Li Wen-Xin, Yuan Jing, Han Fei, Zhou Li-Xin, Ni Jun, Yao Ming, Zhang Shu-Yang, Jin Zheng-Yu, Cui Li-Ying, Zhai Fei-Fei, Zhu Yi-Cheng
Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
Department of Cardiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
Front Aging Neurosci. 2023 Mar 14;15:1065245. doi: 10.3389/fnagi.2023.1065245. eCollection 2023.
Further studies are needed to improve the understanding of the pathological process underlying cognitive impairments. The purpose of this study is to investigate the global and topographic changes of white matter integrity and cortical structure related to cognitive impairments in a community-based population.
A cross-sectional analysis was performed based on 995 subjects (aged 56.8 ± 9.1 years, 34.8% males) from the Shunyi study, a community-dwelling cohort. Cognitive status was accessed by a series of neurocognitive tests including Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), category Verbal Fluency Test (VFT), Digit Span Test (DST), and Trail Making Tests A and B (TMT-A and TMT-B). Structural and diffusional MRI data were acquired. White matter integrity was assessed using fractional anisotropy (FA), mean diffusivity (MD), and peak width of skeletonized mean diffusivity (PSMD). Cortical surface area, thickness, and volume were measured using Freesurfer. Probabilistic tractography was further conducted to track the white matter fibers connecting to the cortical regions related to cognition. General linear models were used to investigate the association between brain structure and cognition.
Global mean FA and MD were significantly associated with performances in VFT (FA, β 0.119, < 0.001; MD, β -0.128, < 0.001). Global cortical surface area, thickness, and volume were not related to cognitive scores. In tract-based spatial statistics analysis, disruptive white matter integrity was related to cognition impairment, mainly in visuomotor processing speed, semantic memory, and executive function (TMT-A and VFT), rather than verbal short-term memory and working memory (DST). In the whole brain vertex-wise analysis, surface area in the left orbitofrontal cortex, right posterior-dorsal part of the cingulate gyrus, and left central sulcus were positively associated with MMSE and MoCA scores, and the association were independent of the connecting white matter tract.
Disrupted white matter integrity and regional cortical surface area were related to cognition in community-dwelling populations. The associations of cortical surface area and cognition were independent of the connecting white matter tract.
需要进一步开展研究以增进对认知障碍潜在病理过程的理解。本研究旨在调查社区人群中与认知障碍相关的白质完整性和皮质结构的整体及局部变化。
基于来自顺义研究（一个社区居住队列）的995名受试者（年龄56.8±9.1岁，男性占34.8%）进行横断面分析。通过一系列神经认知测试评估认知状态，包括简易精神状态检查表（MMSE）、蒙特利尔认知评估量表（MoCA）、分类语言流畅性测试（VFT）、数字广度测试（DST）以及连线测验A和B（TMT - A和TMT - B）。采集结构和扩散磁共振成像（MRI）数据。使用分数各向异性（FA）、平均扩散率（MD）和骨架化平均扩散率峰值宽度（PSMD）评估白质完整性。使用Freesurfer测量皮质表面积、厚度和体积。进一步进行概率纤维束成像以追踪连接与认知相关皮质区域的白质纤维。采用一般线性模型研究脑结构与认知之间的关联。
整体平均FA和MD与VFT表现显著相关（FA，β 0.119，<0.001；MD，β -0.128，<0.001）。整体皮质表面积、厚度和体积与认知得分无关。在基于纤维束的空间统计学分析中，白质完整性破坏与认知障碍相关，主要涉及视运动处理速度、语义记忆和执行功能（TMT - A和VFT），而非言语短期记忆和工作记忆（DST）。在全脑逐点分析中，左侧眶额皮质、右侧扣带回后背部和左侧中央沟的表面积与MMSE和MoCA得分呈正相关，且这种关联独立于连接的白质束。
在社区居住人群中，白质完整性破坏和局部皮质表面积与认知相关。皮质表面积与认知的关联独立于连接的白质束。
