Regional cortical thinning, demyelination and iron loss in cerebral small vessel disease

作者：Hao Li, Mina A. Jacob, Mengfei Cai, Marco Duering, Maxime Chamberland, David G. Norris, Roy P. C. Kessels, Frank‐Erik de Leeuw, José P. Marques, Anil M. Tuladhar · 发表于：Brain · 年份：2023 · DOI：10.1093/brain/awad220 · 被引用次数：39 · 研究领域：Advanced Neuroimaging Techniques and Applications、MRI in cancer diagnosis、Advanced MRI Techniques and Applications

The link between white matter hyperintensities (WMH) and cortical thinning is thought to be an important pathway by which WMH contributes to cognitive deficits in cerebral small vessel disease (SVD). However, the mechanism behind this association and the underlying tissue composition abnormalities are unclear. The objective of this study is to determine the association between WMH and cortical thickness, and the in vivo tissue composition abnormalities in the WMH-connected cortical regions. In this cross-sectional study, we included 213 participants with SVD who underwent standardized protocol including multimodal neuroimaging scans and cognitive assessment (i.e. processing speed, executive function and memory). We identified the cortex connected to WMH using probabilistic tractography starting from the WMH and defined the WMH-connected regions at three connectivity levels (low, medium and high connectivity level). We calculated the cortical thickness, myelin and iron of the cortex based on T1-weighted, quantitative R1, R2* and susceptibility maps. We used diffusion-weighted imaging to estimate the mean diffusivity of the connecting white matter tracts. We found that cortical thickness, R1, R2* and susceptibility values in the WMH-connected regions were significantly lower than in the WMH-unconnected regions (all Pcorrected < 0.001). Linear regression analyses showed that higher mean diffusivity of the connecting white matter tracts were related to lower thickness (β = -0.30,...