Cortical surface-based morphometry in cognitive impairment in sporadic cerebral small vessel disease

Abstract

Background: Analysis of structural MR images plays a key role in assessing the underlying substrate of cognitive impairment (CI) in sporadic age-related cerebral small vessel disease (SVD), leading to up to 45% of all cases of dementia. The variety of MR-morphometry results in SVD requires extensive research and comparisons with clinical data. Aims: to assess the characteristics of brain atrophy in cognitive impairment in patients with SVD using surface-based morphometry (SBM). Materials and methods: A prospective study was conducted assessing patients with SVD and CI of varying severity (subjective - subCI, moderate - MCI and dementia) and a group of volunteers matched by gender and age. MRI was performed with subsequent analysis of MRI signs of SVD and calculation of the general SVD index and processing of T1mpr images using the SBM method with general and regional quantitative assessment of the brain, including the thickness of the cerebral cortex. Results: the main group with SVD consisted of 173 patients, the control group included 47 healthy volunteers. As the severity of structural changes in the brain and the severity of CI increased, there was a significant (p0.05) decrease in the thickness of the cortex of certain regions according to a similar pattern: the cingulate gyri, mainly their posterior sections; medial and middle sections of the frontal lobes, various parts of the insular cortex, temporo-parietal areas (especially the supramarginal gyri). The volume of the brain itself (total volume, gray and white matter) in SVD had significant differences only with controls, but not between groups of patients with different severity of CI. The volume of white matter hyperintensities was significantly different between the groups with dementia and MCI, dementia and sub-CI (p 0.0001). Conclusions: The data obtained during the study confirm the secondary/mixed nature of atrophy in SVD. The wide variety of regions with significant thinning of the cortex limits the specification of the progression of CI in SVD based on their atrophy. This allows the quantitative measurement of the cortex to be used only as an auxiliary method in assessing the prediction of SVD progression.