The burden of microstructural damage modulates cortical activation in elderly subjects with MCI and leuko-araiosis. A DTI and fMRI study

The burden of microstructural damage modulates cortical activation in elderly subjects with MCI and leuko-araiosis. A DTI and fMRI study Mario Mascalchi1,*, Andrea Ginestroni1, Nicola Toschi2, Anna Poggesi3, Paolo Cecchi4, Emilia Salvadori3, Carlo Tessa5, Mirco Cosottini4, Nicola De Stefano6, Giovanni Pracucci3, Leonardo Pantoni3, Domenico Inzitari3, Stefano Diciotti1 and VMCI Tuscany investigators Article first published online: 8 DEC 2012 DOI: 10.1002/hbm.22216 Copyright © 2012 Wiley Periodicals, Inc. Issue Human Brain Mapping Volume 35, Issue 3, pages 819–830, March 2014 Additional Information(Show All) How to CiteAuthor InformationPublication HistoryFunding Information The Vascular Mild Cognitive Impairment in Tuscany (VMCI-Tuscany) investigators: University of Florence: (Coordinating Center): Domenico Inzitari (Study coordinator), Rosanna Abbate, Manuela Bandinelli, Maria Boddi, Francesca Cesari, Laura Ciolli, Mirella Coppo, Alessandra Del Bene, Stefano Diciotti, Andrea Ginestroni, Betti Giusti, Anna Maria Gori, Mario Mascalchi, Serena Nannucci, Leonardo Pantoni, Marco Pasi, Francesca Pescini, Anna Poggesi, Giovanni Pracucci, Emilia Salvadori, Raffaella Valenti. University of Pisa: Ubaldo Bonucelli, Paolo Cecchi, Alberto Chiti, Mirco Cosottini, Giovanni Orlandi, Cristina Pagni, Gabriele Siciliano, Gloria Tognoni. University of Siena: Antonio Federico, Nicola De Stefano, Maria Teresa Dotti, Patrizia Formichi, Claudia Gambetti, Antonio Giorgio, Francesca Rossi, Laura Stromillo, Enza Zicari. Tuscany Region: Arezzo (Paolo Zolo, Alessandro Tiezzi); Empoli (Elisabetta Bertini, Stefania Brotini, Leonello Guidi, Maria Lombardi, Stefania Mugnai, Antonella Notarelli); Florence (Laura Bracco, Massimo Cadelo, Renzo Cisbani, Luciano Gabbani, Guido Gori, Lorella Lambertucci, Luca Massacesi, Enrico Mossello, Marco Paganini, Maristella Piccininni, Francesco Pinto, Claudia Pozzi, Sandro Sorbi, Gaetano Zaccara); Grosseto (Tiziano Borgogni, Mario Mancuso, Roberto Marconi); Lucca (Monica Mazzoni, Marco Vista); Livorno (Giuseppe Meucci, Giovanna Bellini); Massa Carrara (Luciano Gabrielli); Pisa (Cristina Frittelli, Renato Galli, Gianna Gambaccini); Pistoia (Stefano Bartolini, Carlo Biagini, Veronica Caleri, Paola Vanni); Prato (Donatella Calvani, Carla Giorgi, Stefano Magnolfi, Pasquale Palumbo, Carlo Valente); Siena (Alessandro Rossi, Rossana Tassi, Stefania Boschi); Viareggio (Filippo Baldacci). www.vmci-tuscany.it SEARCH Search ScopeAll contentPublication titlesIn this journalIn this issueBy Citation Search String Advanced > Saved Searches > ARTICLE TOOLS Get PDF (344K) Save to My Profile E-mail Link to this Article Export Citation for this Article Get Citation Alerts Request Permissions More Sharing ServicesShare|Share on citeulikeShare on facebookShare on deliciousShare on www.mendeley.comShare on twitter Abstract Article References Supporting Information Cited By View Full Article with Supporting Information (HTML) Enhanced Article (HTML) Get PDF (344K)Go here for SFX Keywords: leuko-araiosis; functional MRI; motor function; diffusion tensor The term leuko-araiosis (LA) describes a common chronic affection of the cerebral white matter (WM) in the elderly due to small vessel disease with variable clinical correlates. To explore whether severity of LA entails some adaptive reorganization in the cerebral cortex we evaluated with functional MRI (fMRI) the cortical activation pattern during a simple motor task in 60 subjects with mild cognitive impairment and moderate or severe (moderate-to-severe LA group, n = 46) and mild (mild LA group, n = 14) LA extension on visual rating. The microstructural damage associated with LA was measured on diffusion tensor data by computation of the mean diffusivity (MD) of the cerebral WM and by applying tract based spatial statistics (TBSS). Subjects were examined with fMRI during continuous tapping of the right dominant hand with task performance measurement. Moderate-to-severe LA group showed hyperactivation of left primary sensorimotor cortex (SM1) and right cerebellum. Regression analyses using the individual median of WM MD as explanatory variable revealed a posterior shift of activation within the left SM1 and hyperactivation of the left SMA and paracentral lobule and of the bilateral cerebellar crus. These data indicate that brain activation is modulated by increasing severity of LA with a local remapping within the SM1 and increased activity in ipsilateral nonprimary sensorimotor cortex and bilateral cerebellum. These potentially adaptive changes as well lack of contralateral cerebral hemisphere hyperactivation are in line with sparing of the U fibers and brainstem and cerebellar WM tracts and the emerging microstructual damage of the corpus callosum revealed by TBSS with increasing severity of LA. Hum Brain Mapp 35:819–830, 2014. © Wiley Periodicals, Inc.