Cognition mediates the relationship between white matter hyperintensity and motor function in patients with cerebral small vessel disease: a cross-sectional study.

IF 2.9 2区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Quantitative Imaging in Medicine and Surgery Pub Date : 2024-10-01 Epub Date: 2024-09-19 DOI:10.21037/qims-24-1058
Xueyang Zhao, Mengyun Zuo, Fufang Zhan, Ping Fan, Sanxin Liu, Marcus Taylor, Mario Ganau, Walter A Hall, Hengfang Ruan, Lihong Wan
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Abstract

Background: White matter hyperintensity (WMH) is a common neuroimaging marker of cerebral small vessel disease (SVD) and a critical independent predictor of motor dysfunction, which increases the risk of disability, morbidity, and mortality. However, the mechanism underlying the relationship between WMH and motor function has not yet been fully clarified. It was hypothesized that cognitive impairment mediates the relationship between WMH and motor dysfunction in patients with SVD, which were considered predictor and outcome variables, respectively.

Methods: A total of 221 patients with SVD were enrolled in this study, and their magnetic resonance imaging (MRI), neuropsychological, and motor function data were collected. The MRI data were visually assessed to determine the WMH burden using the Fazekas scale. Cognition was evaluated using the Montreal Cognitive Assessment (MoCA). Motor function was assessed using the Tinetti Gait and Balance Scale and the Short Physical Performance Battery (SPPB). Finally, a bootstrap analysis was performed to determine whether cognition mediated the relationship between WMH and motor function.

Results: Of all the patients, 30.3% had mild WMH, 37.6% had moderate WMH, and 32.1% had severe WMH. Patients' cognition and motor function decreased as the WMH burden increased (P<0.01). The MoCA scores were associated with the Tinetti scale (r=0.545, P<0.01) and SPPB scores (r=0.365, P<0.01). Finally, multi-categorical mediation models confirmed our research hypothesis; the coefficients for the indirect effects had 95% confidence intervals (CIs) that excluded zero, indicating statistically significant mediation effects.

Conclusions: WMH is associated with motor dysfunction, and this association is mediated by cognition in patients with SVD. This finding highlights the importance of early interventions targeting cognitive function to reduce the risk of motor dysfunction.

认知介导脑小血管疾病患者白质高密度与运动功能之间的关系:一项横断面研究。
背景:白质高密度(WMH)是脑小血管疾病(SVD)的常见神经影像学标志物,也是运动功能障碍的重要独立预测指标,而运动功能障碍会增加残疾、发病率和死亡率的风险。然而,WMH 与运动功能之间的关系机制尚未完全阐明。我们假设认知障碍介导了SVD患者WMH与运动功能障碍之间的关系,并将其分别视为预测变量和结果变量:本研究共招募了221名SVD患者,收集了他们的磁共振成像(MRI)、神经心理学和运动功能数据。采用法泽卡斯量表对核磁共振成像数据进行视觉评估,以确定WMH负荷。认知能力采用蒙特利尔认知评估(MoCA)进行评估。运动功能采用 Tinetti 步态与平衡量表和短期体能测试 (SPPB) 进行评估。最后,进行了引导分析,以确定认知是否介导了 WMH 与运动功能之间的关系:在所有患者中,30.3%患有轻度WMH,37.6%患有中度WMH,32.1%患有重度WMH。随着 WMH 负荷的增加,患者的认知能力和运动功能也随之下降:WMH与运动功能障碍有关,而这种关联是由SVD患者的认知能力介导的。这一发现强调了针对认知功能进行早期干预以降低运动功能障碍风险的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Quantitative Imaging in Medicine and Surgery
Quantitative Imaging in Medicine and Surgery Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
4.20
自引率
17.90%
发文量
252
期刊介绍: Information not localized
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