Functional Magnetic Resonance Imaging of Inhibitory Control Reveals Decreased Blood Oxygen Level Dependent Effect in Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy

Gavazzi, Gioele; Orsolini, Stefano; Salvadori, Emilia; Bianchi, Andrea; Rossi, Arianna; Donnini, Ida; Rinnoci, Valentina; Pescini, Francesca; Diciotti, Stefano; Viggiano, Maria Pia; Mascalchi, Mario; Pantoni, Leonardo

doi:10.1161/strokeaha.118.022923

Cited by 12 publications

(14 citation statements)

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“…Our recent resting-state amplitude of low-frequency fluctuation (ALFF) analyses revealed negative associations between the ALFF values of the left cerebellar anterior and posterior lobes, and executive function scores [18]. An event-related Go/No-go task study on CADASIL patients revealed lower blood oxygen level-dependent (BOLD) effects in the alerting network and in areas involved in executive functions, possibly reflecting hemodynamic responses that developed secondary to small-vessel changes [19].…”

Section: Introductionmentioning

confidence: 99%

Reduced resting-state brain functional network connectivity and poor regional homogeneity in patients with CADASIL

Ban

Wang

et al. 2019

J Headache Pain

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BackgroundCerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) manifests principally as a suite of cognitive impairments, particularly in the executive domain. Executive functioning requires the dynamic coordination of neural activity over large-scale networks. It remains unclear whether changes in resting-state brain functional network connectivity and regional homogeneities (ReHos) underly the mechanisms of executive dysfunction evident in CADASIL patients.MethodsIn this study, 22 CADASIL patients and 44 matched healthy controls underwent resting-state functional magnetic resonance imaging (fMRI). Independent component analysis (ICA) was used to measure functional brain network connectivity, and ReHos were calculated to evaluate local brain activities. We used seed-based functional connectivity (FC) analyses to determine whether dysfunctional areas (as defined by ReHos) exhibited abnormal FC with other brain areas. Relationships among the mean intra-network connectivity z-scores of dysfunctional areas within functional networks, and cognitive scores were evaluated using Pearson correlation analyses.ResultsCompared to the controls, CADASIL patients exhibited decreased intra-network connectivity within the bilateral lingual gyrus (LG) and the right cuneus (CU) (thus within the visual network [VIN)], and within the right precuneus (Pcu), inferior frontal gyrus (IFG), and precentral gyrus (thus within the frontal network [FRN]). Compared to the controls, patients also exhibited significantly lower ReHos in the right precuneus and cuneus (Pcu/CU), visual association cortex, calcarine gyri, posterior cingulate, limbic lobe, and weaker FC between the right Pcu/CU and the bilateral parahippocampal gyrus (PHG), and between the right Pcu/CU and the right postcentral gyrus. Notably, the mean connectivity z-scores of the bilateral LG and the right CU within the VIN were positively associated with compromised attention, calculation and delayed recall as revealed by tests of the various cognitive domains explored by the Mini-Mental State Examination.ConclusionsThe decreases in intra-network connectivity within the VIN and FRN and reduced local brain activity in the posterior parietal area suggest that patients with CADASIL may exhibit dysfunctional visuomotor behaviors (a hallmark of executive function), and that all visual information processing, visuomotor planning, and movement execution may be affected.

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Section: Introductionmentioning

confidence: 99%

Reduced resting-state brain functional network connectivity and poor regional homogeneity in patients with CADASIL

Ban

Wang

et al. 2019

J Headache Pain

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“…Due to underlying SVD, it is difficult to ascertain to what extent decreased BOLD reflects decreased regional tissue blood flow or intrinsic functional changes of the cerebral cortex. 25 We did not evaluate our patients with neuropsychological tests exploring the inhibitory and attention functions. There is little doubt that an increase in rsfMRI acquisition time and the use of a higher number of diffusion weighting gradient directions as well as higher number of signal acquisitions would have further improved the quality of our data.…”

Section: Discussionmentioning

confidence: 99%

“…There is a broad, general limitation on the way in which BOLD fMRI results in CADASIL patients are interpreted. Due to underlying SVD, it is difficult to ascertain to what extent decreased BOLD reflects decreased regional tissue blood flow or intrinsic functional changes of the cerebral cortex 25 . We did not evaluate our patients with neuropsychological tests exploring the inhibitory and attention functions.…”

