Surface-based morphometry of the cerebral cortex in cognitive impairments of varying severity in patients with age-related cerebral small vessel disease

Elena I. Kremneva; Кремнева Елена Игоревна; Elena I. Kremneva; Larisa A. Dobrynina; Добрынина Лариса Анатольевна; Larisa A. Dobrynina; Kamila V. Shamtieva; Шамтиева Камила Витальевна; Kamila V. Shamtieva; Victoria V. Trubitsyna; Трубицына Виктория Владимировна; Victoria V. Trubitsyna; Zukhra S. Gadzhieva; Гаджиева Зухра Шарапутдиновна; Zukhra S. Gadzhieva; Angelina G. Makarova; Макарова Ангелина Геннадьевна; Angelina G. Makarova; Maria M. Tsypushtanova; Цыпуштанова Мария Михайловна; Maria M. Tsypushtanova; Marina V. Krotenkova; Кротенкова Марина Викторовна; Marina V. Krotenkova

doi:10.17816/DD631162

Surface-based morphometry of the cerebral cortex in cognitive impairments of varying severity in patients with age-related cerebral small vessel disease

Authors: Kremneva E.I.¹, Dobrynina L.A.¹, Shamtieva K.V.¹, Trubitsyna V.V.¹, Gadzhieva Z.S.¹, Makarova A.G.¹, Tsypushtanova M.M.¹, Krotenkova M.V.¹
Affiliations:
1. Research Center of Neurology
Issue: Vol 5, No 3 (2024)
Pages: 436-449
Section: Original Study Articles
URL: https://bakhtiniada.ru/DD/article/view/310029
DOI: https://doi.org/10.17816/DD631162
ID: 310029

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Abstract

BACKGROUND: Analysis of structural magnetic resonance images is essential to assessing the main substrate of cognitive impairment in sporadic age-related cerebral small vessel disease, accounting for up to 45% of all dementia cases. Variations in the results of magnetic resonance morphometry applied in cerebral small vessel disease require extensive studies and clinical correlation.

AIM: To assess cerebral atrophy features in cognitive impairment in patients with cerebral small vessel disease by surface-based morphometry.

MATERIALS AND METHODS: A prospective study was conducted to assess patients with cerebral small vessel disease and cognitive impairments of varying severity levels (subjective, moderate, and dementia) and sex- and age-matched groups of volunteers. The assessment included the analysis of signs of cerebral small vessel disease based on the results of magnetic resonance imaging with the computation of general cerebral small vessel disease index and processing T1 multiplanar reconstruction images by surface-based morphometry to quantify general and regional brain parameters, including the thickness of the cerebral cortex.

RESULTS: The main group consisted of 173 patients with cerebral small vessel disease, whereas the control group included 47 healthy volunteers. As the severity of brain structural changes and cognitive impairments increased, a significant (p <0.05) decrease in the cortical thickness of certain regions following a similar pattern was reported, particularly in the cingulate gyri, mainly their posterior sections; medial and middle sections of the frontal lobes, various areas of the insular cortex, and temporoparietal areas, particularly the supramarginal gyri. The brain volumes (overall, gray matter, and white matter volumes) in cerebral small vessel disease were significantly different only in controls but not between patients with cognitive impairment of different severity levels. The hyperintense white matter volume was significantly different between patients with dementia and moderate cognitive impairment, dementia, and subjective cognitive impairment (p <0.0001).

CONCLUSIONS: The results confirm secondary/mixed atrophy in cerebral small vessel disease. The clarification of the severity level of cognitive impairment in cerebral small vessel disease based on atrophy data is limited by the wide variety of regions with significant cortical thinning. Thus, the quantification of the cortex can only be a supplementary method in predicting cerebral small vessel disease progression.

Keywords

cerebral small vessel disease, surface-based morphometry, cognitive impairment, atrophy, magnetic resonance imaging

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2. Fig. 1. Visual display of the results of surface morphometry after statistical analysis of images of the control and Fazekas 2 groups (first row, F2), control and Fazekas 3 (middle row, F3), Fazekas 2 and Fazekas 3 (bottom row) in the CAT12 program with the selection of red-yellow color gradation (according to the scale) of regions with significantly greater differences in cortical thickness between the groups (FWE, pcorr <0.05). L ― left hemisphere, R ― right hemisphere.

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3. Fig. 2. Results of surface morphometry: a ― comparison of cortical thickness between patients of the control group and subjective cognitive impairment (subCI) and dementia; b ― within the cerebral microangiopathy group ― between mild cognitive impairment (MCI) and dementia, subjective (subCI) and moderate (MCI) cognitive impairment. Regions where cortical thickness is significantly greater for the control group (a), mild cognitive impairment compared to dementia (b, top) and subjective cognitive impairment compared to moderate (b, bottom), respectively, are coded in yellow and red (FWE, pcorr < 0.05). L ― left hemisphere; R ― right hemisphere of the cerebrum.

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