PDF(Pubmed)
Abstract：
Atrial fibrillation (AF) is associated with an elevated risk of cognitive impairment and dementia. Understanding the cognitive sequelae and brain structural changes associated with AF is vital for addressing ensuing health care needs.
We examined 1335 stroke-free individuals with AF and 2683 matched controls using neuropsychological assessments and multimodal neuroimaging. The analysis revealed that individuals with AF exhibited deficits in executive function, processing speed, and reasoning, accompanied by reduced cortical thickness, elevated extracellular free-water content, and widespread white matter abnormalities, indicative of small vessel pathology. Notably, brain structural differences statistically mediated the relationship between AF and cognitive performance.
Integrating a comprehensive analysis approach with extensive clinical and magnetic resonance imaging data, our study highlights small vessel pathology as a possible unifying link among AF, cognitive decline, and abnormal brain structure. These insights can inform diagnostic approaches and motivate the ongoing implementation of effective therapeutic strategies. Highlights We investigated neuropsychological and multimodal neuroimaging data of 1335 individuals with atrial fibrillation (AF) and 2683 matched controls. Our analysis revealed AF-associated deficits in cognitive domains of attention, executive function, processing speed, and reasoning. Cognitive deficits in the AF group were accompanied by structural brain alterations including reduced cortical thickness and gray matter volume, alongside increased extracellular free-water content as well as widespread differences of white matter integrity. Structural brain changes statistically mediated the link between AF and cognitive performance, emphasizing the potential of structural imaging markers as a diagnostic tool in AF-related cognitive decline.
We examined 1335 stroke-free individuals with AF and 2683 matched controls using neuropsychological assessments and multimodal neuroimaging. The analysis revealed that individuals with AF exhibited deficits in executive function, processing speed, and reasoning, accompanied by reduced cortical thickness, elevated extracellular free-water content, and widespread white matter abnormalities, indicative of small vessel pathology. Notably, brain structural differences statistically mediated the relationship between AF and cognitive performance.
Integrating a comprehensive analysis approach with extensive clinical and magnetic resonance imaging data, our study highlights small vessel pathology as a possible unifying link among AF, cognitive decline, and abnormal brain structure. These insights can inform diagnostic approaches and motivate the ongoing implementation of effective therapeutic strategies. Highlights We investigated neuropsychological and multimodal neuroimaging data of 1335 individuals with atrial fibrillation (AF) and 2683 matched controls. Our analysis revealed AF-associated deficits in cognitive domains of attention, executive function, processing speed, and reasoning. Cognitive deficits in the AF group were accompanied by structural brain alterations including reduced cortical thickness and gray matter volume, alongside increased extracellular free-water content as well as widespread differences of white matter integrity. Structural brain changes statistically mediated the link between AF and cognitive performance, emphasizing the potential of structural imaging markers as a diagnostic tool in AF-related cognitive decline.
摘要：
背景：心房颤动（AF）与认知障碍和痴呆的风险升高相关。了解与房颤相关的认知后遗症和大脑结构变化对于解决随之而来的医疗保健需求至关重要。
结果：我们使用神经心理学评估和多模式神经影像学检查了1335名房颤患者和2683名匹配对照者。分析显示，房颤患者表现出执行功能缺陷，处理速度,和推理，伴随着皮质厚度的减少，细胞外游离水含量升高，广泛的白质异常，指示小血管病理。值得注意的是,脑结构差异在统计学上介导了AF与认知表现之间的关系。
结论：将全面的分析方法与广泛的临床和磁共振成像数据相结合，我们的研究强调小血管病理学是房颤之间可能的统一联系，认知能力下降,大脑结构异常.这些见解可以为诊断方法提供信息，并激励有效治疗策略的持续实施。我们调查了1335名房颤（AF）患者和2683名匹配对照的神经心理学和多模式神经影像学数据。我们的分析揭示了与AF相关的认知注意领域的缺陷，执行功能，处理速度,和推理。房颤组的认知障碍伴随着结构性脑改变，包括皮质厚度和灰质体积减少。细胞外自由水含量增加以及白质完整性的广泛差异。大脑结构变化在统计学上介导了房颤和认知表现之间的联系，强调结构成像标志物作为房颤相关认知功能减退的诊断工具的潜力。
结果：我们使用神经心理学评估和多模式神经影像学检查了1335名房颤患者和2683名匹配对照者。分析显示，房颤患者表现出执行功能缺陷，处理速度,和推理，伴随着皮质厚度的减少，细胞外游离水含量升高，广泛的白质异常，指示小血管病理。值得注意的是,脑结构差异在统计学上介导了AF与认知表现之间的关系。
结论：将全面的分析方法与广泛的临床和磁共振成像数据相结合，我们的研究强调小血管病理学是房颤之间可能的统一联系，认知能力下降,大脑结构异常.这些见解可以为诊断方法提供信息，并激励有效治疗策略的持续实施。我们调查了1335名房颤（AF）患者和2683名匹配对照的神经心理学和多模式神经影像学数据。我们的分析揭示了与AF相关的认知注意领域的缺陷，执行功能，处理速度,和推理。房颤组的认知障碍伴随着结构性脑改变，包括皮质厚度和灰质体积减少。细胞外自由水含量增加以及白质完整性的广泛差异。大脑结构变化在统计学上介导了房颤和认知表现之间的联系，强调结构成像标志物作为房颤相关认知功能减退的诊断工具的潜力。
