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Advanced Neurology Cortical thickness and regional homogeneity in CSVD

asymptomatic CSVD patients whose neuropsychological in ReHo in different regions, causing overall ReHo to
tests were in the normal range and we found that remain unchanged. Nevertheless, we only explored the
[43]
visuospatial structure and visuospatial memory ReHo pattern in regions with decreased cortical thickness
dysfunction occurred before overall cognitive dysfunction. because we intended to focus on regions that exhibited
These findings suggest that visuospatial function may be stable structural changes. This may have helped to improve
the earliest impaired cognitive domain involved in CSVD. the stability and repeatability of results.
In addition, thinning of the right MTG may be the cause Several limitations of the present study should be
of visuospatial damage in CSVD patients whose overall considered. First, our study employed cross-sectional data
cognition still maintained. Visual system studies have and could not reveal causal effects of brain alterations on
proposed that the ventral occipitotemporal and dorsal cognitive function. Longitudinal data would be helpful
occipitoparietal pathways cooperate to convey the visual for detecting the causal relationships between brain
[44]
and spatial properties of the object and the MTG serves alterations and cognitive function. Second, the CSVD
as an important component . Temporal cortex changes with the CI group included both patients with MCI and
[45]
have also been found to be associated with visuospatial those with dementia, but this differentiation was not taken
and visuoperceptual dysfunction in Parkinson’s disease into consideration, while the study explored the cortical
patients and right parietotemporal gyrus atrophy was thickness and ReHo of the participants. Future studies
[46]
reported to be involved in visuospatial deficits in posterior should focus on brain changes across different stages of CI
cortical atrophy patients . Thus, even if a CSVD patient in CSVD patients.
[47]
exhibits normal global function (defined according to the
MoCA test), assessing visuospatial function and cortical 5. Conclusion
thickness in the right MTG are of great importance, Decreased cortical thickness but normal ReHo in the right
potentially contributing to the detection of early CI in ACG, right cuneus, bilateral insula, and right MTG are
CSVD. characteristic changes related to the development of CI in
The previous studies have explored other features, CSVD patients, and impaired visuospatial function related
including functional connectivity and the integrity of the to cortical thinning in the right MTG may provide a much
WM tract, which are related to CI in CSVD patients [1,48] . earlier sign of CI in these patients. These findings shed
However, conflicting results have been reported. This light on potential markers related to CI in CSVD patients.
discrepancy may have resulted from differences in Further research will be required to predict the onset of CI
methodology between studies. For example, in analyses of on the basis of these brain changes.
functional connectivity, the selection of seed regions and
methods for the identification of functional networks vary Acknowledgments
between studies . Similarly, different methods have been We thank all of the medical workers involved in this study
[48]
employed to measure the integrity of the WM tract . In for their contributions and all participants for taking part
[1]
contrast, our results are more consistent as the cortical in this study.
thickness and ReHo are relatively easily measured on the
basis of T1 images and BOLD images, respectively, and we Funding
used established methods to measure cortical thickness and This work was supported by the National Natural Science
ReHo. We took this approach to maximize the likelihood Foundation of China (81801060, 81971009).
of our results having useful clinical applications, although
more research will be required to validate the present Conflict of interest
findings in the future studies.
The authors declare that they have no known conflicts
Brain functional alterations have traditionally been of interest that could influence the work reported in this
considered to occur earlier than structural alterations. paper.
However, our study found that the CSVD with the CI group
exhibited decreased cortical thickness in five regions, but Author contributions
no altered ReHo, compared with the NC group. There Conceptualization: Qing Ye and Xiaolei Zhu
are at least two possible reasons for this finding. First, the
ReHo pattern was investigated in the mask of each region Investigation: Xiaolei Zhu, Yuting Mo, Lili Huang, Ruomeng
with decreased cortical thickness. Altered ReHo may Qin, Zhihong Ke, Zheqi Hu, and Chenglu Mao
occur in parts of each region or outside the five regions. Formal analysis: Yuting Mo, Lili Huang, Kelei He, Biyun
Second, there may have been decreased and increased Xu, and Ruowen Qi

Volume 1 Issue 1 (2022) 9 https://doi.org/10.36922/an.v1i1.48