期刊
FRONTIERS IN NEUROLOGY
卷 10, 期 -, 页码 -出版社
FRONTIERS MEDIA SA
DOI: 10.3389/fneur.2019.00348
关键词
white matter hyperintensity; normal appearing white matter; penumbra; cerebral blood flow; diffusion tensor imaging; subcortical vascular mild cognitive impairment
资金
- Shanghai Science and Technology Committee Medical Guide Project (western medicine) [17411964300]
- Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support [20172013]
- National Natural Science Foundation of China [81571650]
- Medical Engineering Cross Research Foundation of Shanghai JiaoTong University [YG2017QN47]
- Research Seed Fund of Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University [RJZZ18-003]
- national Key Research and Development Program of China [2016YFC1300600]
- Incubating Program for Clinical Research and Innovation of Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University [PYIV-17-003, PYIII-17-027]
Normal-appearing white matter (NAWM) surrounding white matter hyperintensities (WMHs), frequently known as the WMH penumbra, is associated with subtle white matter injury and has a high risk for future conversion to WMHs. The goal of this study was to define WMH penumbras and to further explore whether the diffusion and perfusion parameters of these penumbras could better reflect cognitive function alterations than WMHs in subjects with subcortical vascular mild cognitive impairment (svMCI). Seventy-three svMCI subjects underwent neuropsychological assessments and 3T MRI scans, including diffusion tensor imaging (DTI) and arterial spin labeling (ASL). To determine the extent of cerebral blood flow (CBF) and DTI penumbras. A NAWM layer mask was generated for periventricular WMHs (PVWMHs) and deep WMHs (DWMHs) separately. Mean values of CBF, fractional anisotropy (FA), mean diffusivity (MD) within the WMHs and their corresponding NAWM layer masks were computed and compared using paired t-tests. Pearson's partial correlations were used to assess the relations of the mean CBF, FA, and MD values within the corresponding penumbras with composite z-scores of global cognition and four cognitive domains controlling for age, sex, and education. For both PVWMHs and DWMHs, the CBF penumbras were wider than the DTI penumbras. Only the mean FA value of the PVWMH-FA penumbra was correlated with the composite z-scores of global cognition before correction (r = 0.268, p = 0.024), but that correlation did not survive after correcting the p-value for multiple comparisons. Our findings showed extensive white matter perfusion disturbances including white matter tissue, both with and without microstructural alterations. The imaging parameters investigated, however, did not correlate to cognition.
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