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Clinical effect of white matter network disruption related to amyloid and small vessel disease

 Hee Jin Kim  ;  Kiho Im  ;  Hunki Kwon  ;  Jong-Min Lee  ;  Changsoo Kim  ;  Yeo Jin Kim  ;  Na-Yeon Jung  ;  Hanna Cho  ;  Byoung Seok Ye  ;  Young Noh  ;  Geon Ha Kim  ;  En-Da Ko  ;  Jae Seung Kim  ;  Yearn Seong Choe  ;  Kyung Han Lee  ;  Sung Tae Kim  ;  Jae Hong Lee  ;  Michael Ewers  ;  Michael W. Weiner  ;  Duk L. Na  ;  Sang Won Seo 
 NEUROLOGY, Vol.85(1) : 63-70, 2015 
Journal Title
Issue Date
Aged ; Aged, 80 and over ; Amyloid beta-Peptides/metabolism* ; Cognition Disorders/diagnosis ; Cognition Disorders/epidemiology ; Cognition Disorders/metabolism ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Microcirculation*/physiology ; Middle Aged ; Nerve Net/metabolism* ; Nerve Net/pathology* ; Positron-Emission Tomography ; Prospective Studies ; Systemic Vasculitis/diagnosis ; Systemic Vasculitis/epidemiology ; Systemic Vasculitis/metabolism ; White Matter/metabolism* ; White Matter/pathology*
BACKGROUND: We tested our hypothesis that the white matter network might mediate the effect of amyloid and small vessel disease (SVD) on cortical thickness and/or cognition. METHODS: We prospectively recruited 232 patients with cognitive impairment. Amyloid was assessed using Pittsburgh compound B-PET. SVD was quantified as white matter hyperintensity volume and lacune number. The regional white matter network connectivity was measured as regional nodal efficiency by applying graph theoretical analysis to diffusion tensor imaging data. We measured cortical thickness and performed neuropsychological tests. RESULTS: SVD burden was associated with decreased nodal efficiency in the bilateral frontal, lateral temporal, lateral parietal, and occipital regions. Path analyses showed that the frontal nodal efficiency mediated the effect of SVD on the frontal atrophy and frontal-executive dysfunction. The temporoparietal nodal efficiency mediated the effect of SVD on the temporoparietal atrophy and memory dysfunction. However, Pittsburgh compound B retention ratio affected cortical atrophy and cognitive impairment without being mediated by nodal efficiency. CONCLUSIONS: We suggest that a disrupted white matter network mediates the effect of SVD, but not amyloid, on specific patterns of cortical atrophy and/or cognitive impairment. Therefore, our findings provide insight to better understand how amyloid and SVD burden can give rise to brain atrophy or cognitive impairment in specific patterns.
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1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Chang Soo(김창수) ORCID logo https://orcid.org/0000-0002-5940-5649
Ye, Byoung Seok(예병석) ORCID logo https://orcid.org/0000-0003-0187-8440
Cho, Hanna(조한나) ORCID logo https://orcid.org/0000-0001-5936-1546
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