Associations between microstructural tissue changes, white matter hyperintensity severity, and cognitive impairment: an intravoxel incoherent motion imaging study

Huihua Lin; Xiaomin Dai; Jiawei Su; Shengsheng Yang; Yonghong Zheng; Mingping Ma; Shun Yu

doi:10.3389/fnagi.2023.1258105

Associations between microstructural tissue changes, white matter hyperintensity severity, and cognitive impairment: an intravoxel incoherent motion imaging study

Front Aging Neurosci. 2023 Nov 28:15:1258105. doi: 10.3389/fnagi.2023.1258105. eCollection 2023.

Authors

Huihua Lin^#^{1

2}, Xiaomin Dai^#^{1

2}, Jiawei Su^{1

2}, Shengsheng Yang^{1

2}, Yonghong Zheng^{1

2}, Mingping Ma^{1

2}, Shun Yu^{1

2}

Affiliations

¹ Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China.
² Department of Radiology, Fujian Provincial Hospital, Fuzhou, Fujian, China.

^# Contributed equally.

Abstract

Introduction: White matter hyperintensities (WMHs) are a common age- and vascular risk factor-related disease and have been recognized to play an important role in cognitive impairment. However, it is still unclear what the mechanism of this effect is. In this study, intravoxel incoherent motion (IVIM) was employed to assess the microvasculature and parenchymal microstructure changes of WMHs and explore their relationship with cognitive function.

Methods: Forty-nine WMH patients and thirty-one healthy controls underwent IVIM imaging, a diffusion technique that provides parenchymal diffusivity D, intravascular diffusivity D^*, and perfusion fraction f . The IVIM dual exponential model parameters were obtained in specific regions of interest, including deep white matter hyperintensities (DWMHs), periventricular white matter hyperintensities (PWMHs), and normal-appearing white matter (NAWM). The independent-sample t-test or Mann-Whitney U-test was utilized to compare IVIM parameters between patients and controls. The Kruskal-Wallis test or one-way analysis of variance was used to compare IVIM parameters among DWMH, PWMH, and NAWM for patients. The Wilcoxon two-sample test or independent-sample t-test was used to assess the differences in IVIM parameters based on the severity of WMH. The multivariate linear regression analysis was conducted to explore the factors influencing cognitive scores.

Results: WMH patients exhibited significantly higher parenchymal diffusivity D than controls in DWMH, PWMH, and NAWM (all p < 0.05). IVIM parameters in the three groups (DWMH, PWMH, and NAWM) were significantly different for patients (all p < 0.001). The severe WMH group had a significantly higher parenchymal diffusivity D (DWMH and PWMH) than mild WMH (both p < 0.05). The multiple linear regression analysis identified D in DWMH and PWMH as influencing cognitive function scores (all p < 0.05).

Conclusion: IVIM has the potential to provide a quantitative marker of parenchymal diffusivity for assessing the severity of WMH and may serve as a quantitative marker of cognitive dysfunction in WMH patients.

Keywords: cognitive impairment; diffusion weighted imaging; intravoxel incoherent motion imaging; parenchymal diffusivity; white matter hyperintensity.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This research was supported by the Startup Fund for Scientific Research of Fujian Medical University (No. 2020QH1183), the Young and Middle-aged Key Personnel Training Project of Fujian Provincial Health Commission (No. 2020GGA005), and the Natural Science Foundation of Fujian Province (No. 2021J01393).