White Matter Fractional Anisotropy Is a Superior Predictor for Cognitive Impairment Than Brain Volumes in Older Adults With Confluent White Matter Hyperintensities

被引:10
|
作者
Xing, Yi [1 ,2 ]
Yang, Jianwei [1 ,2 ]
Zhou, Aihong [1 ,2 ]
Wang, Fen [1 ,2 ]
Wei, Cuibai [1 ,2 ]
Tang, Yi [1 ,2 ]
Jia, Jianping [1 ,2 ]
机构
[1] Capital Med Univ, Xuanwu Hosp, Natl Clin Res Ctr Geriatr Disorders, Innovat Ctr Neurol Disorders,Dept Neurol, Beijing, Peoples R China
[2] Minist Educ Peoples Republ China, Key Lab Neurodegenerat Dis, Beijing, Peoples R China
来源
FRONTIERS IN PSYCHIATRY | 2021年 / 12卷
基金
中国国家自然科学基金; 国家重点研发计划;
关键词
white matter hyperintensities; vascular cognitive impairment; fractional anisotropy; brain volume; hippocampus; nucleus basalis of Meynert; ALZHEIMERS-DISEASE; DEMENTIA; ATROPHY; MRI; ABNORMALITIES; LEUKOARAIOSIS; DECLINE; RISK; AGE;
D O I
10.3389/fpsyt.2021.633811
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Older patients with confluent white matter hyperintensities (WMHs) on magnetic resonance imaging have an increased risk for the onset of vascular cognitive impairment (VCI). This study investigates the predictive effects of the white matter (WM) fractional anisotropy (FA) and brain volumes on cognitive impairment for those with confluent WMHs. This study enrolled 77 participants with confluent WMHs (Fazekas grade 2 or 3), including 44 with VCI-no dementia (VCIND) and 33 with normal cognition (NC). The mean FA of 20 WM tracts was calculated to evaluate the global WM microstructural integrity, and major WM tracts were reconstructed using probabilistic tractography. Voxel-based morphometry was used to calculate brain volumes for the total gray matter (GM), the hippocampus, and the nucleus basalis of Meynert (NbM). All volumetric assays were corrected for total intracranial volume. All regression analyses were adjusted for age, gender, education, and apolipoprotein E (ApoE) gene epsilon 4 status. Logistic regression analysis revealed that the mean FA value for global WM was the only independent risk factor for VCI (z score of FA: OR = 4.649, 95%CI 1.576-13.712, p = 0.005). The tract-specific FAs were not associated with the risk of cognitive impairment after controlling the mean FA for global WM. The mean FA value was significantly associated with scores of Mini-Mental State Examination (MMSE) and Auditory Verbal Learning Test. A lower FA was also associated with smaller volumes of total GM, hippocampus, and NbM. However, brain volumes were not found to be directly related to cognitive performances, except for an association between the hippocampal volume and MMSE. In conclusion, the mean FA for global WM microstructural integrity is a superior predictor for cognitive impairment than tract-specific FA and brain volumes in people with confluent WMHs.
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页数:8
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