Tuladhar Anil M, Lawrence Andrew, Norris David G, Barrick Thomas R, Markus Hugh S, de Leeuw Frank-Erik
Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
Centre for Cognitive Neuroimaging, Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
Hum Brain Mapp. 2017 Apr;38(4):1751-1766. doi: 10.1002/hbm.23479. Epub 2016 Dec 9.
Cerebral small vessel disease (SVD) is an important cause of vascular cognitive impairment. Recent studies have demonstrated that structural connectivity of brain networks in SVD is disrupted. However, little is known about the extent and location of the reduced connectivity in SVD. Here they investigate the rich club organisation-a set of highly connected and interconnected regions-and investigate whether there is preferential rich club disruption in SVD. Diffusion tensor imaging (DTI) and cognitive assessment were performed in a discovery sample of SVD patients (n = 115) and healthy control subjects (n = 50). Results were replicated in an independent dataset (49 SVD with confluent WMH cases and 108 SVD controls) with SVD patients having a similar SVD phenotype to that of the discovery cases. Rich club organisation was examined in structural networks derived from DTI followed by deterministic tractography. Structural networks in SVD patients were less dense with lower network strength and efficiency. Reduced connectivity was found in SVD, which was preferentially located in the connectivity between the rich club nodes rather than in the feeder and peripheral connections, a finding confirmed in both datasets. In discovery dataset, lower rich club connectivity was associated with lower scores on psychomotor speed (β = 0.29, P < 0.001) and executive functions (β = 0.20, P = 0.009). These results suggest that SVD is characterized by abnormal connectivity between rich club hubs in SVD and provide evidence that abnormal rich club organisation might contribute to the development of cognitive impairment in SVD. Hum Brain Mapp 38:1751-1766, 2017. © 2017 Wiley Periodicals, Inc.
脑小血管病（SVD）是血管性认知障碍的一个重要原因。最近的研究表明，SVD中脑网络的结构连接性受到破坏。然而，对于SVD中连接性降低的程度和位置知之甚少。在此，他们研究了富俱乐部组织——一组高度连接且相互连接的区域——并调查SVD中是否存在富俱乐部组织的优先破坏。对SVD患者（n = 115）和健康对照者（n = 50）的发现样本进行了扩散张量成像（DTI）和认知评估。结果在一个独立的数据集中得到了重复（49例伴有融合性白质高信号的SVD病例和108例SVD对照），该数据集中的SVD患者具有与发现病例相似的SVD表型。在源自DTI并随后进行确定性纤维束成像的结构网络中检查富俱乐部组织。SVD患者的结构网络密度较低，网络强度和效率也较低。在SVD中发现连接性降低，其优先位于富俱乐部节点之间的连接中，而不是在输入和周边连接中，这一发现在两个数据集中均得到证实。在发现数据集中，较低的富俱乐部连接性与心理运动速度得分较低（β = 0.29，P < 0.001）和执行功能得分较低（β = 0.20，P = 0.009）相关。这些结果表明，SVD的特征是SVD中富俱乐部枢纽之间的连接异常，并提供了证据表明异常的富俱乐部组织可能促成SVD中认知障碍的发展。《人类大脑图谱》38:1751 - 1766，2017年。© 2017威利期刊公司
