Abstract
Subcortical ischemic vascular disease (SIVD) is a major cause of vascular cognitive impairment (CI) and features extensive atrophy in the cerebral cortex. We aimed to test the hypothesis that cognitive deficits in SIVD are linked to decreased cortical thickness in specific brain regions, which may constitute neuroimaging biomarkers of CI. Sixty-seven SIVD patients without (SIVD-NC, n = 35) and with (SIVD-CI, n = 32) CI and a group of healthy controls (HCs, n = 36) underwent structural magnetic resonance imaging (MRI) and cognitive functional assessments. FreeSurfer was used to preprocess structural MRI data and to calculate and compare cortical thickness. The correlation between cortical thickness and cognitive scores was examined in SIVD patients. Significantly altered cortical thickness in the bilateral insula, middle and inferior temporal lobes, precuneus, and medial temporal lobe (MTL) was identified among the three groups (p < 0.05, Monte Carlo simulation corrected). Post hoc results showed significantly decreased thickness in the bilateral insula and temporal lobe in SIVD-NC and SIVD-CI patients compared with HCs. However, the areas with reduced cortical thickness were larger in SIVD-CI than SIVD-NC patients. SIVD-CI patients had significantly reduced thickness in the bilateral precuneus and left MTL (Bonferroni corrected) compared with SIVD-NC patients when we extracted the mean thickness for each region of interest. In SIVD patients, the thicknesses of the left MTL and bilateral precuneus were positively correlated with immediate recall in the memory test. SIVD might lead to extensive cerebral cortical atrophy, while atrophy in the MTL and precuneus might be associated with memory deficits.
Highlights
Cerebral small vessel disease refers to a heterogeneous group of pathological disorders that affect the small vessels of the brain and are an important cause of cognitive impairment (CI) (Ter Telgte et al, 2018)
The lesion distribution in the frontoparietal white matter was more extensive in the Subcortical ischemic vascular disease (SIVD)-CI group than in the SIVD-NC group
We assessed alterations in cortical thickness in SIVD patients with mild cognitive impairment (MCI) (SIVD-CI group) and without cognitive deficits (SIVD-NC group) compared to healthy senior volunteers. Both the SIVD-CI and SIVD-NC groups showed extensive thinning of the cerebral cortex, including the bilateral temporal lobe and insula, compared to the HC group, but the area of atrophy was distinctly smaller in the SIVD-NC group than in the SIVD-CI group
Summary
Cerebral small vessel disease refers to a heterogeneous group of pathological disorders that affect the small vessels of the brain and are an important cause of cognitive impairment (CI) (Ter Telgte et al, 2018). SIVD is present to some extent in most individuals aged 60 years or older (de Leeuw et al, 2001) and is a major cause of vascular CI and dementia (METACOHORTS Consortium, 2016; Chen L. et al, 2019). Half of the patients with a firstever lacunar infarct of subcortical vascular features have mild cognitive impairment (MCI), and its presence may be a predictor of subcortical vascular dementia in the medium-long term (GrauOlivares et al, 2007; Jacova et al, 2012). Neuroimaging markers to identify CI in SIVD patients must be established
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