Functional Segregation-Integration Preference Configures the Cognitive Decline Against Cerebral Small Vessel Disease: An MRI Study

IF 4.8 1区医学 Q1 NEUROSCIENCES

CNS Neuroscience & Therapeutics Pub Date : 2024-12-17 DOI:10.1111/cns.70162

Wentao Hu, Yao Wang, Zhenhui Xie, Mianxin Liu, Xu Han, Ying Hu, Xingrui Wang, Yongming Dai, Qun Xu, Yan Zhou

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Abstract

Introduction

Cerebral small vessel disease (CSVD) is highly prevalent in elder individuals, and its variable cognitive outcomes indicate some cognitive reserve mechanisms. Contribution from functional network features is still unclear. Here we explore how functional segregation-integration preference influences the cognitive changes against CSVD.

Materials and Methods

A total of, 271 CSVD patients were included, all underwent MRI scans including routine and resting-state functional MRI (rs-fMRI). Hierarchical balance index (H_B) was obtained from the rs-fMRI connectivity using eigenmode-based approach. Individuals were classified into segregated and integrated groups according to negative and positive H_B. A composite CSVD lesion score was calculated from imaging findings. Global and five specific cognitive functions were assessed.

Results

Hierarchical regression analysis revealed negative contribution from lesion load to global and all cognitive domains (β = −0.22~−0.35, ∆R² = 0.046~0.112, all p < 0.001). Inclusion of H_B did not show significant contribution (all p > 0.05), but interaction between H_B and lesion score was significantly associated with global (β = −0.27, ∆R² = 0.013, p = 0.034) and execution score (β = −0.34, ∆R² = 0.023, p = 0.002). Integrated patients show significant better global cognitive (23.9 ± 3.9 vs. 25.5 ± 3.1, p = 0.044) and executive ability (0.235 ± 0.678 vs. 0.535 ± 0.688, p = 0.049) at mild damage stage, visuospatial (−0.001 ± 0.804 vs. 0.379 ± 0.249, p = 0.034) and language ability (−0.133 ± 0.849 vs. 0.218 ± 0.704, p = 0.037) at moderate damage stage. Cross-overs of cognitive scores were observed. Significant better execution (−0.277 ± 0.717 vs. −0.675 ± 0.883, p = 0.027) was found in severe damage stage for segregated patients.

Conclusion

Thus, we concluded that integrated network contributes to cognitive resilience in mild and moderate but not in severe damage stages.

Abstract Image

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功能分离-整合偏好配置对脑血管疾病的认知衰退：一项MRI研究。

脑血管病（CSVD）在老年人中非常普遍，其多变的认知结果提示了一些认知储备机制。功能性网络特性的贡献尚不清楚。在这里，我们探讨功能性分离-整合偏好如何影响对CSVD的认知变化。材料和方法：共纳入271例CSVD患者，所有患者均接受MRI扫描，包括常规和静息状态功能MRI （rs-fMRI）。利用基于特征模型的方法从rs-fMRI连接中获得层次平衡指数（HB）。个体根据HB阴性和阳性分为分离组和整合组。根据影像学结果计算复合CSVD病变评分。评估了整体和五种特定的认知功能。结果：层次回归分析显示，病灶负荷对全局和所有认知域的贡献为负(β = -0.22~-0.35,∆R2 = 0.046~0.112，所有p B均无显著贡献（均p > 0.05），但HB与病灶评分的交互作用与全局（β = -0.27,∆R2 = 0.013, p = 0.034）和执行评分（β = -0.34,∆R2 = 0.023, p = 0.002）显著相关。综合治疗患者在轻度损伤期整体认知能力（23.9±3.9比25.5±3.1,p = 0.044）、执行能力（0.235±0.678比0.535±0.688,p = 0.049）、视觉空间能力（-0.001±0.804比0.379±0.249,p = 0.034）和语言能力（-0.133±0.849比0.218±0.704,p = 0.037）均有显著改善。观察认知评分的交叉。分离组患者在严重损伤期的执行力显著提高（-0.277±0.717 vs -0.675±0.883,p = 0.027）。结论：综合网络在轻度和中度损伤阶段对认知弹性有促进作用，而在重度损伤阶段对认知弹性无促进作用。

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来源期刊

CNS Neuroscience & Therapeutics 医学-神经科学

CiteScore

7.30

自引率

12.70%

发文量

240

审稿时长

2 months

期刊介绍： CNS Neuroscience & Therapeutics provides a medium for rapid publication of original clinical, experimental, and translational research papers, timely reviews and reports of novel findings of therapeutic relevance to the central nervous system, as well as papers related to clinical pharmacology, drug development and novel methodologies for drug evaluation. The journal focuses on neurological and psychiatric diseases such as stroke, Parkinson’s disease, Alzheimer’s disease, depression, schizophrenia, epilepsy, and drug abuse.