Cortical microstructural involvement in cerebral small vessel disease

• Published in: Cerebral circulation - cognition and behavior Vol. 6; p. 100218
• Main Authors: Reiländer, Annemarie, Engel, Marlene, Nöth, Ulrike, Deichmann, Ralf, Shrestha, Manoj, Wagner, Marlies, Gracien, René-Maxime, Seiler, Alexander
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.01.2024; Elsevier
• Subjects: Brain atrophy; Cortical microstructure; Diffusion tensor imaging; Microstructural impairment; quantitative MRI; Small vessel disease; CSVD; CERAD; Microstructural impairment; qMRI; quantitative MRI; SE; DW; Small vessel disease; T; MP-RAGE; BW; WM; MMSE; MD; CMB; FLAIR; NBV; Brain atrophy; Cortical microstructure; FOV; Diffusion tensor imaging; TE; RD; WMH; RF; DTI; TMT; FA; tr; EPI
• ISSN: 2666-2450; 2666-2450
• DOI: 10.1016/j.cccb.2024.100218

•Cortical diffusivity and quantitative T2 values are increased in CSVD patients without significant whole-brain or cortical atrophy as compared to control subjects.•Diffusivity measures and quantitative T2 correlate significantly with the extent of white matter hyperintensities and axonal white matter damage.•No significant association between cognitive performance and cortical imaging parameters.•Findings support cortical diffusivity and quantitative T2 as imaging biomarkers of early microstructural impairment of the cerebral cortex as a correlate of subcortical leukoaraiosis in CSVD. In cerebral small vessel disease (CSVD), cortical atrophy occurs at a later stage compared to microstructural abnormalities and therefore cannot be used for monitoring short-term disease progression. We aimed to investigate whether cortical diffusion tensor imaging (DTI) and quantitative (q) magnetic resonance imaging (MRI) are able to detect early microstructural involvement of the cerebral cortex in CSVD. 33 CSVD patients without significant cortical or whole-brain atrophy and 16 healthy control subjects were included and underwent structural MRI, DTI and high-resolution qMRI with T2, T2* and T2′ mapping at 3 T as well as comprehensive cognitive assessment. After tissue segmentation and reconstruction of the cortical boundaries with the Freesurfer software, DTI and qMRI parameters were saved as surface datasets and averaged across all vertices. Cortical diffusivity and quantitative T2 values were significantly increased in patients compared to controls (p < 0.05). T2 values correlated significantly positively with white matter hyperintensity (WMH) volume (p < 0.01). Both cortical diffusivity and T2 showed significant negative associations with axonal damage to the white matter fiber tracts (p < 0.05). Cortical diffusivity and quantitative T2 mapping are suitable to detect microstructural involvement of the cerebral cortex in CSVD and represent promising imaging biomarkers for monitoring disease progression and effects of therapeutical interventions in clinical studies.