Background: The hyperintensity of cerebral white matter (WM) in T2-weighted MR images of elderly subjects due to small vessel disease (SVD) is associated with variable clinical features including mild cognitive impairment (MCI), also termed subcortical vascular cognitive impairment (SVCI). The latter is typically characterized by psychomotor slowing, attention deficits, and executive dysfunctions. We hypothesized that functional brain changes might be associated with these distinctive cognitive deficits in patients with SVCI.
Methods: Resting-state fMRI (rsfMRI) signal was assessed in conjunction with performance on the Montreal Cognitive Assessment battery (MoCA) and Stroop test in 67 subjects with MCI and moderate to severe extension of cerebral WM T2 hyperintensities qualifying for SVCI. We performed a whole-brain analysis of regional homogeneity (ReHo) of rsfMRI in conjunction with cognitive test scores.
Results: We observed a significant (p<0.05) negative association between ReHo and MoCA scores, with higher ReHo in the left posterior cerebellum (crus I) of patients with greater global cognitive impairment, and a significant positive association between ReHo and Stroop scores, with higher ReHo in the middle cingulate cortex bilaterally of patients with worse executive functions.
Conclusion: ReHo of rsfMRI is significantly correlated with measurements of the cognitive deficits which are distinctive of SVCI. The increased activity could have a maladaptive or compensatory significance towards specific aspects of cognition.
Keywords: Cerebral small vessel disease; Cognition; Executive function; White matter; fMRI.
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