The Cerebellum Is Related to Cognitive Dysfunction in White Matter Hyperintensities

Shanshan Cao; Jiajia Nie; Jun Zhang; Chen Chen; Xiaojing Wang; Yuanyuan Liu; Yuting Mo; Baogen Du; Yajuan Hu; Yanghua Tian; Qiang Wei; Kai Wang

doi:10.3389/fnagi.2021.670463

The Cerebellum Is Related to Cognitive Dysfunction in White Matter Hyperintensities

Front Aging Neurosci. 2021 Jun 23:13:670463. doi: 10.3389/fnagi.2021.670463. eCollection 2021.

Authors

Shanshan Cao^{1

2

3}, Jiajia Nie^{1

2

3}, Jun Zhang⁴, Chen Chen^{1

2

3}, Xiaojing Wang^{1

3}, Yuanyuan Liu^{1

3}, Yuting Mo^{1

2

3}, Baogen Du^{1

2

3}, Yajuan Hu^{1

2

3}, Yanghua Tian^{1

2

3

5}, Qiang Wei^{1

2

3}, Kai Wang^{1

2

3

5}

Affiliations

¹ The School of Mental Health and Psychological Sciences, Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China.
² Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China.
³ Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.
⁴ Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China.
⁵ Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China.

Abstract

Objective: White matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) is frequently presumed to be secondary to cerebral small vessel disease (CSVD) and associated with cognitive decline. The cerebellum plays a key role in cognition and has dense connections with other brain regions. Thus, the aim of this study was to investigate if cerebellar abnormalities could occur in CSVD patients with WMHs and the possible association with cognitive performances.

Methods: A total of 104 right-handed patients with WMHs were divided into the mild WMHs group (n = 39), moderate WMHs group (n = 37), and severe WMHs group (n = 28) according to the Fazekas scale, and 36 healthy controls were matched for sex ratio, age, education years, and acquired resting-state functional MRI. Analysis of voxel-based morphometry of gray matter volume (GMV) and seed-to-whole-brain functional connectivity (FC) was performed from the perspective of the cerebellum, and their correlations with neuropsychological variables were explored.

Results: The analysis revealed a lower GMV in the bilateral cerebellum lobule VI and decreased FC between the left- and right-sided cerebellar lobule VI with the left anterior cingulate gyri in CSVD patients with WMHs. Both changes in structure and function were correlated with cognitive impairment in patients with WMHs.

Conclusion: Our study revealed damaged GMV and FC in the cerebellum associated with cognitive impairment. This indicates that the cerebellum may play a key role in the modulation of cognitive function in CSVD patients with WMHs.

Keywords: cerebellum; magnetic resonance imaging; resting-state functional connectivity; voxel-based morphometry; white matter hyperintensities.