Page 67 - AN-1-1

Advanced Neurologyurology
Advanced Ne Cortical thickness and regional homogeneity in CSVD

1. Introduction associated with altered regional functional homogeneity
in the cortex. Regional homogeneity (ReHo), a widely
Cerebral small vessel disease (CSVD) is a clinical syndrome used functional homogeneity parameter, measures
involving injuries in small vessels in the brain and typically the consistency of a time series of a given voxel with its
causes cognitive impairment (CI), gait dysfunction, and neighboring voxels using Kendall’s coefficient concordance
mood disorders, as well as urinary and rectal dysfunction. and indicates the synchronized oscillation of neurons in
The common neuroimaging features of CSVD include a given brain region . Our recent study revealed that
[13]
white matter (WM) hyperintensities (WMH), lacunes, CSVD patients with CI exhibited higher ReHo in parietal
microbleeds, and perivascular space enlargement . CSVD [14]
[1]
is an age-related disease detected in more than 68% of and occipital regions than CSVD patients without CI .
people over 60 years old and is the most common cause However, determining whether there is a connection
[2]
of vascular CI, contributing to 45% of dementia cases . between altered ReHo and cortical atrophy requires further
investigation. Exploring the patterns of cortical thinning
However, the cognitive performance of individuals with
CSVD tends to vary markedly, with a proportion of and ReHo in CSVD patients with and without CI may be
these individuals exhibiting normal cognitive function . useful for the prediction of CI in these patients.
[3]
Exploring the brain alterations related to the development In the present study, participants exhibiting CSVD with
of CI in CSVD patients is essential for the prediction and CI, participants exhibiting CSVD without CI, and normal
management of CI in these patients. control (NC) participants underwent neuropsychological
Recently, multimodal functional magnetic resonance testing and multimodal fMRI scans. We aimed to: (1)
imaging (fMRI) has been used to detect functional and Explore the different patterns of cortical thinning and
structural brain alterations related to CI in CSVD patients. ReHo across groups and (2) detect early alterations in
For example, altered patterns of resting-state networks, cortical thickness and ReHo related to the development of
including the default mode network, the frontoparietal CI in CSVD patients.
control network, and the dorsal attention network, are 2. Methods
associated with CI in CSVD patients [4-6] . The impaired
information processing speed caused by CSVD is mediated 2.1. Participants
by the nodal global efficiency of resting-state functional A total of 183 CSVD patients and 121 NC participants
networks in the frontal and parietal regions . Fiber were recruited at the Affiliated Drum Tower Hospital
[7]
microstructural integrity, which can be measured using of Nanjing University Medical School. This study was
diffusion tensor imaging technology, is also associated with approved by the Affiliated Drum Tower Hospital of
cognitive performance in CSVD patients. Fiber integrities Nanjing University Medical School Ethics Committee
in the cingulum bundle, the frontal WM, and the corpus and written informed consent was obtained from each
callosum are related to verbal memory, psychomotor speed, participant. All participants underwent multimodal MRI
and global cognitive function, respectively . However, the scans and standardized clinical assessments, including
[8]
methodologies used for exploring resting-state networks demographic data, vascular risk factor recording, and
and fiber microstructural integrity vary across studies, and neuropsychological examination. The inclusion criteria for
it is time consuming to perform analyses of resting-state CSVD patients were as follows: (1) Age between 50 and
networks and fiber microstructural integrity. These factors 80 years; (2) meeting the diagnostic criteria for CSVD; (3)
limit the clinical application of these methodologies for right handed; and (4) no contraindications for MRI.
predicting the development of CI in CSVD patients.
The diagnosis of CSVD was based on neuroimaging
Cortical thickness is a reliable parameter for assessing
structural atrophy in the cerebral cortex. CSVD patients and clinical symptoms. On the basis of established research
criteria, the detailed diagnostic criteria are as follows: (1)
are reported to exhibit cortical thinning in several brain Lesions of moderate-to-severe WMH (Fazekas scores
[15]
regions, including the bilateral temporal lobe, and bilateral of 2 or higher) and/or anatomically appropriate lacunar
insula [9-11] . However, the patterns of cortical thinning infarcts on neuroimaging, with or without perivascular
related to the CI caused by CSVD vary across studies . [16,17]
[12]
This variation may have been caused by heterogeneity spaces, microbleeds, and brain atrophy and (2) acute
in methodologies, including the definition of CI, the symptoms (e.g., lacunar syndromes and transient ischemic
calculation of cortical thickness, and insufficient sample attack) or subacute manifestations (e.g., CI, motor
size. As a result, the pattern of cortical thinning related to disturbances, and emotional disorders).
the development of CI in CSVD patients remains relatively The exclusion criteria were as follows: (1) A history
poorly understood. In addition, cortical atrophy may be of ischemic stroke with infarct size more than 1.5 cm in

Volume 1 Issue 1 (2022) 2 https://doi.org/10.36922/an.v1i1.48