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Santillo AF, Strandberg TO, Reislev NH, Nilsson M, Stomrud E, Spotorno N, van Westen D, Hansson O. Divergent functional connectivity changes associated with white matter hyperintensities. Neuroimage 2024; 296:120672. [PMID: 38851551 DOI: 10.1016/j.neuroimage.2024.120672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 05/17/2024] [Accepted: 06/06/2024] [Indexed: 06/10/2024] Open
Abstract
Age-related white matter hyperintensities are a common feature and are known to be negatively associated with structural integrity, functional connectivity, and cognitive performance. However, this has yet to be fully understood mechanistically. We analyzed multiple MRI modalities acquired in 465 non-demented individuals from the Swedish BioFINDER study including 334 cognitively normal and 131 participants with mild cognitive impairment. White matter hyperintensities were automatically quantified using fluid-attenuated inversion recovery MRI and parameters from diffusion tensor imaging were estimated in major white matter fibre tracts. We calculated fMRI resting state-derived functional connectivity within and between predefined cortical regions structurally linked by the white matter tracts. How change in functional connectivity is affected by white matter lesions and related to cognition (in the form of executive function and processing speed) was explored. We examined the functional changes using a measure of sample entropy. As expected hyperintensities were associated with disrupted structural white matter integrity and were linked to reduced functional interregional lobar connectivity, which was related to decreased processing speed and executive function. Simultaneously, hyperintensities were also associated with increased intraregional functional connectivity, but only within the frontal lobe. This phenomenon was also associated with reduced cognitive performance. The increased connectivity was linked to increased entropy (reduced predictability and increased complexity) of the involved voxels' blood oxygenation level-dependent signal. Our findings expand our previous understanding of the impact of white matter hyperintensities on cognition by indicating novel mechanisms that may be important beyond this particular type of brain lesions.
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Affiliation(s)
- Alexander F Santillo
- Department of Clinical Sciences, Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund/Malmö, Sweden. Postal address: Memory Clinic, Skåne University Hospital, SE-20502 Malmö, Sweden
| | - Tor O Strandberg
- Department of Clinical Sciences, Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund/Malmö, Sweden. Postal address: Memory Clinic, Skåne University Hospital, SE-20502 Malmö, Sweden
| | - Nina H Reislev
- Department of Clinical Sciences, Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund/Malmö, Sweden. Postal address: Memory Clinic, Skåne University Hospital, SE-20502 Malmö, Sweden; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Markus Nilsson
- Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Diagnostic Radiology, Lund. Diagnostic Radiology, Lunds Universitet/SUS/Lund, 221 85 Lund, Sweden, Sweden
| | - Erik Stomrud
- Department of Clinical Sciences, Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund/Malmö, Sweden. Postal address: Memory Clinic, Skåne University Hospital, SE-20502 Malmö, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Nicola Spotorno
- Department of Clinical Sciences, Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund/Malmö, Sweden. Postal address: Memory Clinic, Skåne University Hospital, SE-20502 Malmö, Sweden
| | - Danielle van Westen
- Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Diagnostic Radiology, Lund. Diagnostic Radiology, Lunds Universitet/SUS/Lund, 221 85 Lund, Sweden, Sweden
| | - Oskar Hansson
- Department of Clinical Sciences, Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund/Malmö, Sweden. Postal address: Memory Clinic, Skåne University Hospital, SE-20502 Malmö, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden.
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Malla S, Bryant AG, Jayakumar R, Woost B, Wolf N, Li A, Das S, van Veluw SJ, Bennett RE. Molecular profiling of frontal and occipital subcortical white matter hyperintensities in Alzheimer's disease. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.13.598845. [PMID: 38915516 PMCID: PMC11195168 DOI: 10.1101/2024.06.13.598845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
White matter hyperintensities (WMHs) are commonly detected on T2-weighted magnetic resonance imaging (MRI) scans, occurring in both typical aging and Alzheimer's disease. Despite their frequent appearance and their association with cognitive decline, the molecular factors contributing to WMHs remain unclear. In this study, we investigated the transcriptomic profiles of two commonly affected brain regions with coincident AD pathology-frontal subcortical white matter (frontal-WM) and occipital subcortical white matter (occipital-WM)-and compared with age-matched healthy controls. Through RNA-sequencing in frontal- and occipital-WM bulk tissues, we identified an upregulation of genes associated with brain vasculature function in AD white matter. To further elucidate vasculature-specific transcriptomic features, we performed RNA-seq analysis on blood vessels isolated from these white matter regions, which revealed an upregulation of genes related to protein folding pathways. Finally, comparing gene expression profiles between AD individuals with high- versus low-WMH burden showed an increased expression of pathways associated with immune function. Taken together, our study characterizes the diverse molecular profiles of white matter changes in AD compared to normal aging and provides new mechanistic insights processes underlying AD-related WMHs.
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Affiliation(s)
- Sulochan Malla
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Annie G Bryant
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
- School of Physics, The University of Sydney, Sydney, Australia
| | - Rojashree Jayakumar
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Benjamin Woost
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Nina Wolf
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Andrew Li
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Sudeshna Das
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Susanne J van Veluw
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Rachel E Bennett
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
- Harvard Medical School, Boston, MA, USA
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Xiao Y, Gui Y, Dai J, Zhao H, Rao Z, Luo D, Deng X, Xiao X. Mediation of White Matter Alterations in the Association Between Ventricular Dilation and Cognitive Decline in Hydrocephalus Patients: An MRI Study. J Magn Reson Imaging 2024. [PMID: 38767272 DOI: 10.1002/jmri.29452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 05/02/2024] [Accepted: 05/02/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Cognitive impairment is commonly observed in hydrocephalus patients. Ventricular enlargement compresses brain parenchyma, especially the white matter (WM). PURPOSE To investigate whether the relationship between ventricular dilation and cognitive decline in hydrocephalus patients is mediated by WM alterations. STUDY TYPE Retrospective. POPULATION 51 communicating hydrocephalus patients (median age, 54 years), 50 obstructive hydrocephalus patients (median age, 49 years), and 53 control subjects (median age, 50 years). FIELD STRENGTH/SEQUENCE Diffusion tensors imaging, 3D T1 BRAVO, 3D FIESTA, CUBE T2, and FLAIR sequences at 3T. ASSESSMENT DTI parameters (skeletonized fractional anisotropy (FA), skeletonized mean diffusivity (MD), and peak width of skeletonized mean diffusivity p(PSMD)) were extracted using FSL software. Global, periventricular, and deep white matter hyperintensity (WMH) volumes, degree of ventricular enlargement (Evans index), and other conventional imaging markers (number of lacunes and perivascular spaces, intracranial and brain volume) were extracted using united imaging intelligence. Cognitive tests included Montreal cognitive assessment (MoCA), clock drawing test (CDT), and vocabulary fluency test (VFT). STATISTICAL TESTS Multivariable linear regression analysis, mediation analyses, and dominance analysis. P-value <0.05 was considered significant. RESULTS The degree of ventricular dilation, DTI parameters, and cognitive function scores were interrelated. The skeletonized FA values (β = -0.0917, 95% confidence interval (CI): -0.205, -0.024) and normalized global WMH volume (β = -0.0635, 95% CI: -0.13, -0.0005) together mediated 37.2% of the association between Evans index and MoCA. A comparable causal pathway was found for periventricular WMHs but not for deep WMHs. Dominance analysis indicated skeletonized FA values had a greater impact on cognition than WMH volume. The skeletonized FA values also mediated the association between Evans index and CDT (β = -0.0897, 95% CI: -0.165, -0.026) and VFT (β = -0.1589, 95% CI: -0.27, -0.083). CONCLUSION WM alterations were causal mediators between ventricular dilation and cognitive decline in hydrocephalus patients. EVIDENCE LEVEL 3. TECHNICAL EFFICACY Stage 3.
