Hu Wentao, Wang Yao, Xie Zhenhui, Liu Mianxin, Han Xu, Hu Ying, Wang Xingrui, Dai Yongming, Xu Qun, Zhou Yan
Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Shanghai Artificial Intelligence Laboratory, Shanghai, China.
CNS Neurosci Ther. 2024 Dec;30(12):e70162. doi: 10.1111/cns.70162.
Cerebral small vessel disease (CSVD) is highly prevalent in elder individuals, and its variable cognitive outcomes indicate some cognitive reserve mechanisms. Contribution from functional network features is still unclear. Here we explore how functional segregation-integration preference influences the cognitive changes against CSVD.
A total of, 271 CSVD patients were included, all underwent MRI scans including routine and resting-state functional MRI (rs-fMRI). Hierarchical balance index (H) was obtained from the rs-fMRI connectivity using eigenmode-based approach. Individuals were classified into segregated and integrated groups according to negative and positive H. A composite CSVD lesion score was calculated from imaging findings. Global and five specific cognitive functions were assessed.
Hierarchical regression analysis revealed negative contribution from lesion load to global and all cognitive domains (β = -0.22-0.35, ∆R = 0.0460.112, all p < 0.001). Inclusion of H did not show significant contribution (all p > 0.05), but interaction between H and lesion score was significantly associated with global (β = -0.27, ∆R = 0.013, p = 0.034) and execution score (β = -0.34, ∆R = 0.023, p = 0.002). Integrated patients show significant better global cognitive (23.9 ± 3.9 vs. 25.5 ± 3.1, p = 0.044) and executive ability (0.235 ± 0.678 vs. 0.535 ± 0.688, p = 0.049) at mild damage stage, visuospatial (-0.001 ± 0.804 vs. 0.379 ± 0.249, p = 0.034) and language ability (-0.133 ± 0.849 vs. 0.218 ± 0.704, p = 0.037) at moderate damage stage. Cross-overs of cognitive scores were observed. Significant better execution (-0.277 ± 0.717 vs. -0.675 ± 0.883, p = 0.027) was found in severe damage stage for segregated patients.
Thus, we concluded that integrated network contributes to cognitive resilience in mild and moderate but not in severe damage stages.
脑小血管病（CSVD）在老年人中高度流行，其多样的认知结果提示了一些认知储备机制。功能网络特征的作用仍不清楚。在此，我们探讨功能分离-整合偏好如何影响针对CSVD的认知变化。
共纳入271例CSVD患者，均接受了包括常规和静息态功能磁共振成像（rs-fMRI）的MRI扫描。使用基于本征模式的方法从rs-fMRI连通性中获得分层平衡指数（H）。根据H的正负将个体分为分离组和整合组。根据影像学结果计算综合CSVD病变评分。评估整体和五项特定认知功能。
分层回归分析显示病变负荷对整体和所有认知领域有负向影响（β = -0.22-0.35，∆R = 0.0460.112，均p < 0.001）。纳入H未显示出显著影响（均p > 0.05），但H与病变评分之间的交互作用与整体（β = -0.27，∆R = 0.013，p = 0.034）和执行评分（β = -0.34，∆R = 0.023，p = 0.002）显著相关。在轻度损伤阶段，整合组患者的整体认知（23.9 ± 3.9 vs. 25.5 ± 3.1，p = 0.044）和执行能力（0.235 ± 0.678 vs. 0.535 ± 0.688，p = 0.049）显著更好；在中度损伤阶段，视觉空间能力（-0.001 ± 0.804 vs. 0.379 ± 0.249，p = 0.034）和语言能力（-0.133 ± 0.849 vs. 0.218 ± 0.704，p = 0.037）显著更好。观察到认知评分的交叉情况。在重度损伤阶段，分离组患者的执行能力显著更好（-0.277 ± 0.717 vs. -0.675 ± 0.883，p = 0.027）。
因此，我们得出结论，整合网络在轻度和中度损伤阶段有助于认知恢复，但在重度损伤阶段则不然。
