Role of diffusion tensor imaging and resting-state functional magnetic resonance imaging in early diagnosis of cognitive impairment related to white matter lesions_West China Medical Journal

Authors：

YANG Dan ,  XU Yun

Department of Neurology, Nanjing Drum Tower Hospital, Medical School of Southeast University, Nanjing, Jiangsu 210008, P. R. China;

Corresponding author：

XU Yun, Email: xuyun20042001@aliyun.com

Keywords：

White matter lesion; Cognitive impairment; Diffusion tensor imaging; Resting-state functional magnetic resonance imaging; Microstructural; Brain network connectivity

DOI：

10.7507/1002-0179.201908053

Video：

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Abstract Full text Figures/Tables Video References Cited by

White matter lesion (WML) of presumed vascular origin is one of the common imaging manifestations of cerebral small vessel diseases, which is the main reason of cognitive impairment and even vascular dementia in the elderly. However, there is a lack of early and effective diagnostic methods currently. In recent years, studies of diffusion tensor imaging (DTI) and resting-state functional magnetic resonance imaging (rs-fMRI) have shown that cognitive impairment in patients with WMLs is associated with disrupted white matter microstructural and brain network connectivity. Therefore, it’s speculated that DTI and rs-fMRI can be effective in early imaging diagnosis of WMLs-related cognitive impairment. This article reviews the role and significance of DTI and rs-fMRI in WMLs-related cognitive impairment.

Citation： YANG Dan, XU Yun. Role of diffusion tensor imaging and resting-state functional magnetic resonance imaging in early diagnosis of cognitive impairment related to white matter lesions. West China Medical Journal, 2019, 34(10): 1087-1090. doi: 10.7507/1002-0179.201908053 Copy

