Decreased cortical thickness and normal regional homogeneity underlying cognitive impairment in cerebral small vessel disease

Yuting Mo^1,2,3†, Lili Huang^1,2,3†, Ruomeng Qin^1,2,3, Kelei He⁴, Zhihong Ke^1,2,3, Zheqi Hu^1,2,3, Chenglu Mao^1,2,3, Biyun Xu⁵, Ruowen Qi⁵, Xiaolei Zhu^1,2,3*, Qing Ye^1,2,3*

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¹ Department of Neurology of Drum Tower Hospital, Medical School and the State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing 210008, China

² Nanjing Neurology Clinic Medical Center, Nanjing 210008, China

³ Institute of Brain Science, Nanjing University, Nanjing 210008, China

⁴ National Institute of Healthcare Data Science at Nanjing University, China

⁵ Medical Statistics and Analysis Center, Nanjing Drum Tower Hospital, Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, China

Advanced Neurology 2022, 1(1), 48 https://doi.org/10.36922/an.v1i1.48

Submitted: 16 November 2021 | Accepted: 14 March 2022 | Published: 30 March 2022

© 2022 by the Authors. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )

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Abstract

Cerebral small vessel disease (CSVD) is the most common cause of vascular cognitive impairment (CI). However, the cognitive performance of individuals with CSVD varies considerably. Early identification of neuroimaging changes related to CI caused by CSVD is important for the prediction and management of CI. The present study aimed to explore the early alterations in cortical thickness and regional homogeneity (ReHo) related to CI in people with CSVD. A total of 106 participants with CSVD with CI, 77 participants with CSVD without CI, and 121 control participants underwent neuropsychological tests and multimodal magnetic resonance imaging scans. Cortical thickness was analyzed using FreeSurfer software, and ReHo patterns were explored using the DPARSF toolbox in brain regions that exhibited alterations in cortical thickness. The CSVD with CI group exhibited decreased cortical thickness but normal ReHo in the right anterior cingulate gyrus (ACG), right cuneus, bilateral insula, and right middle temporal gyrus compared with that in the other two groups. Specifically, both cortical thickness and ReHo in the right ACG were significantly associated with memory performance in CSVD patients with CI. In addition, impaired visuospatial function occurred earlier than the decline of global function in CSVD patients and was related to cortical thinning in the right middle temporal gyrus. In conclusion, decreased cortical thickness but normal ReHo in the right ACG, right cuneus, bilateral insula, and right middle temporal gyrus are characteristic alterations related to the development of CI in CSVD patients. These findings may contribute to the early prediction of CI in CSVD patients.

Keywords

Cerebral small vessel disease

Cognitive impairment

Cortical thickness

Regional homogeneity

Funding

National Natural Science Foundation of China

Conflict of interest

The authors declare that they have no known conflicts of interest that could influence the work reported in this paper.

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