Cheng Zhenyu, Li Meng, Li Jing, Zhang Nan, Che Yena, Chen Yiwen, Liang Pengcheng, Wang Yuanyuan, Wang Na, Zhang Xinyue, Liang Changhu, Guo Lingfei
Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education; Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
College of Medical Imaging, Binzhou Medical University, Yantai, Shandong, China.
Alzheimers Dement. 2025 Aug;21(8):e70553. doi: 10.1002/alz.70553.
Cerebral small vessel disease (CSVD) contributes to cognitive decline, yet the impact of white matter hyperintensity (WMH) distribution and plasma amyloid beta (Aβ) on thalamic subregions remains unclear.
In this prospective study, 175 patients with CSVD and matched controls underwent high-resolution magnetic resonance imaging (MRI), plasma biomarker assessment, and cognitive testing. WMHs were segmented and categorized by spatial patterns. Thalamic subregions were parcellated using the THalamus Optimized Multi-Atlas Segmentation (THOMAS) framework. Mixed-effects models evaluated the longitudinal effects of WMH progression and plasma Aβ on thalamic subregional volumes.
CSVD patients exhibited selective atrophy in left medial geniculate nucleus (MGN), mediodorsal-parafascicular (MD-Pf), and lateral geniculate nucleus (LGN), with volumes associated with processing speed and attentional control. Thalamic and basal ganglia WMH burden significantly predicted subregional atrophy. In CSVD, WMH progression dominated longitudinal thalamic degeneration.
Distinct WMH spatial patterns and vascular factors drive thalamic subregional atrophy in CSVD, contributing to cognitive decline.
Patients with cerebral small vessel disease (CSVD) exhibit selective atrophy in thalamic subregions compared to healthy controls (HCs). Thalamic white matter hyperintensity (WMH) burden strongly predicts mediodorsal-parafascicular and lateral geniculate nucleus atrophy in patients with CSVD. Plasma amyloid beta dynamics differentially influence thalamic integrity in CSVD compared to HCs.
脑小血管病（CSVD）会导致认知功能下降，但白质高信号（WMH）分布和血浆淀粉样蛋白β（Aβ）对丘脑亚区域的影响仍不清楚。
在这项前瞻性研究中，175例CSVD患者及匹配的对照组接受了高分辨率磁共振成像（MRI）、血浆生物标志物评估和认知测试。WMH根据空间模式进行分割和分类。使用丘脑优化多图谱分割（THOMAS）框架对丘脑亚区域进行划分。混合效应模型评估WMH进展和血浆Aβ对丘脑亚区域体积的纵向影响。
CSVD患者左侧内侧膝状体（MGN）、内侧背侧-束旁核（MD-Pf）和外侧膝状体（LGN）出现选择性萎缩，其体积与处理速度和注意力控制有关。丘脑和基底节区的WMH负担显著预测亚区域萎缩。在CSVD中，WMH进展主导了丘脑的纵向退变。
不同的WMH空间模式和血管因素驱动CSVD患者丘脑亚区域萎缩，导致认知功能下降。
与健康对照（HC）相比，脑小血管病（CSVD）患者丘脑亚区域出现选择性萎缩。丘脑白质高信号（WMH）负担强烈预测CSVD患者内侧背侧-束旁核和外侧膝状体萎缩。与HC相比，血浆淀粉样蛋白β动态变化对CSVD患者丘脑完整性的影响不同。