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Affiliation(s)
- Yawen Xiao
- Department of Radiology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Yifei Gui
- Department of Radiology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Jiankun Dai
- GE Healthcare, MR Research China, Beijing, China
| | - Heng Zhao
- Department of Radiology, First Affiliated Hospital of University of South China, Hengyang, China
| | - Zhongliang Rao
- Department of Radiology, The Third Hospital of Nanchang, Nanchang, China
| | - Dan Luo
- Department of Radiology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Xinru Deng
- Department of Radiology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Xinlan Xiao
- Department of Radiology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
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DeJong NR, Jansen JFA, van Boxtel MPJ, Schram MT, Stehouwer CDA, van Greevenbroek MMJ, van der Kallen CJH, Koster A, Eussen SJPM, de Galan BE, Backes WH, Köhler S. Brain structure and connectivity mediate the association between lifestyle and cognition: The Maastricht Study. Brain Commun 2024; 6:fcae171. [PMID: 38846531 PMCID: PMC11154141 DOI: 10.1093/braincomms/fcae171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 03/12/2024] [Accepted: 05/15/2024] [Indexed: 06/09/2024] Open
Abstract
Life-course exposure to risk and protective factors impacts brain macro- and micro-structure, which in turn affects cognition. The concept of brain-age gap assesses brain health by comparing an individual's neuroimaging-based predicted age with their calendar age. A higher BAG implies accelerated brain ageing and is expected to be associated with worse cognition. In this study, we comprehensively modelled mutual associations between brain health and lifestyle factors, brain age and cognition in a large, middle-aged population. For this study, cognitive test scores, lifestyle and 3T MRI data for n = 4881 participants [mean age (± SD) = 59.2 (±8.6), 50.1% male] were available from The Maastricht Study, a population-based cohort study with extensive phenotyping. Whole-brain volumes (grey matter, cerebrospinal fluid and white matter hyperintensity), cerebral microbleeds and structural white matter connectivity were calculated. Lifestyle factors were combined into an adapted LIfestyle for BRAin health weighted sum score, with higher score indicating greater dementia risk. Cognition was calculated by averaging z-scores across three cognitive domains (memory, information processing speed and executive function and attention). Brain-age gap was calculated by comparing calendar age to predictions from a neuroimaging-based multivariable regression model. Paths between LIfestyle for BRAin health tertiles, brain-age gap and cognitive function were tested using linear regression and structural equation modelling, adjusting for sociodemographic and clinical confounders. The results show that cerebrospinal fluid, grey matter, white matter hyperintensity and cerebral microbleeds best predicted brain-age gap (R 2 = 0.455, root mean squared error = 6.44). In regression analysis, higher LIfestyle for BRAin health scores (greater dementia risk) were associated with higher brain-age gap (standardized regression coefficient β = 0.126, P < 0.001) and worse cognition (β = -0.046, P = 0.013), while higher brain-age gap was associated with worse cognition (β=-0.163, P < 0.001). In mediation analysis, 24.7% of the total difference in cognition between the highest and lowest LIfestyle for BRAin health tertile was mediated by brain-age gap (β indirect = -0.049, P < 0.001; β total = -0.198, P < 0.001) and an additional 3.8% was mediated via connectivity (β indirect = -0.006, P < 0.001; β total = -0.150, P < 0.001). Findings suggest that associations between health- and lifestyle-based risk/protective factors (LIfestyle for BRAin health) and cognition can be partially explained by structural brain health markers (brain-age gap) and white matter connectivity markers. Lifestyle interventions targeted at high-risk individuals in mid-to-late life may be effective in promoting and preserving cognitive function in the general public.
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Affiliation(s)
- Nathan R DeJong
- Faculty of Health, Medicine and Life Sciences, School for Mental Health & Neuroscience, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6229 ER Maastricht, The Netherlands
- Alzheimer Centrum Limburg, Maastricht University Medical Center+, 6229 ET Maastricht, The Netherlands
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+, 6229 HX Maastricht, The Netherlands
| | - Jacobus F A Jansen
- Faculty of Health, Medicine and Life Sciences, School for Mental Health & Neuroscience, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+, 6229 HX Maastricht, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, 5612 AP Eindhoven, The Netherlands
| | - Martin P J van Boxtel
- Faculty of Health, Medicine and Life Sciences, School for Mental Health & Neuroscience, Maastricht University, 6229 ER Maastricht, The Netherlands
- Alzheimer Centrum Limburg, Maastricht University Medical Center+, 6229 ET Maastricht, The Netherlands
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+, 6229 HX Maastricht, The Netherlands
| | - Miranda T Schram
- Faculty of Health, Medicine and Life Sciences, School for Mental Health & Neuroscience, Maastricht University, 6229 ER Maastricht, The Netherlands
- Faculty of Health, Medicine and Life Sciences, School for Cardiovascular Diseases (CARIM), Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, 6229 HX Maastricht, The Netherlands
- Maastricht Heart & Vascular Center, Maastricht University Medical Center+, 6229 HX Maastricht, The Netherlands
| | - Coen D A Stehouwer
- Faculty of Health, Medicine and Life Sciences, School for Cardiovascular Diseases (CARIM), Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, 6229 HX Maastricht, The Netherlands
| | - Marleen M J van Greevenbroek
- Faculty of Health, Medicine and Life Sciences, School for Cardiovascular Diseases (CARIM), Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, 6229 HX Maastricht, The Netherlands
| | - Carla J H van der Kallen
- Faculty of Health, Medicine and Life Sciences, School for Cardiovascular Diseases (CARIM), Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, 6229 HX Maastricht, The Netherlands
| | - Annemarie Koster
- Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6229 GT Maastricht, The Netherlands
| | - Simone J P M Eussen
- Faculty of Health, Medicine and Life Sciences, School for Cardiovascular Diseases (CARIM), Maastricht University, 6229 ER Maastricht, The Netherlands
- Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Epidemiology, Maastricht University Medical Center+, 6229 HX Maastricht, The Netherlands
| | - Bastiaan E de Galan
- Faculty of Health, Medicine and Life Sciences, School for Cardiovascular Diseases (CARIM), Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, 6229 HX Maastricht, The Netherlands
- Department of Internal Medicine, Radboud University Medical Centre, 6500 HB Nijmegen, The Netherlands
| | - Walter H Backes
- Faculty of Health, Medicine and Life Sciences, School for Mental Health & Neuroscience, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+, 6229 HX Maastricht, The Netherlands
- Faculty of Health, Medicine and Life Sciences, School for Cardiovascular Diseases (CARIM), Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Sebastian Köhler
- Faculty of Health, Medicine and Life Sciences, School for Mental Health & Neuroscience, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6229 ER Maastricht, The Netherlands
- Alzheimer Centrum Limburg, Maastricht University Medical Center+, 6229 ET Maastricht, The Netherlands
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Lu T, Wang Z, Zhu Y, Wang M, Lu CQ, Ju S. Long-range connections damage in white matter hyperintensities affects information processing speed. Brain Commun 2024; 6:fcae042. [PMID: 38410619 PMCID: PMC10896478 DOI: 10.1093/braincomms/fcae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/14/2023] [Accepted: 02/19/2024] [Indexed: 02/28/2024] Open
Abstract
White matter hyperintensities, one of the major markers of cerebral small vessel disease, disrupt the integrity of neuronal networks and ultimately contribute to cognitive dysfunction. However, a deeper understanding of how white matter hyperintensities related to the connectivity patterns of brain hubs at the neural network level could provide valuable insights into the relationship between white matter hyperintensities and cognitive dysfunction. A total of 36 patients with moderate to severe white matter hyperintensities (Fazekas score ≥ 3) and 34 healthy controls underwent comprehensive neuropsychological assessments and resting-state functional MRI scans. The voxel-based graph-theory approach-functional connectivity strength was employed to systematically investigate the topological organization of the whole-brain networks. The white matter hyperintensities patients performed significantly worse than the healthy controls in episodic memory, executive function and information processing speed. Additionally, we found that white matter hyperintensities selectively affected highly connected hub regions, predominantly involving the medial and lateral prefrontal, precuneus, inferior parietal lobule, insula and thalamus. Intriguingly, this impairment was connectivity distance-dependent, with the most prominent disruptions observed in long-range connections (e.g. 100-150 mm). Finally, these disruptions of hub connectivity (e.g. the long-range functional connectivity strength in the left dorsolateral prefrontal cortex) positively correlated with the cognitive performance in white matter hyperintensities patients. Our findings emphasize that the disrupted hub connectivity patterns in white matter hyperintensities are dependent on connection distance, especially longer-distance connections, which in turn predispose white matter hyperintensities patients to worse cognitive function.
