Changes in Gray Matter Asymmetries of the Fusiform and Parahippocampal Gyruses in Patients With Subcortical Ischemic Vascular Disease.

Runtian Cheng,Junwei Gong,Peiling Jiang,Li Chen,Xiaoshuang Liu,Tianyou Luo

doi:10.3389/fneur.2020.603977

Abstract

Objective: Changes in the normal asymmetry of the human brain often mean pathology. Current studies on the correlation between asymmetry and cognitive impairment have focused on Alzheimer's disease (AD) and AD-related mild cognitive impairment (MCI). The purpose of this study was to investigate changes in gray matter asymmetry and their relationship with cognitive impairment in patients with subcortical ischemic vascular disease (SIVD) by using voxel-based morphological measurements.Methods: Fifty-nine SIVD patients with (subcortical vascular cognitive impairment, SVCI, N = 30) and without (pre-SVCI, N = 29) cognitive impairment and 30 normal controls (NC, N = 30) underwent high-resolution structural MRI and neuropsychological examinations. The differences in gray matter asymmetry among the three groups were estimated by using one-way ANOVA. Moreover, partial correlation analysis was performed to explore the relationships between the asymmetry index (AI) values and cognitive assessments controlled for age, sex, and education.Results: The gray matter asymmetries in the fusiform and parahippocampal gyruses of the SVCI group were significantly different from those of the NC group and the pre-SVCI group, while no differences were found between the NC group and the pre-SVCI group in the same areas. More specifically, in the fusiform and parahippocampal gyruses, the SVCI group displayed a dramatic rightward asymmetry, whereas the NC group and pre-SVCI group exhibited a marked leftward asymmetry. The results of the correlation analysis showed that the “mean AI” in significant cluster was strongly correlated with the changes in cognitive outcomes.Conclusion: This study demonstrated different lateralization in the fusiform and parahippocampal gyruses of SIVD patients with cognitive impairment compared to healthy subjects and SIVD patients without cognitive decline. Our findings may contribute to better understanding the possible mechanism of cognitive impairment in patients with SIVD, and they suggest the possibility of using gray matter asymmetry as a biomarker for disease progression.

Highlights

The gray matter asymmetries in the fusiform and parahippocampal gyruses of the SVCI group were significantly different from those of the NC group and the pre-SVCI group, while no differences were found between the NC group and the pre-SVCI group in the same areas
This study demonstrated different lateralization in the fusiform and parahippocampal gyruses of subcortical ischemic vascular disease (SIVD) patients with cognitive impairment compared to healthy subjects and SIVD patients without cognitive decline
SIVD, and they suggest the possibility of using gray matter asymmetry as a biomarker for disease progression

Summary

Introduction

Vascular cognitive impairment (VCI) is a heterogeneous group of disorders caused by multiple vascular factors, including mild vascular cognitive impairment and vascular dementia (VaD) [1]. Mild vascular cognitive impairment is considered to be the prodromal stage of VaD [2, 3], and VaD is the second most common type of dementia after Alzheimer’s disease (AD) [4]. The prodromal stages of SIVD include subcortical ischemic vascular cognitive impairment without dementia and subcortical vascular mild cognitive impairment [7], in which individuals exhibit evidence of relevant vascular risk factors. In the early stage of SIVD, there may be no decline in cognitive function [2], and its mild cognitive impairment features include memory deficits that show a trend of gradual worsening. Early diagnosis and intervention in the prodromal stage are of great significance for clinical outcomes

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Discussion

Conclusion