The effect of the total small vessel disease burden on the structural brain network

Xiaopei Xu, Kui Kai Lau, Yuen Kwun Wong, Henry K F Mak, Edward S Hui, Xiaopei Xu, Kui Kai Lau, Yuen Kwun Wong, Henry K F Mak, Edward S Hui

Abstract

Different cerebral small vessel disease (SVD) lesion types have been shown to disrupt structural brain network individually. Considering that they often coexist, we investigated the relation between their collective effect using the recently proposed total SVD score and structural brain network on MRI in 95 patients with first transient ischemic attack (TIA) or ischemic stroke. Fifty-nine patients with and 36 without any SVD lesions were included. The total SVD score was recorded. Diffusion tensor imaging was performed to estimate structural brain connections for subsequent brain connectivity analysis. The global efficiency and characteristic path length of the structural brain network are respectively lower and higher due to SVD. Lower nodal efficiency is also found in the insular, precuneus, supplementary motor area, paracentral lobule, putamen and hippocampus. The total SVD score is correlated with global network measures, the local clustering coefficient and nodal efficiency of hippocampus, and the nodal efficiency of paracentral lobule. We have successfully demonstrated that the disruption of global and local structural brain networks are associated with the increase in the overall SVD severity or burden of patients with TIA or first-time stroke.

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Illustration of the group-averaged structural brain network of patient with first transient ischemic attack (TIA) or ischemic stroke without (top row) or with (bottom row) small vessel disease (SVD). The brain regions with significantly lower nodal efficiency due to the presence of SVD were indicated as red. The node size and edge width are respectively weighted by nodal efficiency and number of connections.
Figure 2
Figure 2
The measurement (mean + standard deviation) of the measures of the (a) global and (b) local structural brain networks of patients with first TIA or ischemic stroke. Note that only the measures that are significantly different between the two cohorts are shown. *p < 0.05.
Figure 3
Figure 3
Relation between the measures (mean + standard deviation) of the (a) global and (b) local brain network versus the total SVD score for patients with SVD. Spearman rank correlation was performed to test association. The number of patients with total SVD score from 1 to 4 are 30, 19, 8 and 2, respectively.

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