Cheng Hongjiang, Teng Junfang, Jia Longbin, Xu Lina, Yang Fengbing, Li Huimin, Ling Chen, Liu Wei, Li Jinna, Li Yujuan, Guo Zixuan, Geng Xia, Guo Jiaying, Zhang Dandan
Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Department of Neurology, Jincheng People's Hospital, Jincheng, Shanxi, China.
Front Neurol. 2023 Jun 15;14:1198402. doi: 10.3389/fneur.2023.1198402. eCollection 2023.
Brain atrophy represents a final common pathway for pathological processes in patients with cerebral small vessel disease (CSVD) and is now recognized as a strong independent predictor of clinical status and progression. The mechanism underlying brain atrophy in patients with CSVD is not yet fully comprehended. This study aims to investigate the association of morphologic features of intracranial distal arteries (A2, M2, P2 and more distal) with different brain structures [gray matter volume (GMV), white matter volume (WMV), and cerebrospinal fluid volume (CSFV)]. Furthermore, we also examined whether a correlation existed between these cerebrovascular characteristics and GMV in different brain regions.
A total of 39 participants were eventually enrolled. The morphologic features of intracranial distal arteries based on TOF-MRA were extracted and quantified using the intracranial artery feature extraction technique (iCafe). The brain 3D-T1 images were segmented into gray matter (GM), white matter (WM), and cerebrospinal fluid (CSF) using the "Segment" tool in CAT12 for the voxel-based morphometry (VBM) analysis. Univariable and multivariable linear regression models were used to investigate the relationship between these cerebrovascular features and different brain structures. Partial correlation analysis with a one-tailed method was used to evaluate the relationship between these cerebrovascular features and GMV in different brain regions.
Our findings indicate that both distal artery length and density were positively correlated with GM fraction in CSVD patients, regardless of whether univariable or multivariable linear regression analyses were performed. In addition, distal artery length ( = -0.428, = 0.007) and density ( = -0.337, = 0.036) were also found to be negative associated with CSF fraction, although this relationship disappeared after adjusting for potential confounders. Additional adjustment for the effect of WMHs volume did not change these results. In subgroup anasysis, we found that participants in the highest distal artery length tertile had significantly higher GM fraction and lower CSF fraction level than participants in the lowest distal artery length tertile. In partial correlation analysis, we also found that these cerebrovascular characteristics associated with regional GMV, especially subcortical nuclear.
The morphologic features of intracranial distal arteries, including artery length, density and average tortuosity, measured from 3D-TOF MRA, are associated with generalized or focal atrophy indexes of CSVD.
脑萎缩是脑小血管病（CSVD）患者病理过程的最终共同通路，目前被认为是临床状态和病情进展的强有力独立预测因素。CSVD患者脑萎缩的潜在机制尚未完全明了。本研究旨在探讨颅内远端动脉（A2、M2、P2及更远端）的形态学特征与不同脑结构[灰质体积（GMV）、白质体积（WMV）和脑脊液体积（CSFV）]之间的关联。此外，我们还研究了这些脑血管特征与不同脑区GMV之间是否存在相关性。
最终纳入39名参与者。基于TOF-MRA的颅内远端动脉形态学特征采用颅内动脉特征提取技术（iCafe）进行提取和量化。使用CAT12中的“分割”工具将脑3D-T1图像分割为灰质（GM）、白质（WM）和脑脊液（CSF），用于基于体素的形态学测量（VBM）分析。采用单变量和多变量线性回归模型研究这些脑血管特征与不同脑结构之间的关系。采用单尾方法的偏相关分析评估这些脑血管特征与不同脑区GMV之间的关系。
我们的研究结果表明，无论进行单变量还是多变量线性回归分析，CSVD患者的远端动脉长度和密度均与GM分数呈正相关。此外，还发现远端动脉长度（r = -0.428，P = 0.007）和密度（r = -0.337，P = 0.036）与CSF分数呈负相关，尽管在调整潜在混杂因素后这种关系消失。对WMHs体积效应进行额外调整并未改变这些结果。在亚组分析中，我们发现远端动脉长度最高三分位数的参与者的GM分数显著高于最低三分位数的参与者，CSF分数水平则显著低于后者。在偏相关分析中，我们还发现这些脑血管特征与区域GMV相关，尤其是皮质下核团。
从3D-TOF MRA测量的颅内远端动脉形态学特征，包括动脉长度、密度和平均迂曲度，与CSVD的全身性或局灶性萎缩指标相关。
