Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA.
Department of Radiology, Imaging Institute, Cleveland Clinic, 9500 Euclid Ave, Mail code L10-428, Cleveland, OH, 44195, USA.
Neuroradiology. 2021 Jun;63(6):913-924. doi: 10.1007/s00234-020-02614-6. Epub 2021 Jan 6.
Hypertension is a risk factor for cognitive impairment; however, the mechanisms leading to cognitive changes remain unclear. In this cross-sectional study, we evaluate the impact of white matter lesion (WML) burden on brain functional connectivity (FC) and cognition in a large cohort of hypertensive patients from the Systolic Blood Pressure Intervention Trial (SPRINT) at baseline.
Functional networks were identified from baseline resting state functional MRI scans of 660 SPRINT participants using independent component analysis. WML volumes were calculated from structural MRI. Correlation analyses were carried out between mean FC of each functional network and global WML as well as WML within atlas-defined white matter regions. For networks of interest, voxel-wise-adjusted correlation analyses between FC and regional WML volume were performed. Multiple variable linear regression models were built for cognitive test performance as a function of network FC, followed by mediation analysis.
Mean FC of the default mode network (DMN) was negatively correlated with global WML volume, and regional WML volume within the precuneus. Voxel-wise correlation analyses revealed that regional WML was negatively correlated with FC of the DMN's left lateral temporal region. FC in this region of the DMN was positively correlated to performance on the Montreal Cognitive Assessment and demonstrated significant mediation effects. Additional networks also demonstrated global and regional WML correlations; however, they did not demonstrate an association with cognition.
In hypertensive patients, greater WML volume is associated with lower FC of the DMN, which in turn is related to poorer cognitive test performance.
NCT01206062.
高血压是认知障碍的一个危险因素；然而，导致认知变化的机制仍不清楚。在这项横断面研究中，我们评估了在来自 SPRINT（收缩压干预试验）的 660 名高血压患者的基线期，白质病变（WML）负荷对大脑功能连接（FC）和认知的影响。
使用独立成分分析从 660 名 SPRINT 参与者的基线期静息状态功能磁共振成像扫描中识别功能网络。从结构磁共振成像中计算 WML 体积。对每个功能网络的平均 FC 与全局 WML 以及基于图谱定义的白质区域内的 WML 进行相关性分析。对于感兴趣的网络，对 FC 与局部 WML 体积之间的体素级调整相关性进行分析。作为功能网络 FC 的函数，为认知测试表现构建了多个变量线性回归模型，然后进行中介分析。
默认模式网络（DMN）的平均 FC 与全局 WML 体积呈负相关，与后扣带回内的局部 WML 体积呈负相关。体素级相关性分析显示，局部 WML 与 DMN 的左侧颞叶区域的 FC 呈负相关。DMN 这一区域的 FC 与蒙特利尔认知评估的表现呈正相关，并显示出显著的中介效应。其他网络也显示了全局和局部 WML 相关性；然而，它们与认知没有关联。
在高血压患者中，较大的 WML 体积与 DMN 的 FC 降低相关，而 DMN 的 FC 降低与较差的认知测试表现相关。
NCT01206062。
