Density abnormalities in normal-appearing gray matter in the middle-aged brain with white matter hyperintense lesions: a DARTEL-enhanced voxel-based morphometry study.
OBJECTIVE
Little is known about the structural alterations within gray matter (GM) in middle-aged subjects with white matter hyperintense (WMH) lesions. Here, we aimed to examine the anatomical changes within the GM and their relationship to WMH lesion loads in middle-aged subjects.


METHODS
Twenty-three middle-aged subjects with WMH lesions (WMH group) and 23 demographically matched healthy control subjects participated in the study. A Diffeomorphic Anatomical Registration Through Exponentiated Liealgebra-enhanced voxel-based morphometry was used to measure the GM density, and the correlations between WMH lesion volume and extracted GM values in abnormal regions were identified by voxel-based morphometry analysis.


RESULTS
Compared with the healthy control subjects, the WMH group had a significantly decreased GM density in the left middle frontal gyrus, bilateral anterior cingulate cortex, left and right premotor cortex, and left and right middle cingulate cortex and an increased GM density in the bilateral cerebellum anterior lobe, left middle temporal gyrus, right temporoparietal junction, left and right prefrontal cortex (PFC), and left inferior parietal lobule. A relationship was observed between the normalized WMH lesion volume and the decreased GM density, including the left middle frontal gyrus (ρ=-0.629, P=0.002), bilateral anterior cingulate cortex (ρ=-0.507, P=0.019), right middle cingulate cortex (ρ=-0.484, P=0.026), and right premotor cortex (ρ=-0.438, P=0.047). The WMH lesion loads also negatively correlated with increased GM density in the right temporoparietal junction (ρ=-0.484, P=0.026), left PFC (ρ=-0.469, P=0.032), and right PFC (ρ=-0.438, P=0.047).


CONCLUSIONS
We observed that lesion load-associated structural plasticity corresponds to bidirectional changes in regional GM density in the WMH group.
Burn Center, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, People's Republic of China.
Yan
Y
Peng
Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, People's Republic of China.
Shenhong
S
Li
Department of Oncology, The Second Hospital of Nanchang, Nanchang, Jiangxi Province, People's Republic of China.
Ying
Y
Zhuang
Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, People's Republic of China.
Xiaojia
X
Liu
Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, People's Republic of China.
Lin
L
Wu
Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, People's Republic of China.
Honghan
H
Gong
Burn Center, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, People's Republic of China.
Dewu
D
Liu
Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, People's Republic of China.
Fuqing
F
Zhou
D000375:Aging; D016022:Case-Control Studies; D002681:China; D005260:Female; D066128:Gray Matter / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D066127:White Matter / Q000000981:diagnostic imaging / Q000473:pathology*
aging; normal-appearing gray matter; voxel-based morphometry; white matter hyperintense lesion