The Relationship Between Grey Matter Volume And Cognition In Subjects With WMD Based On VBM

Objective White matter disease(WMD)has a higher rate of incidence in the elders and presents with cognitive dysfunction as the main clinical manifestation,which can affects all cognitive domains.Individuals with WMD have a high risk of progressing into dementia.However,in recent years,studies found that the degree of cognitive decline is inconsistent among patients with WMD.There exists other factors that mediate cognitive impairment.Voxel-based morphometry(VBM)can analyze the whole brain in voxel units with high accuracy and objectivity.In this paper,we used VBM,combined with neuropsychological scales,to evaluate the changes of gray matter volume(GMV)in patients with moderate to severe white matter disease and its relationship with cognitive impairment in order to provide theoretical basis for the pathogenesis of cognitive dysfunction in patients with WMD.Methods A total of 114 participants were enrolled from March 2014 to January 2016,including inpatients and outpatients with moderate to severe white matter disease from the department of neurology of Tongji Hospital of Huazhong University of Science and Technology and normal controls with no or mild white matter disease matched by age,sex,education.Image data was acquired on a GE 3.0T MR scanner.All subjects underwent a battery of neuropsychological assessments,including the general cognition function(MMSE)and three cognitive domains(EF,PS,EM).According to the severity of white matter disease and the results of neuropsychological assessments,participants were divided into three groups: ms WMDCI group,ms WMDNCI group and normal controls.Data processing and statistical analyses were carried out using Statistical Parametric Mapping 8(SPM8)and VBM toolbox running under Mat Lab2013 b.We investigated the differences of grey matter volume between ms WMDCI and ms WMDNCI.In ms WMDCI group,a correlation was also performed between the changes of grey matter volume and the scores of cognitive domains.Results 1.There were no demographic differences among three groups in age,sex and education(P>0.05).There were significant differences in scores of the overall cognition and three cognitive domains among three groups.Significant differences were mainly between ms WMDCI group and the other two groups(P<0.05).2.There were significant differences in GMV among three groups,and the brain areas with different GMV were mainly located in left and right inferior frontal gyrus,left and right orbital gyrus,left superior temporal gyrus,left cingulate gyrus,left and right basal ganglia(P<0.05).3.Compared with ms WMDNCI group,ms WMDCI group showed obviously decreased GMV in four brain regions including left inferior frontal gyrus,right inferior frontal gyrus and left cingulate gyrus.The loss of GMV in left and right inferior frontal gyrus was significantly associated with decreased cognitive function.The GMV in left inferior frontal gyrus was positively correlated with executive function,processing speed and episodic memory(P<0.05).The GMV in right inferior frontal gyrus was positively correlated with MMSE,executive function and processing speed(P<0.05).Conclusion The GMV of patients with moderate to severe white matter disease changed,showing grey matter atrophy in multiple brain regions;Grey matter atrophy in patients with ms WMDCI was more obvious in frontal lobe and was significantly associated with decreased cognitive function.Grey matter atrophy is involved in the pathogenesis of cognitive dysfunction caused by white matter disease.