Cerebral white matter lesions and regional blood flow are associated with reduced cognitive function in early-stage cognitive impairment

Takeshi Kuroda; Kenjiro Ono; Motoyasu Honma; Miki Asano; Yukiko Mori; Akinori Futamura; Satoshi Yano; Mizuki Kanemoto; Sotaro Hieda; Yasuhiko Baba; Masahiko Izumizaki; Hidetomo Murakami

doi:10.3389/fnagi.2023.1126618

Cerebral white matter lesions and regional blood flow are associated with reduced cognitive function in early-stage cognitive impairment

Front Aging Neurosci. 2023 Feb 16:15:1126618. doi: 10.3389/fnagi.2023.1126618. eCollection 2023.

Authors

Affiliations

¹ Department of Neurology, Showa University School of Medicine, Tokyo, Japan.
² Department of Neurology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan.
³ Department of Physiology, Showa University School of Medicine, Tokyo, Japan.
⁴ Department of Neurology, Showa University Fujigaoka Hospital, Kanagawa, Japan.

Abstract

Background: Differences in the extent of cerebral white matter lesions (WML) and regional cerebral blood flow (rCBF) in early-stage cognitive impairment (ESCI) contribute to the prognosis of cognitive decline; however, it is unclear precisely how WML and rCBF affect cognitive decline in ESCI.

Objective: We examined the association between WML, rCBF, and cognitive impairment in the ESCI, using path analysis to clarify how these variables affect each other.

Methods: Eighty-three patients who consulted our memory clinic regarding memory loss were included in this study based on the Clinical Dementia Rating. Participants underwent the Mini-Mental State Examination (MMSE), brain magnetic resonance imaging (MRI) for voxel-based morphometry analysis, and brain perfusion single-photon emission computed tomography (SPECT) for rCBF evaluation in cortical regions, using 3D stereotactic surface projection (3D-SSP) analysis.

Results: Path analysis was performed on the MRI voxel-based morphometry and SPECT 3D-SSP data, showing a significant correlation between both and MMSE scores. In the most suitable model (GFI = 0.957), correlations were observed between lateral ventricular (LV-V) and periventricular WML (PvWML-V) volumes [standardized coefficient (SC) = 0.326, p = 0.005], LV-V and rCBF of the anterior cingulate gyrus (ACG-rCBF; SC = 0.395, p < 0.0001), and ACG-rCBF and PvWML-V (SC = 0.231, p = 0.041). Furthermore, a direct relationship between PvWML-V and MMSE scores was identified (SC = -0.238, p = 0.026).

Conclusion: Significant interrelationships were observed among the LV-V, PvWML-V, and ACG-rCBF that directly affected the MMSE score in the ESCI. The mechanisms behind these interactions and the impact of PvWML-V on cognitive function require further investigation.

Keywords: cerebral blood flow; cerebral white matter lesions; cognitive impairment; early-stage cognitive impairment; path analysis; single-photon emission computed tomography.