Journal
JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM
Volume 41, Issue 8, Pages 1858-1872Publisher
SAGE PUBLICATIONS INC
DOI: 10.1177/0271678X21990980
Keywords
Cerebrovascular disease; white matter microstructure; magnetic resonance imaging; population-based; cognition
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Funding
- National Medical Research Council (NMRC), Singapore [R-184-006-184-511, NMRC/CSA/038/2013]
- Bight Focus Foundation [R-608-000-248-597]
- National Medical Research Council, Singapore [NMRC0088/2015]
- Duke-NUS Medical School Signature Research Program - Ministry of Health, Singapore
- Center for Sleep and Cognition - Yong Loo Lin School of Medicine, National University of Singapore
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The study found that lacunar counts, WMH volume, and ICS were associated with worse performance in executive function, attention, language, verbal and visual memory, and these three markers were also related to white matter microstructural damage.
To determine whether white matter network disruption mediates the association between MRI markers of cerebrovascular disease (CeVD) and cognitive impairment. Participants (n = 253, aged >= 60 years) from the Epidemiology of Dementia in Singapore study underwent neuropsychological assessments and MRI. CeVD markers were defined as lacunes, white matter hyperintensities (WMH), microbleeds, cortical microinfarcts, cortical infarcts and intracranial stenosis (ICS). White matter microstructure damage was measured as fractional anisotropy and mean diffusivity by tract based spatial statistics from diffusion tensor imaging. Cognitive function was summarized as domain-specific Z-scores. Lacunar counts, WMH volume and ICS were associated with worse performance in executive function, attention, language, verbal and visual memory. These three CeVD markers were also associated with white matter microstructural damage in the projection, commissural, association, and limbic fibers. Path analyses showed that lacunar counts, higher WMH volume and ICS were associated with executive and verbal memory impairment via white matter disruption in commissural fibers whereas impairment in the attention, visual memory and language were mediated through projection fibers. Our study shows that the abnormalities in white matter connectivity may underlie the relationship between CeVD and cognition. Further longitudinal studies are needed to understand the cause-effect relationship between CeVD, white matter damage and cognition.
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