Structural brain network measures are superior to vascular burden scores in predicting early cognitive impairment in post stroke patients with small vessel disease

Abstract

Objectives In this cross-sectional study, we aimed to explore the mechanisms of early cognitive impairment in a post stroke non-dementia cerebral small vessel disease (SVD) cohort by comparing the SVD score with the structural brain network measures. Method 127 SVD patients were recruited consecutively from a stroke clinic, comprising 76 individuals with mild cognitive impairment (MCI) and 51 with no cognitive impairment (NCI). Detailed neuropsychological assessments and multimodal MRI were performed. SVD scores were calculated on a standard scale, and structural brain network measures were analyzed by diffusion tensor imaging (DTI). Between-group differences were analyzed, and logistic regression was applied to determine the predictive value of SVD and network measures for cognitive status. Mediation analysis with structural equation modeling (SEM) was used to better understand the interactions of SVD burden, brain networks and cognitive deficits. Results Group difference was found on all global brain network measures. After adjustment for age, gender, education and depression, significant correlations were found between global brain network measures and diverse neuropsychological tests, including TMT-B ( r = −0.209, p < .05), DSST ( r = 0.206, p < .05), AVLT short term free recall ( r = 0.233, p < .05), AVLT long term free recall ( r = 0.264, p < .05) and Rey-O copy ( r = 0.272, p < .05). SVD score showed no group difference and was not correlated with cognition tests. Network global efficiency (E Global ) was significantly related to cognitive state ( p < .01) but not the SVD score. Mediation analysis showed that the standardized total effect ( p = .013) and the standardized indirect effect ( p = .016) of SVD score on cognition was significant, but the direct effect was not. Conclusions Brain network measures, but not the SVD score, are significantly correlated with cognition in post-stroke SVD patients. Mediation analysis showed that the cerebral vascular lesions produce cognitive dysfunction by interfering with the structural brain network in SVD patients. The brain network measures may be regarded as direct and independent surrogate markers of cognitive impairment in SVD.

Functional Disorganization of Small-World Brain Networks in Patients With Ischemic Leukoaraiosis

“…Network efficiency analyses also showed aberrant small-world topology (i.e., reduced global and local efficiency) in the ILA patients. These results are compatible with previous connectome-based studies on SVD (Lawrence et al, 2014 ; Tuladhar et al, 2016 , 2017 ; Du et al, 2019 ).…”

“…ILA, ischemic leukoaraiosis. studies on SVD (Lawrence et al, 2014;Tuladhar et al, 2016Tuladhar et al, , 2017Du et al, 2019).…”

Disrupted Brain Structural Connectivity Network in Subcortical Ischemic Vascular Cognitive Impairment With No Dementia

“…Our results were in keeping with previous studies. For instance, Du et al (2019) found that the global network efficiency of the brain structural network was significantly related to the cognitive state in patients with mild cognitive impairment caused by small vessel disease. Moreover, Heinen et al (2018) also found that global network efficiency of the brain structural network was related to cognitive functioning such as information processing speed, attention, and executive functioning in patients with mild cognitive impairment caused by small vessel disease.…”

“…Moreover, the topological organization of whole-brain functional and structural networks could be employed to characterize some neurological and psychiatric disorders (Zhang et al, 2011;Shu et al, 2012;Zhu et al, 2016). Notably, one study recruited 127 small vessel disease patients which were comprised of 76 mild cognitive impairment patients and 51 normal cognitive patients; the results showed that global network efficiency was significantly correlated with cognitive state (p < 0.01) (Du et al, 2019). Another study (Heinen et al, 2018) considered the relationship between total small vessel disease burden score, global network efficiency and cognition; the results showed that global network efficiency was relevant to the performance on the information processing speed, attention and executive functioning.…”

Impacts of Aerobic Exercise on Depression-Like Behaviors in Chronic Unpredictable Mild Stress Mice and Related Factors in the AMPK/PGC-1α Pathway

“…The physical exercise has become an acknowledged, safe, affordable, and important means of promoting health. Aerobic exercises, in particular, have been shown to have a beneficial effect on delaying aging, inhibiting apoptosis, managing hyperlipidemia, improving brain cognition, and treating dementia [1][2][3][4], which has been a boon for improving the life quality of human.…”