| Background Cerebral small vessel disease(CSVD)is the most common cause of vascular dementia and a major contributor to mixed dementia.Its imaging manifestations are diverse,and its pathogenesis is still unclear.White matter hyperintensity of presumed vascular origin(WMH)is one of the most important neuroimaging markers of CSVD,closely related to inflammation and chronic cerebral ischemia.As a biomarker of atherosclerosis,oxidized low-density lipoprotein(ox-LDL)is related to the occurrence and development of cerebrovascular diseases such as acute cerebral infarction caused by cerebrovascular stenosis,but there are few studies on CSVD.This study aimed to explore the relationship between ox-LDL and changes in cerebral blood flow(CBF)of WMH patients.Methods A total of 90 subjects recruited by the Neurology Department of the first affiliated hospital of Anhui Medical University were included in this study,including 45 WMH patients(64.96±8.88 years old;44% female),matched for age,sex,and education with 45 healthy controls(HC)(61.89±6.55 years old;58% female).All the subjects were required to collect general information,neuropsychological assessment,carotid artery ultrasonography,measurement of relevant laboratory indicators and concentration test of ox-LDL.Using arterial spin labeling(ASL)magnetic resonance technology to automatically segment cerebral blood flow(CBF)for all the subjects,and the difference in brain regions was defined as regions of interest(ROI)after comparing CBF between the groups.Further,we correlated brain CBF with ox-LDL levels and executive function score.Linear regression was performed to determine whether oxLDL levels were correlated risk factor with CBF changes.Results The results showed that compared with the ox-LDL concentration of the HC group(166.34±29.72 μg/L),the ox-LDL concentration in the WMH group(184.10±28.34 μg/L)was higher,at the same time,the incidence of carotid plaque was higher,and the difference was statistically significant(P<0.05),the overall cognition of the subjects in the WMH group was preserved,but the executive function was significantly decreased;the comparison of CBF differences found that the CBF of the right precuneus(Pcu.R)in the WMH group was significantly lower than that of the HC group(P<0.05).And the level of ox-LDL in the WMH group was significantly correlated with the CBF of Pcu.R(r=-0.41,P=0.006).Furthermore,there were significant negative correlations between trail making test(TMT)score(TMT-A: r=-0.305,p=0.042;TMT-B: r=-0.347,p=0.019)and CBF in the Pcu.R.Linear regression showed that ox-LDL level(B=-2.437,p=0.018)significantly affected the CBF change in Pcu.R.Conclusion Our results suggested that the early ischemia in patients with WMH may occur in the precuneus and could cause early impairment of executive function.OxLDL may be an important biomarker suggesting the mechanistic linkage to the decrease of CBF in the precuneus. |