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2.	Pantoni L, Garcia JH. Pathogenesis of leukoaraiosis: a review. Stroke, 1997, 28(3): 652-659.
3.	Breteler M, van Swieten JC, Bots ML, et al. Cerebral white matter lesions, vascular risk factors, and cognitive function in a population-based study: the Rotterdam Study. Neurology, 1994, 44(7): 1246-1246.
4.	de Leeuw FE, de Groot JC, Oudkerk M, et al. Hypertension and cerebral white matter lesions in a prospective cohort study. Brain, 2002, 125(4): 765-772.
5.	de Leeuw FE, de Groot JC, Achten E, et al. Prevalence of cerebral white matter lesions in elderly people: a population based magnetic resonance imaging study. J Neurol Neurosurg Psychiatry, 2001, 70(1): 9-14.
6.	Fazekas F, Chawluk J, Alavi A, et al. MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging. Am J Roentgenol, 1987, 149(2): 351-356.
7.	Kloppenborg RP, Nederkoorn PJ, Geerlings MI, et al. Presence and progression of white matter hyperintensities and cognition: a meta-analysis. Neurology, 2014, 82(23): 2127-2138.
8.	Alber J, Alladi S, Bae H, et al. White matter hyperintensities in vascular contributions to cognitive impairment and dementia (VCID): knowledge gaps and opportunities. Alzheimers Dement (N Y), 2019, 5: 107-117.
9.	Dey AK, Stamenova V, Turner G, et al. Pathoconnectomics of cognitive impairment in small vessel disease: a systematic review. Alzheimers Dement, 2016, 12(7): 831-845.
10.	Yuan J, Feng L, Hu W, et al. Use of multimodal magnetic resonance imaging techniques to explore cognitive impairment in leukoaraiosis. Med Sci Monit, 2018, 24: 8910-8915.
11.	Ye Q, Bai F. Contribution of diffusion, perfusion and functional MRI to the disconnection hypothesis in subcortical vascular cognitive impairment. Stroke Vasc Neurol, 2018, 3(3): 131-139.
12.	Lampe L, Kharabian-Masouleh S, Kynast J, et al. Lesion location matters: the relationships between white matter hyperintensities on cognition in the healthy elderly. J Cereb Blood Flow Metab, 2019, 39(1): 36-43.
13.	Frances A, Sandra O, Lucy U. Vascular cognitive impairment, a cardiovascular complication. World J Psychiatry, 2016, 6(2): 199-207.
14.	Svärd D, Nilsson M, Lampinen B, et al. The effect of white matter hyperintensities on statistical analysis of diffusion tensor imaging in cognitively healthy elderly and prodromal Alzheimer’s disease. PLoS One, 2017, 12(9): e0185239.
15.	Bolandzadeh N, Davis JC, Tam R, et al. The association between cognitive function and white matter lesion location in older adults: a systematic review. BMC Neurol, 2012, 12: 126.
16.	Ai Q, Pu YH, Sy C, et al. Impact of regional white matter lesions on cognitive function in subcortical vascular cognitive impairment. Neurol Res, 2014, 36(5): 434-443.
17.	Ding X, Wu J, Zhou Z, et al. Specific locations within the white matter and cortex are involved in the cognitive impairments associated with periventricular white matter lesions (PWMLs). Behav Brain Res, 2015, 289: 9-18.
18.	Prins ND, Scheltens P. White matter hyperintensities, cognitive impairment and dementia: an update. Nat Rev Neurol, 2015, 11(3): 157-165.
19.	Moon SY, Barreto PD, Chupin MA, et al. Associations between white matter hyperintensities and cognitive decline over three years in non-dementia older adults with memory complaints. J Neurol Sci, 2017, 379(6): 266-270.
20.	LADIS Study Group. 2001-2011: a decade of the LADIS (Leukoaraiosis And DISability) Study: what have we learned about white matter changes and small-vessel disease?. Cerebrovasc Dis, 2011, 32(6): 577-588.
21.	Mailhard P, Carmichael O, Harvey D, et al. FLAIR and diffusion MRI signals are Independent predictors of white matter hyperintensities. Am J Neuroradiol, 2013, 34(1): 54-61.
22.	Zhang Y, Schuff N, Camacho M, et al. MRI markers for mild cognitive impairment: comparisons between white matter integrity and gray matter volume measurements. PLoS One, 2013, 8(6): e66367.
23.	Yuan JL, Wang SK, Guo XJ, et al. Disconnections of cortico-subcortical pathways related to cognitive impairment in patients with leukoaraiosis: a preliminary diffusion tensor imaging study. Eur Neurol, 2017, 78(1/2): 41-47.
24.	Lockhart SN, Mayda AB, Roach AE, et al. Episodic memory function is associated with multiple measures of white matter integrity in cognitive aging. Front Hum Neurosci, 2012, 6: 56.
25.	Wei N, Deng YM, Yao L, et al. A neuroimaging marker based on diffusion tensor imaging and cognitive impairment due to cerebral white matter lesions. Front Neurol, 2019, 10: 81.
26.	Seiler S, Fletcher E, Hassan-Ali K, et al. Cerebral tract integrity relates to white matter hyperintensities, cortex volume, and cognition. Neurobiol Aging, 2018, 72: 14-22.
27.	Langen CD, Cremers LM, de Groot M, et al. Disconnection due to white matter hyperintensities is associated with lower cognitive scores. Neuroimage, 2018, 183: 745-756.
28.	Rabin JS, Perea RD, Buckley RF, et al. Global white matter diffusion characteristics predict longitudinal cognitive change independently of amyloid status in clinically normal older adults. Cerebral Cortex, 2019, 29(3): 1251-1262.
29.	Heuvel MD, Pol HH. Exploring the brain network: a review on resting-state fMRI functional connectivity. Eur Neuropsychopharmacol, 2010, 20(8): 519-534.
30.	Harrison BJ, Pujol J, Lopez-Sola M, et al. Consistency and functional specialization in the default mode brain network. Proc Natl Acad Sci USA, 2008, 105(28): 9781-9786.
31.	Spreng RN, Sepulcre J, Turner GR, et al. Intrinsic architecture underlying the relations among the default, dorsal attention, and frontoparietal control networks of the human brain. J Cogn Neurosci, 2013, 25(1): 74-86.
32.	Ferreira LK, Busatto GF. Resting-state functional connectivity in normal brain aging. Neurosci Biobehav Rev, 2013, 37(3): 384-400.
33.	Li C, Yang J, Yin X, et al. Abnormal intrinsic brain activity patterns in leukoaraiosis with and without cognitive impairment. Behav Brain Res, 2015, 292: 409-413.
34.	李倩, 赵路清, 胡风云. 脑白质疏松症患者认知功能损害的特点及其静息态功能磁共振观察. 中华医学杂志, 2017, 97(45): 3529-3533.
35.	Cheng R, Qi H, Liu Y, et al. Abnormal amplitude of low-frequency fluctuations and functional connectivity of resting-state functional magnetic resonance imaging in patients with leukoaraiosis. Brain Behav, 2017, 7(6): e00714.
36.	Ding X, Ding J, Hua B, et al. Abnormal cortical functional activity in patients with ischemic white matter lesions: a resting-state functional magnetic resonance imaging study. Neurosci Lett, 2017, 644: 10-17.
37.	Ye Q, Chen X, Qin RM, et al. Enhanced regional homogeneity and functional connectivity in subjects with white matter hyperintensities and cognitive impairment. Front Neurosci, 2019, 13: 695.
38.	Liang Y, Sun X, Xu SJ, et al. Preclinical cerebral network connectivity evidence of deficits in mild white matter lesions. Front Aging Neurosci, 2016, 8: 27.
39.	Ding JR, Ding X, Hua B, et al. Altered connectivity patterns among resting state networks in patients with ischemic white matter lesions. Brain Imaging Behav, 2018, 12(5): 1239-1250.
40.	Wang JF, Chen Y, Liang HZ, et al. The role of disturbed small-world networks in patients with white matter lesions and cognitive impairment revealed by resting state function magnetic resonance images (rs-fMRI). Med Sci Monit, 2019, 25: 341-356.