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Affiliation(s)
- Tong Lu
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Zan Wang
- Department of Neurology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Yixin Zhu
- Department of Neurology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Mengxue Wang
- Department of Neurology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Chun-Qiang Lu
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Shenghong Ju
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
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Beran M, van Gennip AC, Stehouwer CD, Jansen JF, Gupta MD, Houben AJ, Berendschot TT, Webers CA, Wesselius A, Schalkwijk CG, Backes WH, de Jong JJ, van der Kallen CJ, van Greevenbroek MM, Köhler S, Vonk JM, Geerlings MI, Schram MT, van Sloten TT. Microvascular Dysfunction and Whole-Brain White Matter Connectivity: The Maastricht Study. J Am Heart Assoc 2024; 13:e9112. [PMID: 38240213 PMCID: PMC11056139 DOI: 10.1161/jaha.123.031573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 11/16/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND Microvascular dysfunction is involved in the development of various cerebral disorders. It may contribute to these disorders by disrupting white matter tracts and altering brain connectivity, but evidence is scarce. We investigated the association between multiple biomarkers of microvascular function and whole-brain white matter connectivity. METHODS AND RESULTS Cross-sectional data from The Maastricht Study, a Dutch population-based cohort (n=4326; age, 59.4±8.6 years; 49.7% women). Measures of microvascular function included urinary albumin excretion, central retinal arteriolar and venular calibers, composite scores of flicker light-induced retinal arteriolar and venular dilation, and plasma biomarkers of endothelial dysfunction (intercellular adhesion molecule-1, vascular cell adhesion molecule-1, E-selectin, and von Willebrand factor). White matter connectivity was calculated from 3T diffusion magnetic resonance imaging to quantify the number (average node degree) and organization (characteristic path length, global efficiency, clustering coefficient, and local efficiency) of white matter connections. A higher plasma biomarkers of endothelial dysfunction composite score was associated with a longer characteristic path length (β per SD, 0.066 [95% CI, 0.017-0.114]) after adjustment for sociodemographic, lifestyle, and cardiovascular factors but not with any of the other white matter connectivity measures. After multiple comparison correction, this association was nonsignificant. None of the other microvascular function measures were associated with any of the connectivity measures. CONCLUSIONS These findings suggest that microvascular dysfunction as measured by indirect markers is not associated with whole-brain white matter connectivity.
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Affiliation(s)
- Magdalena Beran
- Department of Internal MedicineMaastricht University Medical Centre+ (MUMC+)MaastrichtThe Netherlands
- School for Cardiovascular Diseases CARIMMaastricht UniversityMaastrichtThe Netherlands
- Department of Epidemiology and Global Health, Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - April C.E. van Gennip
- Department of Internal MedicineMaastricht University Medical Centre+ (MUMC+)MaastrichtThe Netherlands
- School for Cardiovascular Diseases CARIMMaastricht UniversityMaastrichtThe Netherlands
| | - Coen D.A. Stehouwer
- Department of Internal MedicineMaastricht University Medical Centre+ (MUMC+)MaastrichtThe Netherlands
- School for Cardiovascular Diseases CARIMMaastricht UniversityMaastrichtThe Netherlands
| | - Jacobus F.A. Jansen
- School for Mental Health and Neuroscience (MHeNS)Maastricht UniversityMaastrichtThe Netherlands
- Department of Radiology and Nuclear MedicineMaastricht University Medical Centre+ (MUMC+)MaastrichtThe Netherlands
- Department of Electrical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
| | - Monideepa D. Gupta
- Department of Internal MedicineMaastricht University Medical Centre+ (MUMC+)MaastrichtThe Netherlands
- School for Cardiovascular Diseases CARIMMaastricht UniversityMaastrichtThe Netherlands
| | - Alfons J.H.M. Houben
- Department of Internal MedicineMaastricht University Medical Centre+ (MUMC+)MaastrichtThe Netherlands
- School for Cardiovascular Diseases CARIMMaastricht UniversityMaastrichtThe Netherlands
| | - Tos T.J.M. Berendschot
- School for Mental Health and Neuroscience (MHeNS)Maastricht UniversityMaastrichtThe Netherlands
- Department of OphthalmologyMaastricht University Medical Centre (MUMC+)MaastrichtThe Netherlands
| | - Carroll A.B. Webers
- School for Mental Health and Neuroscience (MHeNS)Maastricht UniversityMaastrichtThe Netherlands
- Department of OphthalmologyMaastricht University Medical Centre (MUMC+)MaastrichtThe Netherlands
| | - Anke Wesselius
- Department of EpidemiologyMaastricht UniversityMaastrichtThe Netherlands
| | - Casper G. Schalkwijk
- Department of Internal MedicineMaastricht University Medical Centre+ (MUMC+)MaastrichtThe Netherlands
- School for Cardiovascular Diseases CARIMMaastricht UniversityMaastrichtThe Netherlands
| | - Walter H. Backes
- Department of Internal MedicineMaastricht University Medical Centre+ (MUMC+)MaastrichtThe Netherlands
- School for Cardiovascular Diseases CARIMMaastricht UniversityMaastrichtThe Netherlands
- School for Mental Health and Neuroscience (MHeNS)Maastricht UniversityMaastrichtThe Netherlands
| | - Joost J.A. de Jong
- School for Mental Health and Neuroscience (MHeNS)Maastricht UniversityMaastrichtThe Netherlands
- Department of Radiology and Nuclear MedicineMaastricht University Medical Centre+ (MUMC+)MaastrichtThe Netherlands
| | - Carla J.H. van der Kallen
- Department of Internal MedicineMaastricht University Medical Centre+ (MUMC+)MaastrichtThe Netherlands
- School for Cardiovascular Diseases CARIMMaastricht UniversityMaastrichtThe Netherlands
| | - Marleen M.J. van Greevenbroek
- Department of Internal MedicineMaastricht University Medical Centre+ (MUMC+)MaastrichtThe Netherlands
- School for Cardiovascular Diseases CARIMMaastricht UniversityMaastrichtThe Netherlands
| | - Sebastian Köhler
- School for Mental Health and Neuroscience (MHeNS)Maastricht UniversityMaastrichtThe Netherlands
- Alzheimer Centrum LimburgMaastricht University Medical Center+ (MUMC+)MaastrichtThe Netherlands
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine & Life SciencesMaastricht UniversityMaastrichtThe Netherlands
| | - Jet M.J. Vonk
- Department of Epidemiology and Global Health, Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrechtThe Netherlands
- Memory and Aging Center, Department of NeurologyUniversity of California San FranciscoSan FranciscoCAUSA
| | - Mirjam I. Geerlings
- Department of Epidemiology and Global Health, Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrechtThe Netherlands
- Department of General PracticeAmsterdam UMC, University of AmsterdamAmsterdamThe Netherlands
- Amsterdam Public Health, Aging & Later Life, and Personalized MedicineAmsterdamThe Netherlands
- Amsterdam Neuroscience, Neurodegeneration, and Mood, Anxiety, Psychosis, Stress, and SleepAmsterdamThe Netherlands
| | - Miranda T. Schram
- Department of Internal MedicineMaastricht University Medical Centre+ (MUMC+)MaastrichtThe Netherlands
- School for Cardiovascular Diseases CARIMMaastricht UniversityMaastrichtThe Netherlands
- School for Mental Health and Neuroscience (MHeNS)Maastricht UniversityMaastrichtThe Netherlands
- Heart and Vascular Centre, Maastricht University Medical CentreMaastrichtThe Netherlands
| | - Thomas T. van Sloten
- Department of Internal MedicineMaastricht University Medical Centre+ (MUMC+)MaastrichtThe Netherlands
- School for Cardiovascular Diseases CARIMMaastricht UniversityMaastrichtThe Netherlands
- Department of Vascular MedicineUniversity Medical Center UtrechtUtrechtThe Netherlands
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Yeung SHS, Lee RHS, Cheng GWY, Ma IWT, Kofler J, Kent C, Ma F, Herrup K, Fornage M, Arai K, Tse KH. White matter hyperintensity genetic risk factor TRIM47 regulates autophagy in brain endothelial cells. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.12.18.566359. [PMID: 38187529 PMCID: PMC10769267 DOI: 10.1101/2023.12.18.566359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
White matter hyperintensity (WMH) is strongly correlated with age-related dementia and hypertension, but its pathogenesis remains obscure. GWAS identified TRIM47 at 17q25 locus as a top genetic risk factor for WMH formation. TRIM family is a class of E3 ubiquitin ligase with pivotal functions in autophagy, which is critical for brain endothelial cell (ECs) remodeling during hypertension. We hypothesize that TRIM47 regulates autophagy and its loss-of-function disturbs cerebrovasculature. Based on transcriptomics and immunohistochemistry, TRIM47 is found selectively expressed by brain ECs in human and mouse, and its transcription is upregulated by artificially-induced autophagy while downregulated in hypertension-like conditions. Using in silico simulation, immunocytochemistry and super-resolution microscopy, we identified the highly conserved binding site between TRIM47 and the LIR (LC3-interacting region) motif of LC3B. Importantly, pharmacological autophagy induction increased Trim47 expression on mouse ECs (b.End3) culture, while silencing Trim47 significantly increased autophagy with ULK1 phosphorylation induction, transcription and vacuole formation. Together, we confirm that TRIM47 is an endogenous inhibitor of autophagy in brain ECs, and such TRIM47-mediated regulation connects genetic and physiological risk factors for WMH formation but warrants further investigation. SUMMARY STATEMENT TRIM47, top genetic risk factor for white matter hyperintensity formation, is a negative regulator of autophagy in brain endothelial cells and implicates a novel cellular mechanism for age-related cerebrovascular changes.
