背景:脑小血管病(CSVD)包括以异质性病理机制和不同神经病理学临床表现为特征的血管疾病。CSVD的认知功能障碍与结构协方差网络(SCN)的减少有关。对SCN进行的大多数研究都集中在群体层面的分析上。然而,为了更好地了解CSVD等异质性疾病,研究个体化变异至关重要.因此,本研究旨在利用个性化差分结构协方差网络(IDSCN)分析来检测个性化结构协方差畸变。
方法:共有35名健康对照者和33名CSVD认知障碍患者参与了本研究。使用T1图像中的区域灰质体积,为每位参与者构建了IDSCN.最后,通过使用配对样本t检验比较两组的IDSCN,确定两组之间的差异结构协方差边.在这些差分边缘的基础上,我们确定了认知受损CSVD患者的两种亚型.
结果:研究结果表明,CSVD认知障碍患者的差异结构协方差边缘表现出高度异质性分布,边缘主要交叉分布在枕叶之间(特别是枕下回和cuneus),颞叶(特别是颞上回),还有小脑.在不同程度上,额下回和顶叶上回也有分布。随后,在所得差异边缘和认知量表评分之间进行相关性分析.在认知评分与分布在额下回和枕下回的差异边缘之间观察到显着的负相关。颞上回和枕下回,在颞叶内。特别是在注意力的认知领域,由差异边缘分隔的两个亚型在认知量表得分[迷你精神状态检查(MMSE)和蒙特利尔认知评估(MoCA)]上表现出差异.亚型1的差异边缘,以认知水平较低为特征,主要交叉分布在边缘叶(特别是扣带回和海马),顶叶(包括顶叶上回和前肌),还有小脑.相比之下,具有相对较高认知水平的亚型2的差异边缘分布在cuneus和小脑之间。
结论:研究了健康对照和CSVD认知功能障碍患者之间的差异结构协方差,表明两组之间存在差异的结构协方差。大脑某些部位的边缘分布,如小脑、枕叶和颞叶,验证了这一点。在认知量表得分和一些差异边缘之间发现了显着的关联。还确定了在差异边缘和认知水平上不同的两个亚型。认知水平相对较低的亚型1的差异边缘在扣带回中分布更多,海马体,顶叶上回,和precuneus。这可能在准确诊断和靶向治疗异质性疾病如CSVD方面提供显著益处。
BACKGROUND: Cerebral small vessel disease (CSVD) includes vascular disorders characterized by heterogeneous pathomechanisms and different neuropathological clinical manifestations. Cognitive dysfunction in CSVD is associated with reductions in structural covariance networks (SCNs). A majority of research conducted on SCNs focused on group-level analysis. However, it is crucial to investigate the individualized variations in order to gain a better understanding of heterogeneous disorders such as CSVD. Therefore, this study aimed to utilize individualized differential structural covariance network (IDSCN) analysis to detect individualized structural covariance aberration.
METHODS: A total of 35 healthy controls and 33 CSVD patients with cognitive impairment participated in this investigation. Using the regional gray matter volume in their T1 images, the IDSCN was constructed for each participant. Finally, the differential structural covariance edges between the two groups were determined by comparing their IDSCN using paired-sample t-tests. On the basis of these differential edges, the two subtypes of cognitively impaired CSVD patients were identified.
RESULTS: The findings revealed that the differential structural covariance edges in CSVD patients with cognitive impairment showed a highly heterogeneous idistribution, with the edges primarily cross-distributed between the occipital lobe (specifically inferior occipital gyrus and cuneus), temporal lobe (specifically superior temporal gyrus), and the cerebellum. To varying degrees, the inferior frontal gyrus and the superior parietal gyrus were also distributed. Subsequently, a correlation analysis was performed between the resulting differential edges and the cognitive scale scores. A significant negative association was observed between the cognitive scores and the differential edges distributed in the inferior frontal gyrus and inferior occipital gyrus, the superior temporal gyrus and inferior occipital gyrus, and within the temporal lobe. Particularly in the cognitive domain of attention, the two subtypes separated by differential edges exhibited differences in cognitive scale scores [Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)]. The differential edges of the subtype 1, characterized by lower cognitive level, were mainly cross-distributed in the limbic lobe (specifically the cingulate gyrus and hippocampus), the parietal lobe (including the superior parietal gyrus and precuneus), and the cerebellum. In contrast, the differential edges of the subtype 2 with a relatively high level of cognition were distributed between the cuneus and the cerebellum.
CONCLUSIONS: The differential structural covariance was investigated between the healthy controls and the CSVD patients with cognitive impairment, showing that differential structural covariance existed between the two groups. The edge distributions in certain parts of the brain, such as cerebellum and occipital and temporal lobes, verified this. Significant associations were seen between cognitive scale scores and some of those differential edges .The two subtypes that differed in both differential edges and cognitive levels were also identified. The differential edges of subtype 1 with relatively lower cognitive levels were more distributed in the cingulate gyrus, hippocampus, superior parietal gyrus, and precuneus. This could potentially offer significant benefits in terms of accurate diagnosis and targeted treatment of heterogeneous disorders such as CSVD.