Enhanced Regional Homogeneity and Functional Connectivity in Subjects With White Matter Hyperintensities and Cognitive Impairment.

Qing Ye,Lili Huang,Renyuan Liu,Feng Bai,Xin Chen,Dan Yang,Yun Xu,Bing Zhang,Ruomeng Qin

doi:10.3389/fnins.2019.00695

Qing Ye, Lili Huang + Show 7 more

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https://doi.org/10.3389/fnins.2019.00695

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ObjectiveWhite matter hyperintensities (WMH) is an important cause of vascular cognitive impairment (CI). However, a considerable portion of individuals with WMH do not develop CI. The present study aimed to investigate distinctive regional brain activity and connectivity patterns in WMH subjects with and without CI, who displayed comparable WMH burden.MethodsFourteen WMH subjects with CI, 16 WMH subjects without CI and 37 healthy subjects underwent multimodal MRI scans and neuropsychological tests. All WMH subjects displayed Fazekas grade 2 of WMH. Regional Homogeneity (ReHo) and functional connectivity (FC) patterns were identified based on resting-state functional MRI data.ResultsNo significant differences in WMH volume, the number of WMH lesions and brain volume were shown between the 2 WMH groups. In contrast, the WMH with CI group showed higher ReHo in bilateral superior parietal gyrus (SPG)/superior occipital gyrus (SOG) than the WMH without CI group. Compared with the WMH without CI group, the WMH with CI group also displayed higher FC of the left SPG/SOG with frontal regions, and higher FC of the right SPG/SOG with parietal regions. Furthermore, higher FC of the left SPG/SOG with frontal regions were significantly associated with less worse executive dysfunction in WMH with CI subjects, suggesting a compensatory effect.ConclusionHigher local coherence of activities in the SPG/SOG and higher connectivity of the SPG/SOG with parietal and frontal regions are related to CI in WMH subjects. The findings provide novel insights into functional alterations underlying the cognitive variety in WMH subjects.

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MATERIALS AND METHODSWhite matter hyperintensities (WMH), defined in the T2 weighted magnetic resonance imaging (MRI) representation, is widely common in elderly population
The WMH with cognitive impairment (CI) group performed significantly worse in Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Trail Making Tests (TMT)-B, Stroop-B, and Stroop-C tests than both the control group and the WMH without CI group
No significant differences in cognitive test scores were shown between the WMH without CI group and the control group

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MATERIALS AND METHODSWhite matter hyperintensities (WMH), defined in the T2 weighted magnetic resonance imaging (MRI) representation, is widely common in elderly population. As a MRI marker of cerebral small vessel disease, the pathology of WMH generally reflects loss of axons and myelin, myelin pallor and gliosis (Gouw et al, 2011). These lesions are associated with lacunar infarction occurrence (Xu et al, 2018), and may disrupt white matter tracts or U-fibers that mediate corticalsubcortical or cortical-cortical connections, resulting in cognitive impairment (CI). The baseline WMH burden was related with an increased risk of developing dementia, and the WMH progression was related with declines in global cognitive function and information processing speed (van Dijk et al, 2008).

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