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van der Heide FCT, Steens ILM, Limmen B, Mokhtar S, van Boxtel MPJ, Schram MT, Köhler S, Kroon AA, van der Kallen CJH, Dagnelie PC, van Dongen MCJM, Eussen SJPM, Berendschot TTJM, Webers CAB, van Greevenbroek MMJ, Koster A, van Sloten TT, Jansen JFA, Backes WH, Stehouwer CDA. Thinner inner retinal layers are associated with lower cognitive performance, lower brain volume, and altered white matter network structure-The Maastricht Study. Alzheimers Dement 2024; 20:316-329. [PMID: 37611119 PMCID: PMC10917009 DOI: 10.1002/alz.13442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/26/2023] [Accepted: 08/01/2023] [Indexed: 08/25/2023]
Abstract
INTRODUCTION The retina may provide non-invasive, scalable biomarkers for monitoring cerebral neurodegeneration. METHODS We used cross-sectional data from The Maastricht study (n = 3436; mean age 59.3 years; 48% men; and 21% with type 2 diabetes [the latter oversampled by design]). We evaluated associations of retinal nerve fiber layer, ganglion cell layer, and inner plexiform layer thicknesses with cognitive performance and magnetic resonance imaging indices (global grey and white matter volume, hippocampal volume, whole brain node degree, global efficiency, clustering coefficient, and local efficiency). RESULTS After adjustment, lower thicknesses of most inner retinal layers were significantly associated with worse cognitive performance, lower grey and white matter volume, lower hippocampal volume, and worse brain white matter network structure assessed from lower whole brain node degree, lower global efficiency, higher clustering coefficient, and higher local efficiency. DISCUSSION The retina may provide biomarkers that are informative of cerebral neurodegenerative changes in the pathobiology of dementia.
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Grants
- 31O.041 OP-Zuid, the Province of Limburg, the Dutch Ministry of Economic Affairs
- Stichting De Weijerhorst (Maastricht, the Netherlands), the Pearl String Initiative Diabetes (Amsterdam, the Netherlands), the Cardiovascular Center (CVC, Maastricht, the Netherlands), CARIM School for Cardiovascular Diseases (Maastricht, the Netherlands), CAPHRI School for Public Health and Primary Care (Maastricht, the Netherlands), NUTRIM School for Nutrition and Translational Research in Metabolism (Maastricht, the Netherlands), Stichting Annadal (Maastricht, the Netherlands), Health Foundation Limburg (Maastricht, the Netherlands), Perimed (Järfälla, Sweden), and by unrestricted grants from Janssen-Cilag B.V. (Tilburg, the Netherlands), Novo Nordisk Farma B.V. (Alphen aan den Rijn, the Netherlands), and Sanofi-Aventis Netherlands B.V. (Gouda, the Netherlands)
- 916.19.074 VENI research
- 2018T025 Netherlands Organization for Scientific Research and the Netherlands Organization for Health Research and Development, and a Dutch Heart Foundation research
- 2021.81.004 Diabetes Fonds Fellowship
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Halvorson BD, Bao Y, Singh KK, Frisbee SJ, Hachinski V, Whitehead SN, Melling CWJ, Chantler PD, Goldman D, Frisbee JC. Thromboxane-induced cerebral microvascular rarefaction predicts depressive symptom emergence in metabolic disease. J Appl Physiol (1985) 2024; 136:122-140. [PMID: 37969083 DOI: 10.1152/japplphysiol.00410.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 11/14/2023] [Accepted: 11/14/2023] [Indexed: 11/17/2023] Open
Abstract
Previous studies have suggested that the loss of microvessel density in the peripheral circulation with evolving metabolic disease severity represents a significant contributor to impaired skeletal muscle oxygenation and fatigue-resistance. Based on this and our recent work, we hypothesized that cerebral microvascular rarefaction was initiated from the increased prooxidant and proinflammatory environment with metabolic disease and is predictive of the severity of the emergence of depressive symptoms in obese Zucker rats (OZRs). In male OZR, cerebrovascular rarefaction followed the emergence of elevated oxidant and inflammatory environments characterized by increased vascular production of thromboxane A2 (TxA2). The subsequent emergence of depressive symptoms in OZR was associated with the timing and severity of the rarefaction. Chronic intervention with antioxidant (TEMPOL) or anti-inflammation (pentoxifylline) therapy blunted the severity of rarefaction and depressive symptoms, although the effectiveness was limited. Blockade of TxA2 production (dazmegrel) or action (SQ-29548) resulted in a stronger therapeutic effect, suggesting that vascular production and action represent a significant contributor to rarefaction and the emergence of depressive symptoms with chronic metabolic disease (although other pathways clearly contribute as well). A de novo biosimulation of cerebrovascular oxygenation in the face of progressive rarefaction demonstrates the increased probability of generating hypoxic regions within the microvascular networks, which could contribute to impaired neuronal metabolism and the emergence of depressive symptoms. The results of the present study also implicate the potential importance of aggressive prodromic intervention in reducing the severity of chronic complications arising from metabolic disease.NEW & NOTEWORTHY With clinical studies linking vascular disease risk to depressive symptom emergence, we used obese Zucker rats, a model of chronic metabolic disease, to identify potential mechanistic links between these two negative outcomes. Depressive symptom severity correlated with the extent of cerebrovascular rarefaction, after increased vascular oxidant stress/inflammation and TxA2 production. Anti-TxA2 interventions prevasculopathy blunted rarefaction and depressive symptoms, while biosimulation indicated that cerebrovascular rarefaction increased hypoxia within capillary networks as a potential contributing mechanism.
