IMAGING MARKER FOR COGNITIVE IMPAIRMENT DUE TO CEREBRAL WHITE MATTER LESIONS BASED ON SKELETONIZATION OF WHITE MATTER TRACTS AND DIFFUSION HISTOGRAMS
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Résumé
IntroduceCerebral white matter lesions are indicators of cerebral small vessel disease. WMLs are closely correlated with cognitive impairments in attention, executive function, and information processing speed. DTI is a sensitive technique that allows the quantification of microstructural tissue alterations, which can be invisible on conventional MRI. The peak width of skeletonized mean diffusivity (PSMD) is a new, fully automated, and robust imaging marker for cerebral small vessel disease (SVD). It is considered to be strongly associated with processing speed. However, it has not been applied to cerebral white matter lesions (WMLs) yet.PurposeOur study aimed to investigate the correlation between PSMD and cognition, particularly executive function, which has emerged as the most prominently affected cognitive domain in patients with WMLs.MethodsA total of 111 WML patients and 50 healthy controls (HCs) were enrolled, and their demographic information and cardiovascular disease risk factors were recorded. Subjects were divided into three groups: WMLs with normal cognition (WMLs-NC), WMLs with vascular cognitive impairment (WMLs-VCI), and HCs. They underwent conventional head MRI and DTI scans followed by neuropsychological and psychological examinations, including tests of Montreal Cognitive Assessment (MoCA) and executive function. We compared the difference in executive function and PSMD among the three groups and analyzed the correlation between PSMD and cognitive function in all subjects.Results: There were no significant differences in demographic characteristics (age, gender, level of education, and cardiovascular disease risk factors) among the three groups (Puff1e0.05). However, there were significant differences in global cognition (P<0.0001), executive function (P<0.0001), and PSMD (P<0.0001) among the three groups. The averaged PSMD value (u00d710-4mm2/s) was 2.40u00b10.23, 2.68u00b10.30, and 4.51u00b10.39 in the HC, the WMLs-NC, and the WMLs-VCI groups, respectively. There was no correlation between PSMD and cognition in the HC group. PSMD was significantly correlated with MoCA scores (r=-0.3785, P<0.0001) and executive function (r=-0.4744uff0cP<0.0001) in the WMLs-NC group and in the WMLs-VCI group (r=-0.4448, P<0.0001 and r=-0.6279, P<0.0001, respectively).Conclusions: WML patients have higher PSMD and worse cognitive performance than do healthy controls. PSMD is strongly associated with global cognition and executive functions in WML patients. This result provides new insights into the pathophysiology of cognitive impairment in WML patients. PSMD could be a surrogate marker for disease progression and can thus be used in therapeutic trials involving WML patients.
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Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,000 |
| Bibliométrie | 0,023 | 0,007 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,004 | 0,009 |
| Science ouverte | 0,004 | 0,006 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,028 | 0,004 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle