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The Effect of Cerebral Microbleeds on Surrounding White Matter Integrity in Patients with CADASIL

Poster No:

2193 

Submission Type:

Abstract Submission 

Authors:

Ting-Chien Lu1, Wei-Chi Li1,2, Jiun-Wei Chen1, Feng-Chi Chang3,4, Yi-Chung Lee3,5,6, Chih-Ping Chung3,5,6, Yi-Chu Liao3,5,6, Li-Fen Chen1,6

Institutions:

1Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan, 2Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan, 3School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, 4Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, 5Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, 6Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan

First Author:

Ting-Chien Lu  
Institute of Brain Science, National Yang Ming Chiao Tung University
Taipei, Taiwan

Co-Author(s):

Wei-Chi Li  
Institute of Brain Science, National Yang Ming Chiao Tung University|Department of Biological Science and Technology, National Yang Ming Chiao Tung University
Taipei, Taiwan|Hsinchu, Taiwan
Jiun-Wei Chen  
Institute of Brain Science, National Yang Ming Chiao Tung University
Taipei, Taiwan
Feng-Chi Chang  
School of Medicine, National Yang Ming Chiao Tung University|Department of Radiology, Taipei Veterans General Hospital
Taipei, Taiwan|Taipei, Taiwan
Yi-Chung Lee  
School of Medicine, National Yang Ming Chiao Tung University|Department of Neurology, Neurological Institute, Taipei Veterans General Hospital|Brain Research Center, National Yang Ming Chiao Tung University
Taipei, Taiwan|Taipei, Taiwan|Taipei, Taiwan
Chih-Ping Chung  
School of Medicine, National Yang Ming Chiao Tung University|Department of Neurology, Neurological Institute, Taipei Veterans General Hospital|Brain Research Center, National Yang Ming Chiao Tung University
Taipei, Taiwan|Taipei, Taiwan|Taipei, Taiwan
Yi-Chu Liao  
School of Medicine, National Yang Ming Chiao Tung University|Department of Neurology, Neurological Institute, Taipei Veterans General Hospital|Brain Research Center, National Yang Ming Chiao Tung University
Taipei, Taiwan|Taipei, Taiwan|Taipei, Taiwan
Li-Fen Chen  
Institute of Brain Science, National Yang Ming Chiao Tung University|Brain Research Center, National Yang Ming Chiao Tung University
Taipei, Taiwan|Taipei, Taiwan

Introduction:

Cerebral microbleed (CMB) is considered as a potential marker of neurovascular impairment, which corresponds histologically to perivascular hemosiderin deposit from leakage through cerebral small vessels (Pétrault et al., 2019). CMBs are recognized as neuroimaging findings in patients with dementia, small vessel disease, stroke, and traumatic brain injury (Haller et al., 2018). CMBs located in disparate brain regions may have different clinical influences (Chung et al., 2020). Previous studies showed that CMBs are associated with loss of white matter integrity and damage to the surrounding microstructure through a streamline-based analysis (Irimia et al., 2022; Liu et al., 2020). However, little is known about the effect of CMBs on the white matter in patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). In this study, we aimed to investigate the spatial impacts of cerebral microbleeds on the surrounding white matter integrity in patients with CADASIL. We hypothesized that loss of white matter integrity is associated with the distance to CMBs in CADASIL patients.

Methods:

Sixty-five CADASIL patients were recruited and their multimodal MR images were collected, including T1-weighted structure images, diffusion tensor images (DTI) and susceptibility-weighted angiography (SWAN) images, from Taipei Veterans General Hospital. CMBs were manually specified on SWAN images using a homemade program with semi-automated instance segmentation for each patient. Twenty-three patients were excluded due to the absence of CMB. Fractional anisotropy (FA) values were calculated from DTI images, which represent the white matter integrity. The mean FA values of the voxels located within certain distance, ranging from 1 to 5 voxels away from the CMB, were calculated (Figure 1). Paired t-tests were conducted to characterize the difference between microbleed-affected foci and surrounding areas. Moreover, nine brain areas from the Talairach Daemon lobe atlas were adopted to further investigate the impact of CMBs on microstructure among different brain regions. The significance was set at p < 0.05 with Bonferroni correction for multiple comparison.
Supporting Image: Figure1_OHBM.png
   ·Figure 1：Example illustration of CMB and its surrounding areas on SWAN image. The areas dilated 1 to 5 voxels from CMB are referred to as Vox1~5.
 

Results:

Our findings exhibited significant differences of the mean FA values between the CMB site and its surrounding areas. The results showed an upward trend as the distance from the CMB extended outward, indicating a more severe damage to white matter integrity closer to CMB site. Such phenomenon was observed in almost all brain regions, especially prominent in the limbic and sub-lobar areas.

Conclusions:

The study demonstrated that CMBs impair the surrounding white matter integrity in CADASIL patients through a voxel-based analysis. White matter damage extends around the CMBs in a diminishing pattern. This study highlights the potential role of CMBs on neurological system pathologies and should be carefully considered in the future studies related to cerebral small vessel diseases.

Disorders of the Nervous System:

Neurodegenerative/ Late Life (eg. Parkinson’s, Alzheimer’s) 2

Modeling and Analysis Methods:

Diffusion MRI Modeling and Analysis

Neuroanatomy, Physiology, Metabolism and Neurotransmission:

White Matter Anatomy, Fiber Pathways and Connectivity 1

Keywords:

Cerebrovascular Disease
MRI
White Matter
WHITE MATTER IMAGING - DTI, HARDI, DSI, ETC
Other - Cerebral Microbleed

1|2Indicates the priority used for review

Provide references using author date format

Chung, C. P. (2020). "Cerebral Microbleed Burdens in Specific Brain Regions Are Associated With Disease Severity of Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy." Journal of the American Heart Association 9(13): e016233.

Haller, S. (2018). "Cerebral Microbleeds: Imaging and Clinical Significance." Radiology 287(1): 11-28.

Irimia, A. (2022). "White matter degradation near cerebral microbleeds is associated with cognitive change after mild traumatic brain injury." Neurobiology of Aging 120: 68-80.

Liu, J. Y. (2020). "Cerebral Microbleeds Are Associated with Loss of White Matter Integrity." AJNR Am J Neuroradiol 41(8): 1397-1404.

Pétrault, M. (2019). "Cerebral microbleeds: Beyond the macroscope." International Journal of Stroke 14(5): 468-475.