Tract-Specific Correlates of Neuropsychological Deficits in Patients with Subcortical Vascular Cognitive Impairment

Article type: Research Article

Authors: Jung, Na-Yeon^{a; b; c; 1} | Han, Cheol E.^{d; e; 1} | Kim, Hee Jin^{a; b} | Yoo, Sang Wook^{d; e} | Kim, Hee-Jong^{d; e} | Kim, Eun-Joo^c | Na, Duk L.^{a; b; f} | Lockhart, Samuel N.^{g; h} | Jagust, William J.^{g; h} | Seong, Joon-Kyung^{d; e; *} | Seo, Sang Won^{a; b; i; *}

Affiliations: [a] Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea | [b] Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea | [c] Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Republic of Korea | [d] School of Biomedical Engineering, Korea University, Seoul, Republic of Korea | [e] Department of Bio-convergence Engineering, Korea University, Seoul, Republic of Korea | [f] Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea | [g] Helen Wills Neuroscience Institute, University of California, Berkeley, USA | [h] Lawrence Berkeley National Laboratory, Berkeley, CA, USA | [i] Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea

Correspondence: [*] Correspondence to: Joon-Kyung Seong, PhD, School of Biomedical Engineering, Korea University, 145, Anam-ro, Anam-dong 5-ga, Seongbuk-gu, Seoul 02841, Republic of Korea. Tel.: +82 2 3290 5660; E-mail: jkseong@korea.ac.kr.

Correspondence: [*] Correspondence to: Sang Wong Seo, MD, PhD, Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Kangnam-ku, Seoul 06351, Republic of Korea. Tel.: +82 2 3410 1233; Fax: +82 2 3410 0052; E-mail: sangwonseo@empal.com

Note: [1] These authors contributed equally to this work.

Abstract: The white matter tract-specific correlates of neuropsychological deficits are not fully established in patients with subcortical vascular cognitive impairment (SVCI), where white matter tract damage may be a critical factor in cognitive impairment. The purpose of this study is to investigate the tract-specific correlates of neuropsychological deficits in SVCI patients using tract-specific statistical analysis (TSSA). We prospectively recruited 114 SVCI patients, and 55 age-, gender-, and education-matched individuals with normal cognition (NC). All participants underwent diffusion weighted imaging and neuropsychological testing. We classified tractography results into fourteen major fiber tracts and analyzed group comparison and correlation with cognitive impairments. Relative to NC subjects, SVCI patients showed decreased fractional anisotropy values in bilateral anterior-thalamic radiation, cingulum, superior-longitudinal fasciculus, uncinate fasciculus, corticospinal tract, and left inferior-longitudinal fasciculus. Focal disruptions in specific tracts were associated with specific cognitive impairments. Our findings suggest that disconnection of specific white matter tracts, especially those neighboring and providing connections between gray matter regions important to certain cognitive functions, may contribute to specific cognitive impairments in SVCI.

Keywords: Diffusion-tensor imaging, neuropsychological correlation, subcortical vascular cognitive impairment, tract-specific statistical analysis, white matter connectivity

DOI: 10.3233/JAD-150841

Journal: Journal of Alzheimer's Disease, vol. 50, no. 4, pp. 1125-1135, 2016