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Affiliation(s)
- Brayden D Halvorson
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
| | - Yuki Bao
- Department of Biomedical Engineering, University of Western Ontario, London, Ontario, Canada
| | - Krishna K Singh
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
| | - Stephanie J Frisbee
- Department of Pathology and Laboratory Medicine, University of Western Ontario, London, Ontario, Canada
| | - Vladimir Hachinski
- Department of Anatomy and Cell Biology, University of Western Ontario, London, Ontario, Canada
| | - Shawn N Whitehead
- Department of Anatomy and Cell Biology, University of Western Ontario, London, Ontario, Canada
| | - C W James Melling
- Department of Kinesiology, University of Western Ontario, London, Ontario, Canada
| | - Paul D Chantler
- Division of Exercise Physiology, West Virginia University, Morgantown, West Virginia, United States
| | - Daniel Goldman
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
| | - Jefferson C Frisbee
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
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10
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Zhao J, Jing B, Liu J, Chen F, Wu Y, Li H. Probing bundle-wise abnormalities in patients infected with human immunodeficiency virus using fixel-based analysis: new insights into neurocognitive impairments. Chin Med J (Engl) 2023; 136:2178-2186. [PMID: 37605986 PMCID: PMC10508508 DOI: 10.1097/cm9.0000000000002829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Changes in white matter (WM) underlie the neurocognitive damages induced by a human immunodeficiency virus (HIV) infection. This study aimed to examine using a bundle-associated fixel-based analysis (FBA) pipeline for investigating the microstructural and macrostructural alterations in the WM of the brain of HIV patients. METHODS This study collected 93 HIV infected patients and 45 age/education/handedness matched healthy controls (HCs) at the Beijing Youan Hospital between January 1, 2016 and December 30, 2016.All HIV patients underwent neurocognitive evaluation and laboratory testing followed by magnetic resonance imaging (MRI) scanning. In order to detect the bundle-wise WM abnormalities accurately, a specific WM bundle template with 56 tracts of interest was firstly generated by an automated fiber clustering method using a subset of subjects. Fixel-based analysis was used to investigate bundle-wise differences between HIV patients and HCs in three perspectives: fiber density (FD), fiber cross-section (FC), and fiber density and cross-section (FDC). The between-group differences were detected by a two-sample t -test with the false discovery rate (FDR) correction ( P <0.05). Furthermore, the covarying relationship in FD, FC and FDC between any pair of bundles was also accessed by the constructed covariance networks, which was subsequently compared between HIV and HCs via permutation t -tests. The correlations between abnormal WM metrics and the cognitive functions of HIV patients were explored via partial correlation analysis after controlling age and gender. RESULTS Among FD, FC and FDC, FD was the only metric that showed significant bundle-wise alterations in HIV patients compared to HCs. Increased FD values were observed in the bilateral fronto pontine tract, corona radiata frontal, left arcuate fasciculus, left corona radiata parietal, left superior longitudinal fasciculus III, and right superficial frontal parietal (SFP) (all FDR P <0.05). In bundle-wise covariance network, HIV patients displayed decreased FD and increased FC covarying patterns in comparison to HC ( P <0.05) , especially between associated pathways. Finally, the FCs of several tracts exhibited a significant correlation with language and attention-related functions. CONCLUSIONS Our study demonstrated the utility of FBA on detecting the WM alterations related to HIV infection. The bundle-wise FBA method provides a new perspective for investigating HIV-induced microstructural and macrostructural WM-related changes, which may help to understand cognitive dysfunction in HIV patients thoroughly.
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Affiliation(s)
- Jing Zhao
- School of Biological Science and Medical Engineering, Beihang University, Beijing 100069, China
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Bin Jing
- School of Biomedical Engineering, Capital Medical University, Beijing 100069, China
- Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application,School of Biomedical Engineering, Capital Medical University, Beijing 100069, China
| | - Jiaojiao Liu
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Feng Chen
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Ye Wu
- School of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing, Jiangsu 210094, China
| | - Hongjun Li
- School of Biological Science and Medical Engineering, Beihang University, Beijing 100069, China
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
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11
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da Silva PHR, de Leeuw FE, Zotin MCZ, Neto OMP, Leoni RF, Tuladhar AM. Cortical Thickness and Brain Connectivity Mediate the Relation Between White Matter Hyperintensity and Information Processing Speed in Cerebral Small Vessel Disease. Brain Topogr 2023:10.1007/s10548-023-00973-w. [PMID: 37273021 DOI: 10.1007/s10548-023-00973-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 05/26/2023] [Indexed: 06/06/2023]
Abstract
White matter hyperintensities of presumed vascular origin (WMH) are the most common imaging feature of cerebral small vessel disease (cSVD) and are associated with cognitive impairment, especially information processing speed (IPS) deficits. However, it is unclear how WMH can directly impact IPS or whether the cortical thickness and brain connectivity mediate such association. In this study, it was evaluated the possible mediating roles of cortical thickness and brain (structural and functional) connectivity on the relationship between WMH (also considering its topography distribution) and IPS in 389 patients with cSVD from the RUN-DMC (Radboud University Nijmegen Diffusion tensor and Magnetic resonance imaging Cohort) database. Significant (p < 0.05 after multiple comparisons correction) associations of WMH volume and topography with cortical thickness, brain connectivity, and IPS performance in cSVD individuals were found. Additionally, cortical thickness and brain structural and functional connectivity were shown to mediate the association of WMH volume and location with IPS scores. More specifically, frontal cortical thickness, functional sensorimotor network, and posterior thalamic radiation tract were the essential mediators of WMH and IPS in this clinical group. This study provided insight into the mechanisms underlying the clinical relevance of white matter hyperintensities in information processing speed deficits in cSVD through cortical thinning and network disruptions.
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Affiliation(s)
| | - Frank-Erik de Leeuw
- Department of Neurology, Donders Center for Medical Neuroscience, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Maria Clara Zanon Zotin
- Department of Neurology, J. Philip Kistler Stroke Research Center, MGH, Boston, MA, USA
- Department of Medical Imaging, Hematology, and Clinical Oncology, Ribeirão Preto Medical School, Ribeirão Preto, Brazil
| | - Octavio Marques Pontes Neto
- Department of Neurosciences and Behavioural Sciences, Hospital das Clínicas-Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Anil M Tuladhar
- Department of Neurology, Donders Center for Medical Neuroscience, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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12
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Yang D, Li J, Ke Z, Qin R, Mao C, Huang L, Mo Y, Hu Z, Lv W, Huang Y, Zhang B, Xu Y. Subsystem mechanisms of default mode network underlying white matter hyperintensity-related cognitive impairment. Hum Brain Mapp 2023; 44:2365-2379. [PMID: 36722495 PMCID: PMC10028636 DOI: 10.1002/hbm.26215] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 02/02/2023] Open
Abstract
Functional changes of default mode network (DMN) have been proven to be closely associated with white matter hyperintensity (WMH) related cognitive impairment (CI). However, subsystem mechanisms of DMN underlying WMH-related CI remain unclear. The present study recruited WMH patients (n = 206) with mild CI and normal cognition, as well as healthy controls (HC, n = 102). Static/dynamic functional connectivity (FC) of the DMN's three subsystems were calculated using resting-state functional MRI. K-means clustering analyses were performed to extract distinct dynamic connectivity states. Compared with the WMH-NC group, the WMH-MCI group displayed lower static FC within medial temporal lobe (MTL) and core subsystem, between core-MTL subsystem, as well as between core and dorsal medial prefrontal cortex subsystem. All these static alterations were positively associated with information processing speed (IPS). Regarding dynamic FC, the WMH-MCI group exhibited higher dynamic FC within MTL subsystem than the HC and WMH-NC groups. Altered dynamic FC within MTL subsystem mediated the relationship between WMH and memory span (indirect effect: -0.2251, 95% confidence interval [-0.6295, -0.0267]). Additionally, dynamic FCs of DMN subsystems could be clustered into two recurring states. For dynamic FCs within MTL subsystem, WMH-MCI subjects exhibited longer mean dwell time (MDT) and higher reoccurrence fraction (RF) in a sparsely connected state (State 2). Altered MDT and RF in State 2 were negatively associated with IPS. Taken together, these findings indicated static/dynamic FC of DMN subsystems can provide relevant information on cognitive decline from different aspects, which provides a comprehensive view of subsystem mechanisms of DMN underlying WMH-related CI.
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Affiliation(s)
- Dan Yang
- Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Jiangnan Li
- Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Zhihong Ke
- Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Ruomeng Qin
- Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
| | - ChengLu Mao
- Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
| | - Lili Huang
- Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
| | - Yuting Mo
- Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
| | - Zheqi Hu
- Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
| | - Weiping Lv
- Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
| | - Yanan Huang
- Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
| | - Bing Zhang
- Department of Radiology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Yun Xu
- Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
- Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
- Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
- Nanjing Neurology Clinic Medical Center, Nanjing, China
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13
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Li P, Lennartz S, Consul N, Moy L, Lee SI. Top Covers of the Centennial. Radiology 2023; 306:64-68. [PMID: 36534609 DOI: 10.1148/radiol.229033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Affiliation(s)
- Peter Li
- From the Department of Radiology, Oregon Health and Science University Hospital Dotter Interventional Institute, 3181 SW Sam Jackson Park Rd, Portland, Oregon 97239 (P.L.); Institute for Diagnostic and Interventional Radiology, University of Cologne, Germany (S.L.); Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (N.C, S.I.L.); Department of Radiology, New York University School of Medicine, New York, NY (L.M.)
| | - Simon Lennartz
- From the Department of Radiology, Oregon Health and Science University Hospital Dotter Interventional Institute, 3181 SW Sam Jackson Park Rd, Portland, Oregon 97239 (P.L.); Institute for Diagnostic and Interventional Radiology, University of Cologne, Germany (S.L.); Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (N.C, S.I.L.); Department of Radiology, New York University School of Medicine, New York, NY (L.M.)
| | - Nikita Consul
- From the Department of Radiology, Oregon Health and Science University Hospital Dotter Interventional Institute, 3181 SW Sam Jackson Park Rd, Portland, Oregon 97239 (P.L.); Institute for Diagnostic and Interventional Radiology, University of Cologne, Germany (S.L.); Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (N.C, S.I.L.); Department of Radiology, New York University School of Medicine, New York, NY (L.M.)
| | - Linda Moy
- From the Department of Radiology, Oregon Health and Science University Hospital Dotter Interventional Institute, 3181 SW Sam Jackson Park Rd, Portland, Oregon 97239 (P.L.); Institute for Diagnostic and Interventional Radiology, University of Cologne, Germany (S.L.); Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (N.C, S.I.L.); Department of Radiology, New York University School of Medicine, New York, NY (L.M.)
| | - Susanna I Lee
- From the Department of Radiology, Oregon Health and Science University Hospital Dotter Interventional Institute, 3181 SW Sam Jackson Park Rd, Portland, Oregon 97239 (P.L.); Institute for Diagnostic and Interventional Radiology, University of Cologne, Germany (S.L.); Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (N.C, S.I.L.); Department of Radiology, New York University School of Medicine, New York, NY (L.M.)
