Intravoxel Incoherent Motion Imaging in Small Vessel Disease Microstructural Integrity and Microvascular Perfusion Related to Cognition

C. Eleana Zhang*, Sau May Wong, Renske Uiterwijk, Julie Staals, Walter H. Backes, Erik I. Hoff, Tobien Schreuder, Cecile R. L. P. N. Jeukens, Jacobus F. A. Jansen, Robert J. van Oostenbrugge

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

21 Citations (Web of Science)

Abstract

Background and Purpose-Cerebral small vessel disease (SVD) is associated with cognitive impairment. This may be because of decreased microstructural integrity and microvascular perfusion, but data on these relationships are scarce. We determined the relationship between cognition and microvascular perfusion and microstructural integrity in SVD patients, using intravoxel incoherent motion imaging-a diffusion-weighted magnetic resonance imaging technique designed to determine microvascular perfusion and microstructural integrity simultaneously.

Methods-Seventy-three patients with SVD and 39 controls underwent intravoxel incoherent motion imaging and neuropsychological assessment. Parenchymal diffusivity D (a surrogate measure of microstructural integrity) and perfusion-related measure fD* were calculated for the normal appearing white matter, white matter hyperintensities, and cortical gray matter. The associations between cognitive performance and D and fD* were determined.

Results-In SVD patients, multivariable analysis showed that lower fD* in the normal appearing white matter and cortical gray matter was associated with lower overall cognition (P=0.03 and P=0.002, respectively), lower executive function (P=0.04 and P=0.01, respectively), and lower information-processing speed (P=0.04 and P=0.01, respectively). D was not associated with cognitive function. In controls, no association was found between D, fD*, and cognition.

Conclusions-In SVD patients, lower cognitive performance is associated with lower microvascular perfusion in the normal appearing white matter and cortical gray matter. Our results support recent findings that both cortical gray matter and normal appearing white matter perfusion may play a role in the pathophysiology of cognitive dysfunction in SVD.

Original languageEnglish
Pages (from-to)658-663
Number of pages6
JournalStroke
Volume48
Issue number3
DOIs
Publication statusPublished - Mar 2017

Keywords

  • cerebral blood flow
  • cerebral small vessel disease
  • cognition
  • CEREBRAL-BLOOD-FLOW
  • WHITE-MATTER HYPERINTENSITIES
  • ISCHEMIC LEUKOARAIOSIS
  • VASCULAR DEMENTIA
  • PROCESSING SPEED
  • BRAIN PERFUSION
  • DIFFUSION
  • MRI
  • IMPAIRMENT
  • NETWORK

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