1. Debette S, Markus HS. The clinical importance of white matter hyperintensities on brain magnetic resonance imaging: systematic review and meta-analysis. BMJ, 2010, 341: c3666.
2. Pantoni L, Garcia JH. Pathogenesis of leukoaraiosis: a review. Stroke, 1997, 28(3): 652-659.
3. Breteler M, van Swieten JC, Bots ML, et al. Cerebral white matter lesions, vascular risk factors, and cognitive function in a population-based study: the Rotterdam Study. Neurology, 1994, 44(7): 1246-1246.
4. de Leeuw FE, de Groot JC, Oudkerk M, et al. Hypertension and cerebral white matter lesions in a prospective cohort study. Brain, 2002, 125(4): 765-772.
5. de Leeuw FE, de Groot JC, Achten E, et al. Prevalence of cerebral white matter lesions in elderly people: a population based magnetic resonance imaging study. J Neurol Neurosurg Psychiatry, 2001, 70(1): 9-14.
6. Fazekas F, Chawluk J, Alavi A, et al. MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging. Am J Roentgenol, 1987, 149(2): 351-356.
7. Kloppenborg RP, Nederkoorn PJ, Geerlings MI, et al. Presence and progression of white matter hyperintensities and cognition: a meta-analysis. Neurology, 2014, 82(23): 2127-2138.
8. Alber J, Alladi S, Bae H, et al. White matter hyperintensities in vascular contributions to cognitive impairment and dementia (VCID): knowledge gaps and opportunities. Alzheimers Dement (N Y), 2019, 5: 107-117.
9. Dey AK, Stamenova V, Turner G, et al. Pathoconnectomics of cognitive impairment in small vessel disease: a systematic review. Alzheimers Dement, 2016, 12(7): 831-845.
10. Yuan J, Feng L, Hu W, et al. Use of multimodal magnetic resonance imaging techniques to explore cognitive impairment in leukoaraiosis. Med Sci Monit, 2018, 24: 8910-8915.
11. Ye Q, Bai F. Contribution of diffusion, perfusion and functional MRI to the disconnection hypothesis in subcortical vascular cognitive impairment. Stroke Vasc Neurol, 2018, 3(3): 131-139.
12. Lampe L, Kharabian-Masouleh S, Kynast J, et al. Lesion location matters: the relationships between white matter hyperintensities on cognition in the healthy elderly. J Cereb Blood Flow Metab, 2019, 39(1): 36-43.
13. Frances A, Sandra O, Lucy U. Vascular cognitive impairment, a cardiovascular complication. World J Psychiatry, 2016, 6(2): 199-207.
14. Svärd D, Nilsson M, Lampinen B, et al. The effect of white matter hyperintensities on statistical analysis of diffusion tensor imaging in cognitively healthy elderly and prodromal Alzheimer’s disease. PLoS One, 2017, 12(9): e0185239.
15. Bolandzadeh N, Davis JC, Tam R, et al. The association between cognitive function and white matter lesion location in older adults: a systematic review. BMC Neurol, 2012, 12: 126.
16. Ai Q, Pu YH, Sy C, et al. Impact of regional white matter lesions on cognitive function in subcortical vascular cognitive impairment. Neurol Res, 2014, 36(5): 434-443.
17. Ding X, Wu J, Zhou Z, et al. Specific locations within the white matter and cortex are involved in the cognitive impairments associated with periventricular white matter lesions (PWMLs). Behav Brain Res, 2015, 289: 9-18.
18. Prins ND, Scheltens P. White matter hyperintensities, cognitive impairment and dementia: an update. Nat Rev Neurol, 2015, 11(3): 157-165.
19. Moon SY, Barreto PD, Chupin MA, et al. Associations between white matter hyperintensities and cognitive decline over three years in non-dementia older adults with memory complaints. J Neurol Sci, 2017, 379(6): 266-270.
20. LADIS Study Group. 2001-2011: a decade of the LADIS (Leukoaraiosis And DISability) Study: what have we learned about white matter changes and small-vessel disease?. Cerebrovasc Dis, 2011, 32(6): 577-588.
21. Mailhard P, Carmichael O, Harvey D, et al. FLAIR and diffusion MRI signals are Independent predictors of white matter hyperintensities. Am J Neuroradiol, 2013, 34(1): 54-61.
