Study On The Correlation Between Cognitive Impairment And Dynamic Topological Property In Patients With White Matter Hyperintensities

BackgroundCerebral small vessel disease(CSVD)refers to a series of clinical,neuroimaging and pathological syndrome caused by a variety of different reasons in cerebral small vessel lesions.Common imaging abnormalities include white matter hyperintensities(WMHs),lacunar infarction,enlarged perivascular space and microbleeding.Among which,WMHs is one of the typical imaging manifestations of CSVD,and the detection rate in the elderly population is as high as 72-96%.Previous studies on resting-state functional magnetic resonance image(rs-fMRI)have found that the cognitive impairment of WMHs patients is related to the change of static functional connectivity.At present,the dynamic topological property has been gradually applied to explore the neuroimaging mechanism of various neuropsychiatric diseases,but the research on WMHs is relatively lacking.ObjectiveWe aim to investigate the neuroimaging mechanism of patients with WMHs by using dynamic functional connectivity combined with graph theory,and to explore the relationship between dynamic topological properties and cognitive impairment in patients with WMHs.MethodsWe included 36 healthy controls(HC)and 104 patients with mild WMHs(n = 39),moderate WMHs(n = 37),and severe(n = 28)WMHs.The fMRI data of all participants were analyzed using Anatomical Automatic Labeling(AAL)and a slidingwindow approach to generate dynamic functional connectivity matrics.Then,graph theory methods were applied to calculate the topological properties.The Montreal cognitive assessment(MoCA)assessed overall cognitive function,the Auditory verbal learning test(AVLT)assessed memory,the Symbol digit modalities test(SDMT)and Digital span test(DST)assessed attention function,the Color trail test(CTT)assessed executive function,and the Boston naming test(BNT)assessed verbal function.Relationships between cognitive functions and abnormal dynamic topological properties were evaluated by Pearson’s correlation.ResultsThere were no significant differences in the time variability of small-world properties between the HC and three WMH groups.However,there were significant differences in the time variability of nodal properties(FDR corrected p < 0.05)between the four groups.The betweenness centrality exhibited high time variability in right rectus gyri(REC.R),right dorsolateral superior frontal gyrus(SFGdor.R),right inferior occipital lobe(IOG.R),right paracentral lobule(PCL.R),left rectus gyri(REC.L)and left orbital part of the superior frontal gyrus(ORBsup.R).The nodal efficiencies exhibited high time variability in the right Rolandic opercula(ROL.R),right superior temporal gyrus(TPOsup.R),right medial orbital part of the superior frontal gyrus(ROL.R),right superior frontal gyrus(ORBsup.R),left Rolandic opercula(ROL.L)and left postcentral gyrus(Po CG.L).The nodal clustering coefficient exhibited high time variability in right cunei(CUN.R),right medial orbital parts of superior frontal gyrus(ORBsupmed.R),right superior occipital gyrus(SOG.R),right middle occipital gyrus(MOG.R),right inferior occipital lobe(IOG.R),left supramarginal gyrus(SMG.L),left orbital parts of superior frontal gyrus(ORBsup.L),left medial orbital parts of superior frontal gyrus(ORBsupmed.L),left cunei(CUN.L)and left supramarginal gyrus(SMG.L).Compared with the HC group,not only the score of MoCA,the score of AVLT-immediate,AVLT-delay,AVLT-recognition score and BNT score decreased in the WMHs group,but also the completion time of CTT-A、CTT-B and CTT(B-A)increased(all P<0.05).Correlation analysis revealed that as the temporal variability of the nodal cluster coefficient increased in the SMG.L,the completion time of CTT-A gradually increased and the score of AVLT-study gradually decreased in patients with WMHs.Moreover,as the nodal efficiency of the ROL.L increased,the score of MoCA gradually decreased,the the completion time of CTT-A gradually increased,and the completion time of CTT-B gradually increased in patients with WMHs(all P<0.05).ConclusionOur results indicate that patients with WMHs have higher temporal variabilities in regional properties and are associated with executive and memory function.