Cao Zhiyu, Mai Yingren, Fang Wenli, Lei Ming, Luo Yishan, Zhao Lei, Liao Wang, Yu Qun, Xu Jiaxin, Ruan Yuting, Xiao Songhua, Mok Vincent C T, Shi Lin, Liu Jun
Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
BrainNow Research Institute, Shenzhen, China.
Front Hum Neurosci. 2022 Jun 14;16:760360. doi: 10.3389/fnhum.2022.760360. eCollection 2022.
White matter hyperintensities (WMHs) and regional brain lobe atrophy coexist in the brain of patients with Alzheimer's disease (AD), but the association between them in patients with AD still lacks comprehensive investigation and solid imaging data support.
We explored whether WMHs can promote the pathological process of AD by aggravating atrophy in specific brain regions and tried to explain the regional specificity of these relationships.
A sample of 240 adults including 180 normal controls (NCs) and 80 cases with AD were drawn from the ADNI database. T1-weighted magnetic resonance imaging (MRI) and T2-weighted fluid-attenuated MRI of the participants were downloaded and were analyzed using AccuBrain to generate the quantitative ratio of WMHs (WMHr, WMH volumes corrected by intracranial volume) and regional brain atrophy. We also divided WMHr into periventricular WMHr (PVWMHr) and deep WMHr (DWMHr) for the purpose of this study. The Cholinergic Pathways Hyperintensities Scale (CHIPS) scores were conducted by two evaluators. Independent -test, Mann-Whitney test, or χ test were used to compare the demographic characteristics, and Spearman correlation coefficient values were used to determine the association between WMHs and different regions of brain atrophy.
Positive association between WMHr and quantitative medial temporal lobe atrophy (QMTA) ( = 0.281, = 0.011), temporal lobe atrophy ( = 0.285, = 0.011), and insular atrophy ( = 0.406, < 0.001) was found in the AD group before Bonferroni correction. PVWMHr contributed to these correlations. By separately analyzing the relationship between PVWMHr and brain atrophy, we found that there were still positive correlations after correction in QMTA ( = 0.325, = 0.003), temporal lobe atrophy ( = 0.298, = 0.007), and insular atrophy ( = 0.429, < 0.001) in AD group.
WMH severity tends to be associated with regional brain atrophy in patients with AD, especially with medial temporal lobe, temporal lobe, and insular lobe atrophy. PVWMHs were devoted to these correlations.
白质高信号（WMHs）与区域脑叶萎缩在阿尔茨海默病（AD）患者脑中并存，但二者在AD患者中的关联仍缺乏全面研究及可靠的影像学数据支持。
我们探讨WMHs是否会通过加重特定脑区萎缩来促进AD的病理进程，并试图解释这些关系的区域特异性。
从ADNI数据库中抽取240名成年人样本，包括180名正常对照（NCs）和80例AD患者。下载参与者的T1加权磁共振成像（MRI）和T2加权液体衰减反转恢复序列（FLAIR）MRI，并使用AccuBrain进行分析，以生成WMHs的定量比率（WMHr，WMH体积经颅内体积校正）和区域脑萎缩情况。为本研究目的，我们还将WMHr分为脑室周围WMHr（PVWMHr）和深部WMHr（DWMHr）。由两名评估者进行胆碱能通路高信号量表（CHIPS）评分。采用独立样本t检验、曼-惠特尼U检验或χ²检验比较人口统计学特征，使用斯皮尔曼相关系数值确定WMHs与不同脑区萎缩之间的关联。
在进行Bonferroni校正前，AD组中发现WMHr与内侧颞叶定量萎缩（QMTA）（r = 0.281，P = 0.011）、颞叶萎缩（r = 表 0.285，P = 0.011）和岛叶萎缩（r = 0.406，P < 0.001）呈正相关。PVWMHr促成了这些相关性。通过分别分析PVWMHr与脑萎缩之间的关系，我们发现在AD组中，校正后QMTA（r = 0.325，P = 0.003）、颞叶萎缩（r = 0.298，P = 0.007）和岛叶萎缩（r = 0.429，P < 0.001）仍呈正相关。
AD患者的WMH严重程度往往与区域脑萎缩相关，尤其是与内侧颞叶、颞叶和岛叶萎缩相关。PVWMHs促成了这些相关性。
