aim of this study was to use tract-based spatial statistics (TBSS) to map voxelwise the spatial distribution of brain microstructural change revealed by DTI-derived indices in patients with CADASIL to further study the underlying neuropsychopathological mechanism of CADASIL. METHOD:Twelve patients with CADASIL and 11 age-, sex-matched healthy controls underwent magnetic resonance imaging at 3 T. Then we evaluated DTI-derived indices (fractional anisotropy [FA], mode of anisotropy [MO], mean diffusivity [MD], axial diffusivity [AD] and radial diffusivity [RD]) of brain white matter (WM) between CADASIL patients and healthy subjects through TBSS. RESULTS:Compared with healthy controls, patients with CADASIL showed extensive decreased FA, MO and increased RD, AD, and MD throughout the entire brain (mainly the WM of the temporal poles, inferior and superior longitudinal fasciculus, inferior fronto-occipital fasciculus, corpus callosum, uncinate fasciculus, internal capsule, external capsule, corona radiata, thalamic radiation, and cingulum). Furthermore, these WM microstructural alterations were significantly correlated with cognitive scores and Scheltens scores. Decreased FA values and MO values were positively correlated with Montreal Cognitive Assessment scores in CADASIL patients. Increased AD, RD, and MD values were significantly negatively correlated with Montreal Cognitive Assessment scores. CONCLUSIONS:Widespread WM abnormalities were clearly shown in CADASIL by using TBSS. Severity of microstructural changes correlates significantly with extension of T2 hyperintensity. Moreover, WM microstructural damage and cognitive impairment were significantly correlated. This study indicated that WM tract damage plays an important role in cognitive impairment in CADASIL.

摘要

目的: 伴有皮质下梗死和白质脑病的常染色体显性遗传性脑动脉病 (CADASIL) 是最常见的家族性动脉病,以复发性腔隙性卒中、偏头痛和抑郁症为特征。CADASIL的认知功能障碍机制仍不明确。本研究的目的是使用基于束的空间统计 (TBSS) 来绘制CADASIL患者通过DTI衍生指数揭示的脑微观结构变化的空间分布,以进一步研究CADASIL的潜在神经精神病理学机制。 方法: 12例CADASIL患者和11例年龄、性别匹配的健康对照者在3 t下进行磁共振成像。然后我们通过TBSS评估了CADASIL患者和健康受试者之间脑白质 (WM) 的DTI衍生指数 (各向异性分数 [FA] 、各向异性模式 [MO] 、平均扩散率 [MD] 、轴向扩散率 [AD] 和径向扩散率 [RD])。 结果: 与健康对照组相比,CADASIL患者表现为全脑范围广泛的FA、MO降低和RD、AD、MD增高 (主要是颞极、下和上纵束、下额-枕束、胼胝体、钩突束、内囊、外囊,放射冠,丘脑辐射和扣带回)。此外,这些WM微观结构改变与认知评分和Scheltens评分显著相关。在CADASIL患者中,降低的FA值和MO值与蒙特利尔认知评估评分呈正相关。增加的AD、RD和MD值与蒙特利尔认知评估评分显著负相关。 结论: 使用TBSS在CADASIL中清楚地显示了广泛的WM异常。显微结构改变的严重程度与T2高强度的延长显著相关。此外,WM微观结构损伤与认知功能障碍显著相关。本研究表明,在CADASIL认知功能损害中,WM束损害起重要作用。

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发表时间:2021-02-01
DOI:10.1080/14656566.2020.1814255
作者列表:["Sawada H","Oeda T","Kohsaka M","Tomita S","Umemura A","Park K","Yamamoto K","Kiyohara K"]

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DOI:10.1007/s11033-021-06299-9
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