Li Yingying, Liu Xin, Jia Xuejia, Li Haoyuan, Jia Xiuqin, Yang Qi
Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, No.8 Gongti South Road, Chaoyang District, Beijing 100020, China.
Key Lab of Medical Engineering for Cardiovascular Disease, Ministry of Education, Beijing 100020, China.
Cereb Cortex. 2023 Apr 25;33(9):5484-5492. doi: 10.1093/cercor/bhac435.
Cerebral small vessel disease (CSVD) is one of the most important causes of stroke and dementia. Although increasing studies have reported alterations of brain structural or neuronal functional activity exhibited in patients with CSVD, it is still unclear which alterations are reliable. Here, we performed a meta-analysis to establish which brain structural or neuronal functional activity changes in those studies were consistent. Activation likelihood estimation revealed that changes in neuronal functional activity in the left angular gyrus, bilateral anterior cingulate cortex/left medial prefrontal cortex, right rolandic operculum, and alterations of gray structure in the left insular cortex/superior temporal gyrus/claustrum were reliable in sporadic CSVD. Decreased neuronal functional activity in the caudate head, anterior cingulate cortex, and reduced gray matter volume in the insular cortex/superior temporal gyrus/claustrum were associated with CSVD-related cognitive impairment. Furthermore, unlike sporadic CSVD, the reliable alterations of neuronal functional activity in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy were concentrated in the left parahippocampal gyrus. The current study presents stable brain structural and neuronal functional abnormalities within the brain, which can help further understand the pathogenesis of CSVD and CSVD-cognitive impairment and provide an index to evaluate the effectiveness of treatment protocols.
• Default mode network and salience network are reliable networks affected in sporadic CSVD in resting-state.• Altered corticostriatal circuitry is associated with cognitive decline.• Decreased gray matter volume in the insular cortex is stable "remote effects" of sporadic CSVD.• The parahippocampal gyrus may be a reliable affected brain region in CADASIL.
脑小血管病(CSVD)是中风和痴呆的最重要病因之一。尽管越来越多的研究报告了CSVD患者大脑结构或神经元功能活动的改变,但仍不清楚哪些改变是可靠的。在此,我们进行了一项荟萃分析,以确定这些研究中哪些大脑结构或神经元功能活动变化是一致的。激活可能性估计显示,在散发性CSVD中,左侧角回、双侧前扣带回皮质/左侧内侧前额叶皮质、右侧中央沟盖的神经元功能活动变化以及左侧岛叶皮质/颞上回/屏状核的灰质结构改变是可靠的。尾状核头部、前扣带回皮质的神经元功能活动降低以及岛叶皮质/颞上回/屏状核的灰质体积减少与CSVD相关的认知障碍有关。此外,与散发性CSVD不同,伴有皮质下梗死和白质脑病的常染色体显性遗传性脑动脉病中神经元功能活动的可靠改变集中在左侧海马旁回。本研究揭示了大脑内稳定的脑结构和神经元功能异常,这有助于进一步了解CSVD和CSVD相关认知障碍的发病机制,并为评估治疗方案的有效性提供指标。
• 默认模式网络和突显网络是静息状态下散发性CSVD中受影响的可靠网络。• 皮质纹状体回路改变与认知衰退相关。• 岛叶皮质灰质体积减少是散发性CSVD稳定的“远隔效应”。• 海马旁回可能是伴皮质下梗死和白质脑病的常染色体显性遗传性脑动脉病中一个可靠的受累脑区。