Abstract
Generalized fractional anisotropy (GFA) can eliminate the crossing fiber effect, which may be more reflective of brain tissue changes in patients with cerebral small vessel disease (CSVD). This study aimed to explore the alterations of structural networks based on GFA and its relationship with cognitive performance in CSVD patients. We recruited 50 CSVD patients which were divided into two groups: cognitive impairment (CSVD-CI) and normal cognition (CSVD-NC), and 22 healthy controls (HCs). All participants underwent the Montreal Cognitive Assessment (MoCA) and MRI examinations. The structural topological properties were compared among the three groups. The correlation between these structural alterations and MoCA was analyzed. Compared with HCs, significantly decreased nodal efficiency and connectivity were detected in the corticothalamic pathways in both patient groups, of which some were significantly decreased in CSVD-CIs compared with CSVD-NCs. Moreover, both patient groups exhibited global network disruption including decreased global efficiency and increased characteristic path length compared with HCs. Furthermore, the nodal efficiency in the right pallidum positively correlated with MoCA in CSVD-NCs controlling for nuisance variables (r = 0.471, p = 0.031). The alterations in corticothalamic pathways indicated that the brain structural network underwent extensive disruption, providing evidence for the consideration of CSVD as a global brain disease.