Abstract
PURPOSE: To investigate the concurrent brain structural and functional alterations related to cognition in patients with cerebral small vessel disease (CSVD). METHODS: Thirty normal controls and 65 CSVD patients, including 33 patients with mild cognitive impairment and 32 patients with no cognitive impairment were included. Structural and resting-state functional MRI measures, including gray matter volume (GMV) and white matter volume (WMV) using voxel-based morphometry (VBM) analysis and amplitude of low-frequency fluctuation (ALFF), were obtained and compared among the three groups. Associations between cognitive scores and ALFF/VBM coupling in the co-altered regions were investigated in CSVD groups. RESULTS: Multiple brain regions showed significant differences in GMV and WMV among the three groups (P < 0.01). Abnormal ALFF among the three groups was identified in the left putamen, Rolandic operculum, fusiform gyrus, caudate, parahippocampal gyrus, insula, middle cingulum, bilateral lingual gyrus, and right frontal lobe (P < 0.01). Importantly, a decrease in VBM and increase in ALFF in the left parahippocampal gyrus, caudate and Rolandic operculum, a reduction of the WMV and ALFF in the right superior frontal lobe, and a united rise of GMV and ALFF in the left caudate were detected in CSVD groups. In addition, abnormal ALFF/VBM coupling was significantly related to multiple cognitive assessments. CONCLUSION: The study indicated a reversed pattern of the brain structural deficits and functional activation in the left parahippocampal gyrus, caudate, and Rolandic operculum, suggesting structure-function decoupling in CSVD groups. These might help further understand the pathophysiological mechanism of CSVD.