Glymphatic Dysfunction Mediates the Influence of White Matter Hyperintensities on Episodic Memory in Cerebral Small Vessel Disease
Abstract
:1. Introduction
2. Methods
2.1. Participants
2.2. MRI Scanning
2.3. MRI Analysis
2.3.1. DTI-ALPS Analysis
2.3.2. Imaging Biomarkers of CSVD
2.3.3. Neuropsychological Measurements
2.4. Statistical Analysis
3. Results
3.1. Demographics and Cognitive Function
3.2. CSVD Neuroimaging Features
3.3. ALPS-Index
3.4. Correlation Analysis between Demographics and ALPS-Index
3.5. Correlation Analysis between ALPS-Index and CSVD Neuroimaging Features
3.6. Relationship between ALPS-Index and Cognitive Performance
3.7. Mediation Analysis
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | NC Group (n = 52) | CSVS-Non-CI Group (n = 56) | CSVD-MCI Group (n = 52) | CSVD-VaD Group (n = 29) | F\χ2 | p Value |
---|---|---|---|---|---|---|
Gender (F/M) | 25/27 | 28/28 | 26/26 | 15/14 | 0.106 | 0.991 |
Age (years, mean ± s.d.) | 58.88 ± 6.41 | 66.28 ± 9.25 | 67.48 ± 6.74 | 66.07 ± 8.75 | 12.87 | <0.001 a–c |
Education (years, mean ± s.d.) | 14.48 ± 3.58 | 12.96 ± 3.46 | 10.19 ± 3.07 | 9.41 ± 3.19 | 21.75 | <0.001 b–e |
Vascular risk factors | ||||||
Hypertension, n (%) | 24 (46.2%) | 40 (71.4%) | 39 (75.0%) | 19 (65.5%) | 13.203 | 0.004 a–c |
Diabetes mellitus, n (%) | 8 (15.4%) | 12 (21.4%) | 16 (31.4%) | 6 (20.7%) | 3.745 | 0.298 |
Hyperlipidemia, n (%) | 13 (25.0%) | 12 (21.4%) | 8 (15.7%) | 2 (6.9%) | 1.36 | 0.253 |
Smoking, n (%) | 10 (19.2%) | 10 (17.9%) | 12 (23.5%) | 5 (17.2%) | 0.491 | 0.920 |
Alcohol drinking, n (%) | 10 (19.2%) | 9 (16.7%) | 11 (21.6%) | 1 (3.4%) | 4.41 | 0.214 |
Variables | NC Group (n = 52) | CSVS-Non-CI Group (n = 56) | CSVD-MCI Group (n = 52) | CSVD-VaD Group (n = 29) | Statistics | p Value |
---|---|---|---|---|---|---|
General cognitive function | ||||||
MMSE | 29.36 ± 0.77 | 28.84 ± 1.06 | 27.48 ± 1.39 | 20.24 ± 2.73 | 277.736 | <0.001 b–f |
MoCA | 27.40 ± 1.30 | 26.87 ± 1.41 | 21.07 ± 2.60 | 14.52 ± 3.42 | 289.684 | <0.001 b–f |
Cognitive domains | ||||||
episodic memory | 0.34 ± 0.09 | 0.44 ± 0.08 | −0.23 ± 0.08 | −1.03 ± 0.11 | 38.164 | <0.001 b–f |
Z-linguistic function | 0.53 ± 0.10 | 0.30 ± 0.10 | −0.31 ± 0.10 | −1.21 ± 0.15 | 30.603 | <0.001 b–f |
Z-processing speed | 0.40 ± 0.10 | 0.32 ± 0.09 | −0.38 ± 0.09 | −0.88 ± 0.14 | 24.675 | <0.001 b–f |
Z-executive function | 0.17 ± 0.11 | 0.27 ± 0.09 | −0.26 ± 0.10 | −0.53 ± 0.15 | 8.724 | <0.05 b–e |
Z-visuospatial | 0.30 ± 0.10 | 0.34 ± 0.09 | −0.06 ± 0.10 | −1.54 ± 0.15 | 37.914 | <0.01 c–f |
Variables | NC Group (n = 52) | CSVS-Non-CI Group (n = 56) | CSVD-MCI Group (n = 52) | CSVD-VaD Group (n = 29) | Statistics | p Value |
---|---|---|---|---|---|---|
ALPS-index (mean ± s. d.) | 1.76 ± 0.18 | 1.64 ± 0.20 | 1.52 ± 0.20 | 1.44 ± 0.26 | 13.706 | <0.001 b–e |
neuroimaging features | ||||||
WMH volume (mL, median (interquartile range)) | 0.93 (0.87) | 6.65 (8.84) | 8.00 (15.69) | 13.14 (34.93) | 95.429 | <0.001 a–c,e |
CMB numbers median (interquartile range) | 0 | 0 (2.00) | 0 (5.00) | 2.00 (28.00) | 56.604 | <0.001 a–c,e,f |
LI numbers median (interquartile range) | 0 | 0 (1.00) | 1.00 (2.00) | 1.00 (2.00) | 54.170 | <0.05 a–e |
EPVS-bg, n (%) | 0 (0%) | 19 (33.9%) | 19 (36.5%) | 11 (37.9%) | 25.293 | <0.001 a–c |
global gray matter volume (mL, mean ± s.d.) | 547.52 ± 46.58 | 546.67 ± 50.30 | 539.32 ± 51.20 | 543.96 ± 57.33 | 1.103 | 0.349 |
global white matter volume (mL, mean ± s.d.) | 463.36 ± 60.50 | 466.46 ± 57.20 | 448.13 ± 52.42 | 449.37 ± 69.49 | 0.514 | 0.673 |
cerebrospinal fluid volume (mL, mean ± s.d.) | 309.21 ± 37.08 | 337.38 ± 42.64 | 334.80 ± 56.48 | 341.77 ± 60.29 | 5.246 | 0.001 c |
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Ke, Z.; Mo, Y.; Li, J.; Yang, D.; Huang, L.; Yang, Z.; Qin, R.; Mao, C.; Lv, W.; Huang, Y.; et al. Glymphatic Dysfunction Mediates the Influence of White Matter Hyperintensities on Episodic Memory in Cerebral Small Vessel Disease. Brain Sci. 2022, 12, 1611. https://doi.org/10.3390/brainsci12121611
Ke Z, Mo Y, Li J, Yang D, Huang L, Yang Z, Qin R, Mao C, Lv W, Huang Y, et al. Glymphatic Dysfunction Mediates the Influence of White Matter Hyperintensities on Episodic Memory in Cerebral Small Vessel Disease. Brain Sciences. 2022; 12(12):1611. https://doi.org/10.3390/brainsci12121611
Chicago/Turabian StyleKe, Zhihong, Yuting Mo, Jiangnan Li, Dan Yang, Lili Huang, Zhiyuan Yang, Ruomeng Qin, Chenglu Mao, Weiping Lv, Yanan Huang, and et al. 2022. "Glymphatic Dysfunction Mediates the Influence of White Matter Hyperintensities on Episodic Memory in Cerebral Small Vessel Disease" Brain Sciences 12, no. 12: 1611. https://doi.org/10.3390/brainsci12121611