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14
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Wang S, Zhang F, Huang P, Hong H, Jiaerken Y, Yu X, Zhang R, Zeng Q, Zhang Y, Kikinis R, Rathi Y, Makris N, Lou M, Pasternak O, Zhang M, O'Donnell LJ. Superficial white matter microstructure affects processing speed in cerebral small vessel disease. Hum Brain Mapp 2022; 43:5310-5325. [PMID: 35822593 PMCID: PMC9812245 DOI: 10.1002/hbm.26004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 06/10/2022] [Accepted: 06/15/2022] [Indexed: 01/15/2023] Open
Abstract
White matter hyperintensities (WMH) are a typical feature of cerebral small vessel disease (CSVD), which contributes to about 50% of dementias worldwide. Microstructural alterations in deep white matter (DWM) have been widely examined in CSVD. However, little is known about abnormalities in superficial white matter (SWM) and their relevance for processing speed, the main cognitive deficit in CSVD. In 141 CSVD patients, processing speed was assessed using Trail Making Test Part A. White matter abnormalities were assessed by WMH burden (volume on T2-FLAIR) and diffusion MRI measures. SWM imaging measures had a large contribution to processing speed, despite a relatively low SWM WMH burden. Across all imaging measures, SWM free water (FW) had the strongest association with processing speed, followed by SWM mean diffusivity (MD). SWM FW was the only marker to significantly increase between two subgroups with the lowest WMH burdens. When comparing two subgroups with the highest WMH burdens, the involvement of WMH in the SWM was accompanied by significant differences in processing speed and white matter microstructure. Mediation analysis revealed that SWM FW fully mediated the association between WMH volume and processing speed, while no mediation effect of MD or DWM FW was observed. Overall, results suggest that the SWM has an important contribution to processing speed, while SWM FW is a sensitive imaging marker associated with cognition in CSVD. This study extends the current understanding of CSVD-related dysfunction and suggests that the SWM, as an understudied region, can be a potential target for monitoring pathophysiological processes.
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Affiliation(s)
- Shuyue Wang
- Department of Radiologythe Second Affiliated Hospital of Zhejiang University School of MedicineChina
- Brigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Fan Zhang
- Brigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Peiyu Huang
- Department of Radiologythe Second Affiliated Hospital of Zhejiang University School of MedicineChina
| | - Hui Hong
- Department of Radiologythe Second Affiliated Hospital of Zhejiang University School of MedicineChina
| | - Yeerfan Jiaerken
- Department of Radiologythe Second Affiliated Hospital of Zhejiang University School of MedicineChina
| | - Xinfeng Yu
- Department of Radiologythe Second Affiliated Hospital of Zhejiang University School of MedicineChina
| | - Ruiting Zhang
- Department of Radiologythe Second Affiliated Hospital of Zhejiang University School of MedicineChina
| | - Qingze Zeng
- Department of Radiologythe Second Affiliated Hospital of Zhejiang University School of MedicineChina
| | - Yao Zhang
- Department of Radiologythe Second Affiliated Hospital of Zhejiang University School of MedicineChina
| | - Ron Kikinis
- Brigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Yogesh Rathi
- Brigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Nikos Makris
- Brigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Center for Morphometric AnalysisMassachusetts General Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Min Lou
- Department of Neurologythe Second Affiliated Hospital of Zhejiang University School of MedicineChina
| | - Ofer Pasternak
- Brigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Minming Zhang
- Department of Radiologythe Second Affiliated Hospital of Zhejiang University School of MedicineChina
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15
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Chen J, Ge A, Zhou Y, Ma Y, Zhong S, Chen C, Shi W, Ding J, Wang X. White matter integrity mediates the associations between white matter hyperintensities and cognitive function in patients with silent cerebrovascular diseases. CNS Neurosci Ther 2022; 29:412-428. [PMID: 36415139 PMCID: PMC9804066 DOI: 10.1111/cns.14015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To evaluate the relationships between cognitive function and white matter hyperintensity volume (WMHV) in patients with silent cerebrovascular disease and to investigate whether white matter integrity or brain atrophy play a role in this association. METHODS Automated Fiber Quantification and Voxel- based morphometry were used to track and identify the integrity of 20 well-defined white matter tracts and to measure the gray matter volume (GMV). A linear regression model was applied for examining the associations between cognitive function and WMHV and mediation analysis was used to identify the roles of white matter integrity or GMV in the influence of WMHV on cognitive function. RESULTS Two hundred and thirty-six individuals were included for analysis. Executive function was linearly associated with fractional anisotropy (FA) of the right interior frontal occipital fasciculus (IFOF) (β = 0.193; 95% CI, 0.126 to 1.218) and with WMHV (β = -0.188; 95% CI, -0.372 to -0.037). Information processing speed was linearly associated with WMHV (β = -0.357; 95% CI, -0.643 to -0.245), FA of the right anterior thalamic radiation (ATR) (β = 0.207; 95% CI, 0.116 to 0.920), and FA of the left superior longitudinal fasciculus (SLF) (β = 0.177; 95% CI, 0.103 to 1.315). The relationship between WMHV and executive function was mediated by FA of the right IFOF (effect size = -0.045, 95% CI, -0.015 to -0.092). Parallel mediation analysis showed that the association between WMHV and information processing speed was mediated by FA of the right ATR (effect size = -0.099, 95% CI, -0.198 to -0.038) and FA of the left SLF (effect size = -0.038, 95% CI, -0.080 to -0.003). CONCLUSION These findings suggest a mechanism by which WMH affects executive function and information processing speed by impairing white matter integrity. This may be helpful in providing a theoretical basis for rehabilitation strategies of cognitive function in patients with silent cerebrovascular diseases.
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Affiliation(s)
- Jing Chen
- Department of Neurology, Zhongshan HospitalFudan UniversityShanghaiChina
| | - Anyan Ge
- Department of Neurology, Zhongshan HospitalFudan UniversityShanghaiChina
| | - Ying Zhou
- Department of Neurology, XiaMen Branch, Zhongshan HospitalFudan UniversityShanghaiChina
| | - Yuanyuan Ma
- Department of Neurology, Zhongshan HospitalFudan UniversityShanghaiChina
| | - Shaoping Zhong
- Department of Neurology, Zhongshan HospitalFudan UniversityShanghaiChina
| | - Caizhong Chen
- Department of Radiology, Zhongshan HospitalFudan UniversityShanghaiChina
| | - Weibin Shi
- Health Examination Center, Zhongshan HospitalFudan UniversityShanghaiChina
| | - Jing Ding
- Department of Neurology, Zhongshan HospitalFudan UniversityShanghaiChina
| | - Xin Wang
- Department of Neurology, Zhongshan HospitalFudan UniversityShanghaiChina,Department of the State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science,Institutes of Brain ScienceFudan UniversityShanghaiChina
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16
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Guo W, Shi J. White matter hyperintensities volume and cognition: A meta-analysis. Front Aging Neurosci 2022; 14:949763. [PMID: 36118701 PMCID: PMC9476945 DOI: 10.3389/fnagi.2022.949763] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background Cerebral small vessel disease (CSVD) is prevalent in the elderly and leads to an increased risk of cognitive impairment and dementia. The volume of white matter hyperintensities (WMHs) increases with age, which affects cognition. Objective To explore the relationship between WMH volume and cognitive decline in patients with CSVD. Methods We performed a systematic search of PubMed, Embase, and the Web of Science databases from their respective creation dates to the 5 May 2022 to identify all the clinical studies on either mild cognitive impairment (MCI) or dementia in regards to WMH volume in CSVD. Results White matter hyperintensities was associated with the risk of both the MCI and dementia, with a 35% increased risk [relative risk (RR) = 1.35; (95% CI: 1.01–1.81)] of progression from cognitively unimpaired (CU) to MCI (six studies, n = 2,278) and a 49% increased risk [RR = 1.49; (95% CI: 1.21–1.84)] of progression to dementia (six studies, n = 6,330). In a subgroup analysis, a follow-up period of over 5 years increased the risk of MCI by 40% [RR = 1.40; (95% CI: 1.07–1.82)] and dementia by 48% [RR = 1.48; (95% CI: 1.15–1.92)]. Conclusion White matter hyperintensities was found to be substantially correlated with the risk of cognitive impairment. Furthermore, cognitive decline was found to be a chronic process, such that WMH predicted the rate of cognitive decline in CSVD beyond 5 years. The cognitive decline observed in patients with WMH may, therefore, be minimized by early intervention.
