Micro-structural white matter abnormalities and cognitive impairment in asymptomatic carotid plaque patients: A DTI study using TBSS analysis.


Journal

Clinical neurology and neurosurgery
ISSN: 1872-6968
Titre abrégé: Clin Neurol Neurosurg
Pays: Netherlands
ID NLM: 7502039

Informations de publication

Date de publication:
10 2020
Historique:
received: 04 05 2020
revised: 03 06 2020
accepted: 16 07 2020
pubmed: 28 7 2020
medline: 16 6 2021
entrez: 28 7 2020
Statut: ppublish

Résumé

It has been shown that symptomatic or severe carotid atherosclerosis is closely related to cognitive impairment and brain white matter damage. However, there is still a lack of effective and non-invasive imaging biomarkers to identify early high-risk cerebrovascular diseases. Therefore, the purpose of this study is to explore the integrity of brain white matter and cognitive impairment in patients with asymptomatic carotid plaques by using imaging technology. All subjects were from a project of Stroke Risk Screening and Prevention and were defined as stroke high-risk patients (with three or more stroke risk factors). Tract-based spatial statistics (TBSS) based on diffusion tensor imaging (DTI) was used to analyze the whole brain white matter abnormalities in 61 patients with carotid artery plaque and in 40 healthy controls. At the same time, the general clinical data between the two groups were compared, such as age, gender, smoking, hypertension and cognitive function scores etc. Furthermore, the plaque group was divided into the have-hyperintensities group and the no-hyperintensities group to compare their microstructure of white matter injuries. The cognitive scores of plaque group were significantly lower than that of control group. We found that when plaque group and control group were compared, no white matter fiber tracts with difference was found in FA, MD, AD and RD. However, the decrease of FA and the increase of RD were found in some white matter regions (P < 0.05) when comparing the have-hyperintensities group and the no-hyperintensities group. These white matter regions included anterior thalamic radiation, corticospinal tract, cingulum (cingulate gyrus), forceps minor, inferior fronto-occipital fasciculus, superior longitudinal fasciculus, uncinate fasciculus. What's more, there were significant differences in blood pressure between the two groups. The cognitive function of patients with early high-risk cerebrovascular diseases (asymptomatic carotid plaques) has a downward trend. TBSS based on DTI can help to find out the actual damage of brain white matter in patients with early carotid plaque, and reflect the early pathological changes from the micro level.

Sections du résumé

BACKGROUND
It has been shown that symptomatic or severe carotid atherosclerosis is closely related to cognitive impairment and brain white matter damage. However, there is still a lack of effective and non-invasive imaging biomarkers to identify early high-risk cerebrovascular diseases. Therefore, the purpose of this study is to explore the integrity of brain white matter and cognitive impairment in patients with asymptomatic carotid plaques by using imaging technology.
METHODS
All subjects were from a project of Stroke Risk Screening and Prevention and were defined as stroke high-risk patients (with three or more stroke risk factors). Tract-based spatial statistics (TBSS) based on diffusion tensor imaging (DTI) was used to analyze the whole brain white matter abnormalities in 61 patients with carotid artery plaque and in 40 healthy controls. At the same time, the general clinical data between the two groups were compared, such as age, gender, smoking, hypertension and cognitive function scores etc. Furthermore, the plaque group was divided into the have-hyperintensities group and the no-hyperintensities group to compare their microstructure of white matter injuries.
RESULTS
The cognitive scores of plaque group were significantly lower than that of control group. We found that when plaque group and control group were compared, no white matter fiber tracts with difference was found in FA, MD, AD and RD. However, the decrease of FA and the increase of RD were found in some white matter regions (P < 0.05) when comparing the have-hyperintensities group and the no-hyperintensities group. These white matter regions included anterior thalamic radiation, corticospinal tract, cingulum (cingulate gyrus), forceps minor, inferior fronto-occipital fasciculus, superior longitudinal fasciculus, uncinate fasciculus. What's more, there were significant differences in blood pressure between the two groups.
CONCLUSION
The cognitive function of patients with early high-risk cerebrovascular diseases (asymptomatic carotid plaques) has a downward trend. TBSS based on DTI can help to find out the actual damage of brain white matter in patients with early carotid plaque, and reflect the early pathological changes from the micro level.

Identifiants

pubmed: 32717561
pii: S0303-8467(20)30439-X
doi: 10.1016/j.clineuro.2020.106096
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

106096

Informations de copyright

Copyright © 2020 Elsevier B.V. All rights reserved.

Auteurs

Lihui Liu (L)

Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China; Cerebrovascular Disease Clinical Research Center of Hunan Province, Changsha, Hunan, China; Department of Geriatrics Stroke Center, Xiangya Hospital, Central South University, Changsha, Hunan, China.

Qing Huang (Q)

Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China; Cerebrovascular Disease Clinical Research Center of Hunan Province, Changsha, Hunan, China; Department of Geriatrics Stroke Center, Xiangya Hospital, Central South University, Changsha, Hunan, China. Electronic address: qinghuang_stroke@126.com.

Shuai Yang (S)

Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China.

Yanbin Wen (Y)

Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China; Cerebrovascular Disease Clinical Research Center of Hunan Province, Changsha, Hunan, China; Department of Geriatrics Stroke Center, Xiangya Hospital, Central South University, Changsha, Hunan, China.

Wei He (W)

Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China; Cerebrovascular Disease Clinical Research Center of Hunan Province, Changsha, Hunan, China; Department of Geriatrics Stroke Center, Xiangya Hospital, Central South University, Changsha, Hunan, China.

Hui Liu (H)

Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China.

Li Meng (L)

Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China.

Hong Jiang (H)

Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China; Laboratory of Medical Genetics, Central South University, Changsha, Hunan, China; National Clinical Research Center for Geriatric Diseases, Central South University, Changsha, Huan, China; Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, Hunan, China.

Jian Xia (J)

Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China; Cerebrovascular Disease Clinical Research Center of Hunan Province, Changsha, Hunan, China; Department of Geriatrics Stroke Center, Xiangya Hospital, Central South University, Changsha, Hunan, China.

Weihua Liao (W)

Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China.

Yunhai Liu (Y)

Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China; Cerebrovascular Disease Clinical Research Center of Hunan Province, Changsha, Hunan, China; Department of Geriatrics Stroke Center, Xiangya Hospital, Central South University, Changsha, Hunan, China.

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