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小血管疾病导致的白质网络损伤及其对认知功能的影响。

Damage to white matter networks resulting from small vessel disease and the effects on cognitive function.

作者信息

Busby Natalie, Wilmskoetter Janina, Newman-Norlund Roger, Newman-Norlund Sarah, Sayers Sara, Wilson Sarah C, Riccardi Nicholas, Teghipco Alex, Roth Rebecca W, Bakos Lumi, Rorden Chris, Fridriksson Julius, Bonilha Leonardo

机构信息

Department of Communication Sciences and Disorders, University of South Carolina, 915 Green Street, Columbia, SC, 29209, USA.

Department of Rehabilitation Sciences, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA.

出版信息

Sci Rep. 2025 Jul 30;15(1):27736. doi: 10.1038/s41598-025-13813-7.

Abstract

White matter hyperintensities (WMHs) are prevalent in older age and are associated with cognitive decline. The location and extent of WMHs likely influences the relationship with behavior. Identifying which tracts are more likely impacted by WMHs might enable better understanding of which behaviors are affected. Therefore, this study aimed to i) identify which white matter tracts are most affected by WMHs, and ii) identify tracts where the presence of WMHs is associated with poorer cognitive scores. Participants (N = 212, 20-80 years) completed the Montreal Cognitive Assessment (MoCA). WMHs were manually delineated on FLAIR scans. In DSIStudio, we used the Human Connectome Project 1065FIB template to track how many fibers of each white matter tract intersected each participant's WMH map. Values obtained represent disconnection associated with WMHs. These scores were correlated with age, MoCA total and memory index scores. There was significantly more disconnection with older age in the right arcuate fasciculus, extreme capsule, frontal aslant tract, bilateral inferior, middle and superior longitudinal fasciculi, and the corpus callosum. Disconnection associated with WMHs in the right superior longitudinal fasciculus was significantly associated with a lower MoCA scores. Finally, disconnection in the right extreme capsule, middle and superior longitudinal fascicli, and bilateral frontal aslant tracts were significantly associated with lower MoCA memory index scores. This study highlights the prevalence of WMHs across the lifespan and demonstrates a clear relationship between tract-specific WMHs and cognition. Age-related white-matter degeneration was pronounced in many association fibers, particularly in the right hemisphere. These data suggest age related disruption of specific white matter tracts represents a clear and present risk factor for global cognition and memory as we age.

摘要

脑白质高信号(WMHs)在老年人中普遍存在,且与认知衰退相关。WMHs的位置和范围可能会影响其与行为的关系。确定哪些神经束更易受WMHs影响,可能有助于更好地理解哪些行为会受到影响。因此,本研究旨在:i)确定哪些白质神经束受WMHs影响最大;ii)确定WMHs的存在与较差认知评分相关的神经束。参与者(N = 212,年龄20 - 80岁)完成了蒙特利尔认知评估(MoCA)。在液体衰减反转恢复(FLAIR)扫描上手动勾勒出WMHs。在DSIStudio中,我们使用人类连接组计划1065FIB模板来追踪每个白质神经束的多少纤维与每个参与者的WMH图谱相交。获得的值代表与WMHs相关的连接中断。这些分数与年龄、MoCA总分及记忆指数分数相关。在右侧弓状束、极端囊、额斜束、双侧下、中、上纵束以及胼胝体中,与老年相关的连接中断明显更多。右侧上纵束中与WMHs相关的连接中断与较低的MoCA分数显著相关。最后,右侧极端囊、中纵束和上纵束以及双侧额斜束中的连接中断与较低的MoCA记忆指数分数显著相关。本研究强调了WMHs在整个生命周期中的普遍性,并证明了特定神经束的WMHs与认知之间存在明确的关系。与年龄相关的白质变性在许多联合纤维中很明显,尤其是在右半球。这些数据表明,随着年龄增长,特定白质神经束的破坏是全球认知和记忆的一个明显且存在的风险因素。

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