Association between Subcortical Vascular Lesion Location and Cognition: A Voxel-Based and Tract-Based Lesion-Symptom Mapping Study. The SMART-MR Study

被引:104
作者
Biesbroek, J. Matthijs [1 ]
Kuijf, Hugo J. [2 ]
van der Graaf, Yolanda [3 ]
Vincken, Koen L. [2 ]
Postma, Albert [1 ,4 ]
Mali, Willem P. T. M. [5 ]
Biessels, Geert J. [1 ]
Geerlings, Mirjam I. [3 ]
机构
[1] Univ Med Ctr Utrecht, Rudolf Magnus Inst Neurosci, Dept Neurol, Utrecht, Netherlands
[2] Univ Med Ctr Utrecht, Image Sci Inst, Utrecht, Netherlands
[3] Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands
[4] Univ Utrecht, Helmholtz Inst, Utrecht, Netherlands
[5] Univ Med Ctr Utrecht, Dept Radiol, Utrecht, Netherlands
关键词
SMALL-VESSEL DISEASE; EXECUTIVE FUNCTION; PROBABILISTIC SEGMENTATION; CLINICAL DETERMINANTS; DEMENTIA; CADASIL; INTELLIGENCE; IMPAIRMENT; DECLINE; STROKE;
D O I
10.1371/journal.pone.0060541
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
070301 [无机化学]; 070403 [天体物理学]; 070507 [自然资源与国土空间规划学]; 090105 [作物生产系统与生态工程];
摘要
Introduction: Lacunar lesions (LLs) and white matter lesions (WMLs) affect cognition. We assessed whether lesions located in specific white matter tracts were associated with cognitive performance taking into account total lesion burden. Methods: Within the Second Manifestations of ARTerial disease Magnetic Resonance (SMART-MR) study, cross-sectional analyses were performed on 516 patients with manifest arterial disease. We applied an assumption-free voxel-based lesion-symptom mapping approach to investigate the relation between LL and WML locations on 1.5 Tesla brain MRI and compound scores of executive functioning, memory and processing speed. Secondly, a multivariable linear regression model was used to relate the regional volume of LLs and WMLs within specific white matter tracts to cognitive functioning. Results: Voxel-based lesion-symptom mapping identified several clusters of voxels with a significant correlation between WMLs and executive functioning, mostly located within the superior longitudinal fasciculus and anterior thalamic radiation. In the multivariable linear regression model, a statistically significant association was found between regional LL volume within the superior longitudinal fasciculus and anterior thalamic radiation and executive functioning after adjustment for total LL and WML burden. Conclusion: These findings identify the superior longitudinal fasciculus and anterior thalamic radiation as key anatomical structures in executive functioning and emphasize the role of strategically located vascular lesions in vascular cognitive impairment.
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页数:7
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