22. Zhang Y, Schuff N, Camacho M, et al. MRI markers for mild cognitive impairment: comparisons between white matter integrity and gray matter volume measurements. PLoS One, 2013, 8(6): e66367.
23. Yuan JL, Wang SK, Guo XJ, et al. Disconnections of cortico-subcortical pathways related to cognitive impairment in patients with leukoaraiosis: a preliminary diffusion tensor imaging study. Eur Neurol, 2017, 78(1/2): 41-47.
24. Lockhart SN, Mayda AB, Roach AE, et al. Episodic memory function is associated with multiple measures of white matter integrity in cognitive aging. Front Hum Neurosci, 2012, 6: 56.
25. Wei N, Deng YM, Yao L, et al. A neuroimaging marker based on diffusion tensor imaging and cognitive impairment due to cerebral white matter lesions. Front Neurol, 2019, 10: 81.
26. Seiler S, Fletcher E, Hassan-Ali K, et al. Cerebral tract integrity relates to white matter hyperintensities, cortex volume, and cognition. Neurobiol Aging, 2018, 72: 14-22.
27. Langen CD, Cremers LM, de Groot M, et al. Disconnection due to white matter hyperintensities is associated with lower cognitive scores. Neuroimage, 2018, 183: 745-756.
28. Rabin JS, Perea RD, Buckley RF, et al. Global white matter diffusion characteristics predict longitudinal cognitive change independently of amyloid status in clinically normal older adults. Cerebral Cortex, 2019, 29(3): 1251-1262.
29. Heuvel MD, Pol HH. Exploring the brain network: a review on resting-state fMRI functional connectivity. Eur Neuropsychopharmacol, 2010, 20(8): 519-534.
30. Harrison BJ, Pujol J, Lopez-Sola M, et al. Consistency and functional specialization in the default mode brain network. Proc Natl Acad Sci USA, 2008, 105(28): 9781-9786.
31. Spreng RN, Sepulcre J, Turner GR, et al. Intrinsic architecture underlying the relations among the default, dorsal attention, and frontoparietal control networks of the human brain. J Cogn Neurosci, 2013, 25(1): 74-86.
32. Ferreira LK, Busatto GF. Resting-state functional connectivity in normal brain aging. Neurosci Biobehav Rev, 2013, 37(3): 384-400.
33. Li C, Yang J, Yin X, et al. Abnormal intrinsic brain activity patterns in leukoaraiosis with and without cognitive impairment. Behav Brain Res, 2015, 292: 409-413.
34. 李倩, 赵路清, 胡风云. 脑白质疏松症患者认知功能损害的特点及其静息态功能磁共振观察. 中华医学杂志, 2017, 97(45): 3529-3533.
35. Cheng R, Qi H, Liu Y, et al. Abnormal amplitude of low-frequency fluctuations and functional connectivity of resting-state functional magnetic resonance imaging in patients with leukoaraiosis. Brain Behav, 2017, 7(6): e00714.
36. Ding X, Ding J, Hua B, et al. Abnormal cortical functional activity in patients with ischemic white matter lesions: a resting-state functional magnetic resonance imaging study. Neurosci Lett, 2017, 644: 10-17.
37. Ye Q, Chen X, Qin RM, et al. Enhanced regional homogeneity and functional connectivity in subjects with white matter hyperintensities and cognitive impairment. Front Neurosci, 2019, 13: 695.
38. Liang Y, Sun X, Xu SJ, et al. Preclinical cerebral network connectivity evidence of deficits in mild white matter lesions. Front Aging Neurosci, 2016, 8: 27.
39. Ding JR, Ding X, Hua B, et al. Altered connectivity patterns among resting state networks in patients with ischemic white matter lesions. Brain Imaging Behav, 2018, 12(5): 1239-1250.
40. Wang JF, Chen Y, Liang HZ, et al. The role of disturbed small-world networks in patients with white matter lesions and cognitive impairment revealed by resting state function magnetic resonance images (rs-fMRI). Med Sci Monit, 2019, 25: 341-356.

West China Medical Journal

Role of diffusion tensor imaging and resting-state functional magnetic resonance imaging in early diagnosis of cognitive impairment related to white matter lesions

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