AUTHOR=Xie Yao , Xie Le , Kang Fuliang , Jiang Junlin , Yao Ting , Mao Guo , Fang Rui , Fan Jianhu , Wu Dahua 

TITLE=Association between white matter alterations and domain-specific cognitive impairment in cerebral small vessel disease: A meta-analysis of diffusion tensor imaging

JOURNAL=Frontiers in Aging Neuroscience

VOLUME=Volume 14 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2022.1019088

DOI=10.3389/fnagi.2022.1019088

ISSN=1663-4365

ABSTRACT=Objective: To investigate the knowledge of association between diffusion tensor imaging (DTI) findings and domain-specific cognitive impairment in cerebral small vessel disease (CSVD). 
Methods: PubMed, EMBASE, Web of science, Cochrane library, CNKI, Wanfang, SinoMed, and VIP were comprehensive searched. The included studies needed to report correlation coefficients between cognition and DTI values. Random effects models and meta-regression were applied to explain heterogeneity. Subgroup analysis, and publication bias were also performed with Stata.
Results: 77 studies were selected for meta-analysis, involving 6558 participants. The diagnosis classification included CSVD, WMH, SIVD, cerebral microbleeding, CAA, CADASIL, and Fabry disease. Significant pooled data showed that the FA-overall were moderate correlation with general cognition, executive function, attention, construction and motor performance (r=0.451, 0.339, 0.410, 0.319), and the MD/ADC-overall were moderate associated with general cognition, executive function, memory (r=-0.388, -0.332, -0.303) (all p<0.05). The following summary findings were pooled data with large (r ≥ 0.5) correlations based on more than one study. For general cognition, FA in cingulate gyrus (CG), cerebral peduncle (CP), corona radiata (CR), external capsule (EC), frontal lobe (FL), fornix (FOR), internal capsule (IC), thalamic radiation (TR) were all strongly associated with it (r=0.591, 0.584, 0.543, 0.662, 0.614, 0.543, 0.597, 0.571), and MD/ADC in CG, normal appearing white matter, whole brain white matter were also in strong correlation (r=-0.526, -0.546, -0.505). For executive function, FA in fronto-occipital fasciculus and FL were strongly associated with it (r=0.523, 0.509). Only MD/ADC of corpus callosum (CC) was strongly associated with the memory (r=-0.730). In the attention domain, FA in CG, CC, FL were also strongly related with it (r=0.532, 0.538, 0.732). Sample size, aetiology, magnet strength, study type, quality of study contributed to the heterogeneity.
Conclusions: The lower FA values or higher MD/ADC values were related to more severe cognitive impairment. General cognition and executive function were the greatest interest domains. The FL was commonly examined and strongly associated with general cognition, executive function and attention. The CC was strongly associated with memory and attention. The CG was strongly related to general cognition and attention. The CR, IC, TR were also strongly related to general cognition.