Zhou X, You M Z, Wan K, Zhang W, Yin W W, Yu X F, Zhu X Q, Sun Z W
Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
Zhonghua Yi Xue Za Zhi. 2021 Apr 20;101(15):1057-1063. doi: 10.3760/cma.j.cn112137-20200826-02471.
To explore the characteristics of cortical morphology in cerebral small vessel disease (CSVD) patients with subcortical ischemic depression (SID) and its relationship with clinical symptoms. A total of 88 patients with CSVD in the First Affiliated Hospital of Anhui Medical University were enrolled from July 2017 to July 2020. The subjects were divided into CSVD-non depression group (CSVD-ND, =58) and SID group (=30) according to the geriatric depression scale (GDS). The 3D-T MRI images were obtained from all subjects. The computed anatomy toolbox 12 (CAT 12) was used for image processing and cortical segmentation to obtain the cortical thickness (CTh) and surface metrics, including gyrification index (GI), sulcus depth (SD) and fractal dimension (FD). A comparison at the vertex- and region-of-interest (ROI)-wise levels were performed by the general linear model, and correlation analysis were conducted between cortical morphometric measurements and GDS scores. Finally, mean CTh (mCTh) was extracted for binary logistic regression analysis. At the vertex-wise level, compared with the CSVD-ND group, the SID patients showed increased CTh in clusters mainly located in the posterior default mode network (pDMN), such as the precuneus(Pcu), the superior parietal gyrus (SPG) and the right postcentral gyrus (PoCG). As for the surface measurements, the GI value and the FD value were increased in clusters of Pcu and inferior temporal gyrus (ITG), respectively, in the SID group. ROIs analyses showed that apart from the Pcu, the SPG and the right PoCG, CTh alterations in the SID group were involved in a wider range of regions, extending to the right precentral gyrus ((2.27±0.20) cm vs (2.12±0.26) cm, =0.007), the left paracentral gyrus ((2.18±0.20) cm vs (2.05±0.23) cm, =0.008) and so on, than that in the CSVD-ND group.Compared with the CSVD-ND patients, the SID patients showed increased GI in the right PoCG ((25.31±1.11) vs (24.23±1.27), <0.05). Correlation analysis showed that CTh in the right Pcu was positively correlated with the GDS scores (=0.4, <0.05). Further binary logistic regression analysis showed that in comparison with the subjects in the reference group (<2.367 cm), the odds ratio(95%) for SID patients in the highest tertile of mCTh (>2.473 cm) were 6.373 (1.254-32.389) after multivariable adjustment (sex, age, years of education, total intracranial volume, traditional imaging findings of CSVD, cognitive function (CAMCOG-C) and mCTh). Both CTh and cortical complexity were increased in CSVD patients with SID, especially in the clusters of pDMN, and CTh may be an important risk factor for SID.
探讨伴有皮质下缺血性抑郁（SID）的脑小血管病（CSVD）患者的皮质形态特征及其与临床症状的关系。2017年7月至2020年7月，安徽医科大学第一附属医院共纳入88例CSVD患者。根据老年抑郁量表（GDS）将研究对象分为CSVD无抑郁组（CSVD-ND，n = 58）和SID组（n = 30）。对所有研究对象进行三维T1加权磁共振成像（3D-T1 MRI）扫描。采用计算机解剖工具箱12（CAT 12）进行图像处理和皮质分割，以获取皮质厚度（CTh）和表面测量指标，包括脑回指数（GI）、脑沟深度（SD）和分形维数（FD）。采用一般线性模型在顶点水平和感兴趣区域（ROI）水平进行比较，并对皮质形态测量指标与GDS评分进行相关性分析。最后，提取平均CTh（mCTh）进行二元逻辑回归分析。在顶点水平上，与CSVD-ND组相比，SID患者主要位于后默认模式网络（pDMN）的簇中CTh增加，如楔前叶（Pcu）、顶上叶（SPG）和右侧中央后回（PoCG）。在表面测量方面，SID组Pcu和颞下回（ITG）簇中的GI值和FD值分别增加。ROI分析显示，除Pcu、SPG和右侧PoCG外，SID组CTh改变涉及更广泛的区域，延伸至右侧中央前回（（2.27±0.20）cm vs（2.12±0.26）cm，P = 0.
