Association Of Resting State Functional MRI Abnormalities With Cognitive Disfunction In Patients With Leukoaraiosis

Objective:To achieve the features of cognitive disfuction and cerebral spontaneous activity using neuropsychological assessment and resting state functional magnetic resonance imaging(rs-fMRI) in patients with leukoaraiosis(LA), and to determine the association of the abnormalities of rs-fMRI parameters with cognitive function, and then explore the probable pathophysiological mechanism of LA.Methods:A total of 13 patients with LA(LA group) and 13 healthy controls(NC group) were recruuited, the two groups were matched for age, sex, education, and vascular risk factors.All the subjects underwent neuropsychological assessment and the scan of magnetic resonance imaging(MRI), rs-fMRI, and the amplitude of low frequency fluctuation(ALFF) maps were computed and analysed, showed the regions of abnormal pontaneous activities in resing state. The neuropsychological assessment scores were compared between the two groups, and the correlations of neuropsychological assessment with ALFF were analysed.Results:1.Compared with the NC group, patients with LA performed significantly worse cognitive function, especilly in the fields of executive function, memory, attention, and information processing speed. The results of our study showed that LA group were associated with comprehensive cognitive deficits, including minimum mental state examination(MMSE), montreal cognitive assessment(MoCA), digit spandigit span test(DS) forwards and backwards, trail making test(TMT) part A, immediate memory and delayed memory of auditory verbal learning test(AVLT), Stroop B and C, verbal similarity test(all P<0.05). However, there was no difference in the performance of verbal fluency test(VFT), recognition memory of AVLT, clock drawing test(CDT) and building blocks test of Wechsler adult intelligence scale(WAIS-RC)(all P>0.05).2.Compared with the NC group, patients with LA performed decreased ALFF in ares of Posterior cingulate cortex(PCC), Precuneus_R, Cuneus, Postcentral_R,Precentral_R, Calcarine_R(all P<0.05), and increased ALFF in ares of superior frontal gyrus_R, superior frontal gyrus_L, inferior frontal gyrus_L,inferior frontal gyrus_R, Insula_L, Hippocampus_L, ParaHippocampal_L(all P<0.05).3.With age, gender and education as covariates, the correlation analysis showed that there are closely correlation between the score of neuropsychological assessment and ALFF.Conclusions:1.Patients with LA exhibited significant cognitive disfunction, especilly in the domains of memory, attention, executive function and information processing speed, the damage of visuospatial skill is not apparent.2.In resting state, cognitive disfunction of LA related to abnormal cerebral spontaneous activity, ares like PCC and precuneus have activity decline, ares like frontal lobe, temporal lobe may have functional compensation, all these abnormal cerebral spontaneous activities are closely related with cognitive deficit, and compensatory mechanism maybe a possible pathophysiology in LA.3.Rs-MRI will have better development prospects, ALFF can be used to reflect cognitive decline and be used to detect the mechanism of LA.