Section: Discussionmentioning

confidence: 99%

“…The former include the overall burden of lacunar infarcts, 14,15 brain atrophy, 8,16 thinning of the corpus callosum, 17 severity or extent of WM or thalamic damage evaluated in T 2 -weighted or diffusion tensor images, 4,6,7,[18][19][20] the number and continuity of lenticulostriate arteries, 21 and deep gray matter (GM) iron deposition. 22 Functional MRI (fMRI), exploiting the blood oxygenation level dependent (BOLD) contrast, is sensitive to hemodynamic changes and has been applied to CADASIL patients during the execution of motor, 23,24 visual 23 and cognitive 25 tasks. In CADASIL patients versus controls, these revealed an increased BOLD amplitude response in the visual cortex during a visual stimulus but not in the motor cortex during a motor task, 23 more frequent bilateral activation of the motor cortex during a simple motor task, 24 and a lower BOLD amplitude response in the cerebral regions belonging to the alerting network, the lower brainstem and the left cerebellum when the proactive inhibition during a Go/NoGo cognitive task was analyzed.…”

Section: Introductionmentioning

confidence: 99%

“…In CADASIL patients versus controls, these revealed an increased BOLD amplitude response in the visual cortex during a visual stimulus but not in the motor cortex during a motor task, 23 more frequent bilateral activation of the motor cortex during a simple motor task, 24 and a lower BOLD amplitude response in the cerebral regions belonging to the alerting network, the lower brainstem and the left cerebellum when the proactive inhibition during a Go/NoGo cognitive task was analyzed. 25 Some inconsistency in the fMRI results during the task execution may be due to a number of reasons including different MR equipment, 26,27 task selection, and variable patient compliance and capability to correctly perform the task. 28 Resting state fMRI (rsfMRI) may overcome these issues.…”

Section: Introductionmentioning

confidence: 99%

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Altered Regional Brain Homogeneity of BOLD Signal in CADASIL: A Resting State fMRI Study

Orsolini

Marzi

Gavazzi

et al. 2020

Journal of Neuroimaging

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The cognitive decline in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is assumed to be due to a cortical-subcortical disconnection secondary to damage to the cerebral white matter (WM). Using resting state functional MRI (rsfMRI) and analysis of the regional homogeneity (ReHo), we examined a group of CADASIL patients and a group of healthy subjects in order to: (1) explore possible differences between the two groups; and (2) to assess, in CADASIL patients, whether any ReHo abnormalities correlate with individual burdens of WM T 2-weighted hyperintensity and diffusion tensor imaging (DTI)-derived index of mean diffusivity (MD) of the cerebral WM, an index reflecting microstructural damage in CADASIL. METHODS: Twenty-three paucisymptomatic CADASIL patients (13 females; age mean ± standard deviation = 43.6 ± 11.1 years; three symptomatic and 20 with no or few symptoms) and 16 healthy controls (nine females; age 46.6 ± 11.0 years) were examined with T 1-weighted, T 2-weighted fluid attenuated inversion recovery images, DTI, and rsfMRI. RESULTS: When compared to controls, CADASIL patients showed four clusters of significantly lower ReHo values in cortical areas belonging to networks involved in inhibition and attention, including the right insula, the left superior frontal gyrus, and the bilateral anterior cingulated cortex. ReHo changes did not correlate with an individual patient's lesion burden or MD. CONCLUSIONS: This study reveals decreased ReHo of rsfMRI signals in cortical areas involved in inhibition and attention processes, suggesting a potential role for these functional cortical changes in CADASIL.

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Contrast agent‐free state‐of‐the‐art magnetic resonance imaging on cerebral small vessel disease – Part 2: Diffusion tensor imaging and functional magnetic resonance imaging

et al. 2022

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Functional Magnetic Resonance Imaging of Inhibitory Control Reveals Decreased Blood Oxygen Level Dependent Effect in Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy

Cited by 12 publications

References 48 publications

Reduced resting-state brain functional network connectivity and poor regional homogeneity in patients with CADASIL

Reduced resting-state brain functional network connectivity and poor regional homogeneity in patients with CADASIL

Altered Regional Brain Homogeneity of BOLD Signal in CADASIL: A Resting State fMRI Study

Contrast agent‐free state‐of‐the‐art magnetic resonance imaging on cerebral small vessel disease – Part 2: Diffusion tensor imaging and functional magnetic resonance imaging

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