Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
Department of Biomedical Engineering, Hanyang University, Seoul, Korea.
Brain Behav. 2021 May;11(5):e02112. doi: 10.1002/brb3.2112. Epub 2021 Apr 1.
We evaluated disruption of the white matter (WM) network related with Alzheimer's disease (AD) and Lewy body disease (LBD), which includes Parkinson's disease and dementia with Lewy bodies.
We consecutively recruited 37 controls and 77 patients with AD-related cognitive impairment (ADCI) and/or LBD-related cognitive impairment (LBCI). Diagnoses of ADCI and LBCI were supported by amyloid PET and dopamine transporter PET, respectively. There were 22 patients with ADCI, 19 patients with LBCI, and 36 patients with mixed ADCI/LBCI. We investigated the relationship between ADCI, LBCI, graph theory-based network measures on diffusion tensor images, and cognitive dysfunction using general linear models after controlling for age, sex, education, deep WM hyperintensities (WMH), periventricular WMH, and intracranial volume.
LBCI, especially mixed with ADCI, was associated with increased normalized path length and decreased normalized global efficiency. LBCI was related to the decreased nodal degree of left caudate, which was further associated with broad cognitive dysfunction. Decreased left caudate nodal degree was associated with decreased fractional anisotropy (FA) in the brain regions vulnerable to LBD. Compared with the control group, the LBCI group had an increased betweenness centrality in the occipital nodes, which was associated with decreased FA in the WM adjacent to the striatum and visuospatial dysfunction.
Concomitant ADCI and LBCI are associated with the accentuation of LBCI-related WM network disruption centered in the left caudate nucleus. The increase of occipital betweenness centrality could be a characteristic biologic change associated with visuospatial dysfunction in LBCI.
我们评估了与阿尔茨海默病（AD）和路易体病（LBD）相关的脑白质（WM）网络破坏，LBD 包括帕金森病和路易体痴呆。
我们连续招募了 37 名对照者和 77 名 AD 相关认知障碍（ADCI）和/或 LBD 相关认知障碍（LBCI）患者。ADCI 和 LBCI 的诊断分别得到淀粉样蛋白 PET 和多巴胺转运蛋白 PET 的支持。其中 22 名患者为 ADCI，19 名患者为 LBCI，36 名患者为 ADCI/LBCI 混合患者。我们在控制年龄、性别、教育程度、深部 WM 高信号（WMH）、脑室周围 WMH 和颅内容积后，使用广义线性模型，研究了 ADCI、LBCI、基于图论的弥散张量图像网络测量值与认知功能障碍之间的关系。
LBCI，尤其是与 ADCI 混合，与正常化路径长度增加和正常化全局效率降低有关。LBCI 与左侧尾状核的节点度降低有关，这与广泛的认知功能障碍进一步相关。左侧尾状核的节点度降低与 LBD 易损脑区的分数各向异性（FA）降低有关。与对照组相比，LBCI 组在枕叶节点的介数中心度增加，与纹状体相邻 WM 的 FA 降低和视空间功能障碍有关。
ADCI 和 LBCI 并存与以左侧尾状核为中心的 LBCI 相关 WM 网络破坏加重有关。枕叶节点介数中心度的增加可能是与 LBCI 视空间功能障碍相关的特征性生物学变化。