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17
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DeJong NR, Jansen JFA, van Boxtel MPJ, Schram MT, Stehouwer CDA, Dagnelie PC, van der Kallen CJH, Kroon AA, Wesselius A, Koster A, Backes WH, Köhler S. Cognitive resilience depends on white matter connectivity: The Maastricht Study. Alzheimers Dement 2022; 19:1164-1174. [PMID: 35920350 DOI: 10.1002/alz.12758] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/26/2022] [Accepted: 06/22/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Differences in brain network connectivity may reflect the capability of the neurological substrate to compensate for brain damage and preserve cognitive function (cognitive reserve). We examined the associations between white matter connectivity, brain damage markers, and cognition in a population sample of middle-aged individuals. METHODS A total of 4759 participants from The Maastricht Study (mean age = 59.2, SD = 8.7, 50.2% male) underwent cognitive testing and diffusion magnetic resonance imaging (dMRI), from which brain volume, structural connectivity, and vascular damage were quantified. Multivariable linear regression was used to investigate whether connectivity modified the association between brain damage and cognition, adjusted for demographic and cardiometabolic risk factors. RESULTS More atrophic and vascular brain damage was associated with worse cognition scores. Increasing connectivity moderated the negative association between damage and cognition (χ2 = 8.64, df = 3, p ≤ 0.001); individuals with high damage but strong connectivity showed normal cognition. DISCUSSION Findings support the reserve hypothesis by showing that brain connectivity is associated with cognitive resilience.
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Affiliation(s)
- Nathan R DeJong
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Alzheimer Centrum Limburg, Maastricht University Medical Center+, Maastricht, The Netherlands.,Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Jacobus F A Jansen
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Martin P J van Boxtel
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Alzheimer Centrum Limburg, Maastricht University Medical Center+, Maastricht, The Netherlands.,Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Miranda T Schram
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,School for Cardiovascular Diseases (CARIM), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands.,Maastricht Heart & Vascular Center, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- School for Cardiovascular Diseases (CARIM), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Pieter C Dagnelie
- School for Cardiovascular Diseases (CARIM), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Carla J H van der Kallen
- School for Cardiovascular Diseases (CARIM), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Abraham A Kroon
- School for Cardiovascular Diseases (CARIM), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Anke Wesselius
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Annemarie Koster
- Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Walter H Backes
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Sebastian Köhler
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Alzheimer Centrum Limburg, Maastricht University Medical Center+, Maastricht, The Netherlands
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18
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da Silva PHR, Paschoal AM, Secchinatto KF, Zotin MCZ, Dos Santos AC, Viswanathan A, Pontes-Neto OM, Leoni RF. Contrast agent-free state-of-the-art magnetic resonance imaging on cerebral small vessel disease - Part 2: Diffusion tensor imaging and functional magnetic resonance imaging. NMR IN BIOMEDICINE 2022; 35:e4743. [PMID: 35429070 DOI: 10.1002/nbm.4743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 04/04/2022] [Indexed: 06/14/2023]
Abstract
Cerebral small vessel disease (cSVD) has been widely studied using conventional magnetic resonance imaging (MRI) methods, although the association between MRI findings and clinical features of cSVD is not always concordant. We assessed the additional contribution of contrast agent-free, state-of-the-art MRI techniques, particularly diffusion tensor imaging (DTI) and functional magnetic resonance imaging (fMRI), to understand brain damage and structural and functional connectivity impairment related to cSVD. We performed a review following the PICOS worksheet and Search Strategy, including 152 original papers in English, published from 2000 to 2022. For each MRI method, we extracted information about their contributions regarding the origins, pathology, markers, and clinical outcomes in cSVD. In general, DTI studies have shown that changes in mean, radial, and axial diffusivity measures are related to the presence of cSVD. In addition to the classical deficit in executive functions and processing speed, fMRI studies indicate connectivity dysfunctions in other domains, such as sensorimotor, memory, and attention. Neuroimaging metrics have been correlated with the diagnosis, prognosis, and rehabilitation of patients with cSVD. In short, the application of contrast agent-free, state-of-the-art MRI techniques has provided a complete picture of cSVD markers and tools to explore questions that have not yet been clarified about this clinical condition. Longitudinal studies are desirable to look for causal relationships between image biomarkers and clinical outcomes.
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Affiliation(s)
| | - André Monteiro Paschoal
- Department of Physics, FFCLRP, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Maria Clara Zanon Zotin
- Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- J Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Antônio Carlos Dos Santos
- Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Anand Viswanathan
- J Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Octavio M Pontes-Neto
- Department of Neurosciences and Behavioral Science, Ribeirão Preto Medical School, University of Sao Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Renata Ferranti Leoni
- Department of Physics, FFCLRP, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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19
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Zhang Q, Jin K, Chen B, Liu R, Cheng S, Zhang Y, Lu J. Overnutrition Induced Cognitive Impairment: Insulin Resistance, Gut-Brain Axis, and Neuroinflammation. Front Neurosci 2022; 16:884579. [PMID: 35873818 PMCID: PMC9298971 DOI: 10.3389/fnins.2022.884579] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 06/02/2022] [Indexed: 12/11/2022] Open
Abstract
Overnutrition-related obesity has become a worldwide epidemic, and its prevalence is expected to steadily rise in the future. It is widely recognized that obesity exerts negative impacts on metabolic disorders such as type 2 diabetes mellitus (T2DM) and cardiovascular diseases. However, relatively fewer reports exist on the impairment of brain structure and function, in the form of memory and executive dysfunction, as well as neurogenerative diseases. Emerging evidence indicates that besides obesity, overnutrition diets independently induce cognitive impairments via multiple mechanisms. In this study, we reviewed the clinical and preclinical literature about the detrimental effects of obesity or high-nutrition diets on cognitive performance and cerebral structure. We mainly focused on the role of brain insulin resistance (IR), microbiota-gut-brain axis, and neuroinflammation. We concluded that before the onset of obesity, short-term exposure to high-nutrition diets already blunted central responses to insulin, altered gut microbiome composition, and activated inflammatory mediators. Overnutrition is linked with the changes in protein expression in brain insulin signaling, leading to pathological features in the brain. Microbiome alteration, bacterial endotoxin release, and gut barrier hyperpermeability also occur to trigger mental and neuronal diseases. In addition, obesity or high-nutrition diets cause chronic and low-grade systematic inflammation, which eventually spreads from the peripheral tissue to the central nervous system (CNS). Altogether, a large number of unknown but potential routes interact and contribute to obesity or diet-induced cognitive impairment. The challenge for future research is to identify effective interventions involving dietary shifts and personalized therapy targeting the underlying mechanisms to prevent and improve cognition deficits.
