Meso-cortical pathway damage in cognition, apathy and gait in cerebral small vessel disease

作者：Hao Li, Mina A. Jacob, Mengfei Cai, Roy P. C. Kessels, David G. Norris, Marco Duering, Frank‐Erik de Leeuw, Anil M. Tuladhar · 发表于：Brain · 年份：2024 · DOI：10.1093/brain/awae145 · 被引用次数：24 · 研究领域：Advanced Neuroimaging Techniques and Applications、Neurological Disorders and Treatments、Neurological Disease Mechanisms and Treatments

Cerebral small vessel disease (SVD) is known to contribute to cognitive impairment, apathy and gait dysfunction. Although associations between cognitive impairment and either apathy or gait dysfunction have been shown in SVD, the inter-relations among these three clinical features and their potential common neural basis remain unexplored. The dopaminergic meso-cortical and meso-limbic pathways have been known as the important brain circuits for both cognitive control, emotion regulation and motor function. Here, we investigated the potential inter-relations between cognitive impairment, apathy and gait dysfunction, with a specific focus on determining whether these clinical features are associated with damage to the meso-cortical and meso-limbic pathways in SVD. In this cross-sectional study, we included 213 participants with SVD for whom MRI and comprehensive neurobehavioural assessments were performed. These assessments comprised six clinical measures: processing speed, executive function, memory, apathy (based on the Apathy Evaluation Scale) and gait function (based on the time and steps in the Timed Up and Go Test). We reconstructed five tracts connecting the ventral tegmental area (VTA) and dorsolateral prefrontal cortex (PFC), ventral lateral PFC, medial orbitofrontal cortex, anterior cingulate cortex (ACC) and nucleus accumbens within meso-cortical and meso-limbic pathways using diffusion weighted imaging. The damage along the five tracts was quantified using the free ...