Cortical similarity network abnormalities reveal the neuroimaging mechanisms of cognitive impairment in cerebral small vessel disease with microbleeds
10.19845/j.cnki.zfysjjbzz.2025.0194
- VernacularTitle:皮质相似性网络异常特征：揭示伴微出血脑小血管病认知障碍神经影像机制
- Author:
Zheqi HU
1
;
Yun XU
1
Author Information
1. Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University， Nanjing 210008， China
- Publication Type:Journal Article
- Keywords:
Cerebral microbleeds;
Cerebral small vessel disease;
Cognitive impairment / Cortical similarity network;
Network efficiency;
Default mode network
- From:
Journal of Apoplexy and Nervous Diseases
2025;42(12):1059-1068
- CountryChina
- Language:Chinese
-
Abstract:
Objective Excessive cerebral microbleeds（CMB）are a critical risk factor for cognitive impairment in cerebral small vessel disease（CSVD），yet their neuroimaging mechanisms remain unclear. By using multivariate divergence among multi-contrast MRI features， this study constructs a morphometric inverse divergence （MIND） networks to reveal the pattern of CMB-related structural disruption at the network level and investigate the potential imaging mechanisms of cognitive impairment. Methods A total of 69 CSVD patients with CMB were enrolled as CSVD-c group， 61 patients without CMB were enrolled as CSVD-n group， and 66 healthy controls （HC） were enrolled as HC group. MIND network topology was compared between the three groups， and the correlation between network abnormalities and neuropsychological parameters was analyzed. Results At the cognitive domain level， CSVD patients showed global cognitive decline， significantly affecting multiple domains including memory，visuospatial ability， executive function， and language. Compared with the HCs， CSVD patients had reductions in MIND strength in the frontal lobe （left area 9a and right p32） and the right temporal lobe （Mβ and Pβ），as well as increases in the extent and severity of CMB. For global topology， the patients with CSVD showed significant reductions in global and local efficiency and a significant increase in shortest-path length， with significantly greater changes in the CSVD-c group； for regional topology， there was a significant reduction in nodal efficiency in right Mβ. The correlation analysis showed that global and local efficiency and shortest-path length were significantly correlated with the scores of global cognition and multiple cognitive domains. Network-based statistic further revealed diminished connectivity within the default-mode network （DMN） and between DMN and visual/sensorimotor networks in the CSVD-c group. Conclusion CMB not only exacerbate global cognitive decline in CSVD patients，but also significantly affect multiple cognitive domains including memory， visuospatial ability， executive function， and language.Characteristic network alterations， including reduced synchrony in fronto-temporal regions， impaired global network efficiency and local temporal lobe efficiency， and weakened DMN-related connectivity，may be the potential mechanisms by which CMB aggravate cognitive impairment in CSVD.