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Affiliation(s)
- Qin Zhang
- First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Kangyu Jin
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Bing Chen
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ripeng Liu
- First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.,Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Shangping Cheng
- School of Life Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yuyan Zhang
- School of Life Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jing Lu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Mental Disorder Management in Zhejiang Province, Hangzhou, China
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20
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Liu K, Wang X, Zhang T, Wang W, Li R, Lu L, Deng Y, Xu K, Kwok T. Cortical Short-Range Fiber Connectivity and Its Association With Deep Brain White Matter Hyperintensities in Older Diabetic People With Low Serum Vitamin B12. Front Aging Neurosci 2022; 14:754997. [PMID: 35401148 PMCID: PMC8990772 DOI: 10.3389/fnagi.2022.754997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 03/03/2022] [Indexed: 11/25/2022] Open
Abstract
Although previous studies have indicated that older people with diabetes mellitus (DM) had an approximately two times larger white matter hyperintensity (WMH) load than those without DM, the influence of WMHs on cognition is uncertain and inconsistent in the literature. It is unclear whether the short-range fibers in the juxtacortical region, traditionally considered to be spared from WMH pathology, are enhanced as an adaptive response to deep WM degeneration in older diabetic people with normal cognition. Moreover, the specific effect of vitamin B12 deficiency, commonly accompanied by DM, remains to be investigated. This study implemented a specialized analysis of the superficial cortical short-range fiber connectivity density (SFiCD) based on a data-driven framework in 70 older individuals with DM and low serum vitamin B12. Moreover, the effects of time and vitamin B12 supplementation were assessed based on a randomized placebo-controlled trial in 59 individuals. The results demonstrated a higher SFiCD in diabetic individuals with a higher deep WMH load. Additionally, a significant interaction between DWMH load and homocysteine on SFiCD was found. During the 27-month follow-up period, a longitudinal increase in the SFiCD was observed in the bilateral frontal cortices. However, the observed longitudinal SFiCD change was not dependent on vitamin B12 supplementation; thus, the specific reason for the longitudinal cortical short fiber densification may need further study. Overall, these findings may help us better understand the neurobiology of brain plasticity in older patients with DM, as well as the interplay among DM, WMH, and vitamin B12 deficiency.
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Affiliation(s)
- Kai Liu
- Department of Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
| | - Xiaopeng Wang
- Department of Neurology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Teng Zhang
- Department of Nuclear Medicine and PET-CT Center, The Second Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Wei Wang
- Department of Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
| | - Ruohan Li
- Department of Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
| | - Li Lu
- Department of Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
| | - Yanjia Deng
- School of Medical Imaging, Xuzhou Medical University, Xuzhou, China
- *Correspondence: Yanjia Deng,
| | - Kai Xu
- Department of Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
- Kai Xu,
| | - Timothy Kwok
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
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21
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Kritikos M, Huang C, Clouston SAP, Pellecchia AC, Mejia-Santiago S, Carr MA, Hagan T, Kotov R, Gandy S, Sano M, Horton M, Bromet EJ, Lucchini RG, Luft BJ. DTI Connectometry Analysis Reveals White Matter Changes in Cognitively Impaired World Trade Center Responders at Midlife. J Alzheimers Dis 2022; 89:1075-1089. [PMID: 35964183 PMCID: PMC9730899 DOI: 10.3233/jad-220255] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND More than 8% of responders who participated in the search and rescue efforts at the World Trade Center (WTC) following 9/11 developed early-onset cognitive impairment (CI). Approximately 23% were also diagnosed with chronic post-traumatic stress disorder (PTSD). OBJECTIVE To shed light on the pathophysiology of these WTC-related conditions, we examined diffusion connectometry to identify altered white matter tracts in WTC responders with CI and/or PTSD compared to unaffected responders. METHODS 99 WTC responders (mean age 56 years) consisting of CI-/PTSD- (n = 27), CI+/PTSD- (n = 25), CI-/PTSD+ (n = 24), and CI+/PTSD+ (n = 23) were matched on age, sex, occupation, race, and education. Cognitive status was determined using the Montreal Cognitive Assessment and PTSD status was determined using the DSM-IV SCID. Diffusion tensor imaging was acquired on a 3T Siemens Biograph mMR scanner. Connectometry analysis was used to examine whole-brain tract-level differences in white matter integrity as reflected by fractional anisotropy (FA) values after adjusting for confounders. RESULTS Analyses identified that FA was negatively correlated with CI and PTSD status in the fornix, cingulum, forceps minor of the corpus callosum and the right uncinate fasciculus. Furthermore, FA was negatively correlated with PTSD status, regardless of CI status in the superior thalamic radiation and the cerebellum. CONCLUSION This is the first connectometry study to examine altered white matter tracts in a sample of WTC responders with CI and/or PTSD. Results from this study suggest that WTC responders with early-onset CI may be experiencing an early neurodegenerative process characterized by decreased FA in white matter tracts.
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Affiliation(s)
- Minos Kritikos
- Program in Public Health and Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Chuan Huang
- Department of Radiology, Renaissance School of Medicine at Stony Brook, Stony Brook, NY
| | - Sean A. P. Clouston
- Program in Public Health and Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Alison C. Pellecchia
- Stony Brook World Trade Center Wellness Program, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Stephanie Mejia-Santiago
- Stony Brook World Trade Center Wellness Program, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Melissa A. Carr
- Stony Brook World Trade Center Wellness Program, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Thomas Hagan
- Department of Radiology, Renaissance School of Medicine at Stony Brook, Stony Brook, NY
| | - Roman Kotov
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Sam Gandy
- James J Peters VA Medical Center, 130 West Kingsbridge Road, Bronx NY, 10468
- Department of Psychiatry and Mount Sinai Alzheimer’s Disease Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Cognitive Health and Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mary Sano
- Department of Psychiatry and Mount Sinai Alzheimer’s Disease Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Cognitive Health and Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Megan Horton
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinair, New York, NY, USA
| | - Evelyn J. Bromet
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Roberto G. Lucchini
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinair, New York, NY, USA
| | - Benjamin J. Luft
- Stony Brook World Trade Center Wellness Program, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
- Department of Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
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22
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Bonacchi R, Rocca MA, Filippi M. Editorial for "Amide Proton Transfer MRI Could Be Used to Evaluate the Pathophysiological Status of White Matter Hyperintensities". J Magn Reson Imaging 2021; 56:310-311. [PMID: 34939258 DOI: 10.1002/jmri.28036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 12/08/2021] [Indexed: 11/08/2022] Open
Affiliation(s)
- Raffaello Bonacchi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Maria A Rocca
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy.,Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
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23
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Lu T, Wang Z, Cui Y, Zhou J, Wang Y, Ju S. Disrupted Structural Brain Connectome Is Related to Cognitive Impairment in Patients With Ischemic Leukoaraiosis. Front Hum Neurosci 2021; 15:654750. [PMID: 34177491 PMCID: PMC8223255 DOI: 10.3389/fnhum.2021.654750] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 04/30/2021] [Indexed: 11/13/2022] Open
Abstract
Ischemic leukoaraiosis (ILA) is related to cognitive impairment and vascular dementia in the elderly. One possible mechanism could be the disruption of white matter (WM) tracts and network function that connect distributed brain regions involved in cognition. The purpose of this study was to investigate the relationship between structural connectome and cognitive functions in ILA patients. A total of 89 patients with ILA (Fazekas score ≥ 3) and 90 healthy controls (HCs) underwent comprehensive neuropsychological examinations and diffusion tensor imaging scans. The tract-based spatial statistics approach was employed to investigate the WM integrity. Graph theoretical analysis was further applied to construct the topological architecture of the structural connectome in ILA patients. Partial correlation analysis was used to investigate the relationships between network measures and cognitive performances in the ILA group. Compared with HCs, the ILA patients showed widespread WM integrity disruptions. The ILA group displayed increased characteristic path length (L p) and decreased global network efficiency at the level of the whole brain relative to HCs, and reduced nodal efficiencies, predominantly in the frontal-subcortical and limbic system regions. Furthermore, these structural connectomic alterations were associated with cognitive impairment in ILA patients. The association between WM changes (i.e., fractional anisotropy and mean diffusivity measures) and cognitive function was mediated by the structural connectivity measures (i.e., local network efficiency and L p). In conclusion, cognitive impairment in ILA patients is related to microstructural disruption of multiple WM fibers and topological disorganization of structural networks, which have implications in understanding the relationship between ILA and the possible attendant cognitive impairment.
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Affiliation(s)
- Tong Lu
- Nanjing Medical University, Nanjing, China.,Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zan Wang
- Department of Neurology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Ying Cui
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Jiaying Zhou
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yuancheng Wang
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Shenghong Ju
- Nanjing Medical University, Nanjing, China.,Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
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