非痴呆型脑小血管病患者脑白质完整性和结构网络连通性的变化。
Changes of white matter integrity and structural network connectivity in nondemented cerebral small-vessel disease.
机构信息
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Electrical and Electronic Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, China.
出版信息
J Magn Reson Imaging. 2020 Apr;51(4):1162-1169. doi: 10.1002/jmri.26906. Epub 2019 Aug 26.
BACKGROUND
Previous studies have found widespread impairment of white matter (WM) integrity and disruption of structural network connectivity in cerebral small-vessel disease, but have not evaluated these changes jointly in nondemented patients.
PURPOSE
To jointly investigate the microstructural impairment of WM and the related alterations of structural network topology in nondemented cerebral small-vessel disease (CSVD-ND).
STUDY TYPE
Prospective.
POPULATION
Thirty-seven CSVD-ND patients and 34 elderly controls, who were age-, sex-, and education-matched.
FIELD STRENGTH/SEQUENCE: 3.0T/diffusion tensor imaging (DTI).
ASSESSMENT
Clinical characteristics, lacunar infarct, and white matter hyperintensity (WMH) was assessed. A multiatlas likelihood fusion (MALF) algorithm was used for DTI-based brain segmentation and network node defining. Then the alterations of WM integrity and structural network topology were investigated jointly.
STATISTICAL TESTS
Student's t-test, chi-square test, Mann-Whitney U-test, linear regression, Pearson correlation, and multiple comparison correction.
RESULTS
Decreased fractional anisotropy and increased trace values were observed in predefined structures (P < 0.05, familywise error rate-corrected), including major commissural fibers, projection fibers, and some association fibers. Topologically, both groups showed small-worldness. CSVD-ND patients showed reduced global and local efficiency (P < 0.001). Despite widespread impairment of WM integrity, CSVD-ND patients only showed reduced nodal efficiency in the right superior occipital gyrus and the right lingual gyrus (P < 0.05, familywise error rate-corrected). The nodal local efficiency of the right precuneus was associated with the processing speed after adjusting the effect of lacunar infarct and WMH (r = -0.499, P = 0.038).
DATA CONCLUSION
WM integrity was widely impaired in nondemented CSVD patients but structural network connectivity was relatively preserved. DTI may potentially provide information for the pathophysiology of CSVD in the nondemented phase.
LEVEL OF EVIDENCE
1 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2020;51:1162-1169.
背景
先前的研究发现，脑小血管病患者的白质（WM）完整性广泛受损，结构网络连接中断，但并未在非痴呆患者中联合评估这些变化。
目的
联合研究非痴呆型脑小血管病（CSVD-ND）患者的 WM 微观结构损伤及相关结构网络拓扑变化。
研究类型
前瞻性。
人群
37 名 CSVD-ND 患者和 34 名年龄、性别和教育程度匹配的老年对照者。
磁场强度/序列：3.0T/弥散张量成像（DTI）。
评估
评估临床特征、腔隙性梗死和脑白质高信号（WMH）。采用多图谱似然融合（MALF）算法进行 DTI 脑分割和网络节点定义。然后联合研究 WM 完整性和结构网络拓扑的变化。
统计学检验
学生 t 检验、卡方检验、Mann-Whitney U 检验、线性回归、Pearson 相关和多重比较校正。
结果
在预定义结构中观察到各向异性分数（FA）降低和轨迹值增加（P < 0.05，经校正的家族性错误率），包括主要联合纤维、投射纤维和一些联合纤维。两组均表现出小世界特性。CSVD-ND 患者的全局和局部效率降低（P < 0.001）。尽管 WM 完整性广泛受损，但 CSVD-ND 患者仅在右侧顶枕叶和右侧舌回的节点效率降低（P < 0.05，经校正的家族性错误率）。校正腔隙性梗死和 WMH 影响后，右侧楔前叶的节点局部效率与处理速度相关（r = -0.499，P = 0.038）。
数据结论
非痴呆 CSVD 患者的 WM 完整性广泛受损，但结构网络连接相对保留。DTI 可能为非痴呆期 CSVD 的病理生理学提供信息。
证据水平
1 技术功效：3 级。J. Magn. Reson. Imaging 2020；51：1162-1169.
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