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• Clinical Article •
Correlation of cognitive reserve, neurovascular coupling and cognitive function in patients with mild cognitive impairment
YANG Wenxia  ZHOU Liang  XU Lili  LÜ Zixin  HU Wanjun  LIU Yang  LI Darui  ZHANG Jing 

Cite this article as: YANG W X, ZHOU L, XU L L, et al. Correlation of cognitive reserve, neurovascular coupling and cognitive function in patients with mild cognitive impairment[J]. Chin J Magn Reson Imaging, 2024, 15(9): 41-46, 52. DOI:10.12015/issn.1674-8034.2024.09.008.


[Abstract] Objective To investigate the neural vascular coupling mechanisms of cognitive reserve (CR) influencing cognitive function in patients with mild cognitive impairment (MCI) using arterial spin labeling (ASL) and resting-state functional MRI (rs-fMRI) methods.Materials and Methods This study prospectively recruited 40 MCI patients and 26 age- and gender-matched healthy controls (HC). All participants underwent ASL and rs-fMRI imaging on a 3.0 T MRI scanner and standardized neuropsychological assessments, including the Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), Activity of Daily Living Scale (ADL), Auditory Verbal Learning Test (AVLT), and Verbal Fluency Test (VFT). Cognitive Reserve Index questionnaire (CRIq) scores were generated based on education level, leisure activities, and work experience ratings for both groups to assess CR. Amplitude of low frequency fluctuations (ALFF), fractional ALFF (fALFF), and cerebral blood flow (CBF) were obtained at the voxel level, and CBF/ALFF and CBF/fALFF values were calculated to assess neural vascular coupling. Regions of interest (ROIs) with significant between-group differences in CBF/ALFF and CBF/fALFF were selected for further correlation analysis with cognitive function and CR scales to elucidate the relationship between cognitive reserve, neural vascular coupling, and cognitive performance.Results CRIq scores were significantly lower in the MCI group compared to the HC group (89.23±11.03 vs. 98.70±12.75). In MCI and HC, CRIq scores were positively correlated with MoCA and AVLT scores (r=0.447, P=0.004; r=0.344, P=0.030; r=0.245, P=0.050; r=0.900, P<0.001). Compared to HC, MCI patients showed significantly increased CBF/ALFF ratios in bilateral temporal middle gyrus (bilateral, two-tailed P<0.005, alphsim corrected, cluster size>39), and significantly decreased CBF/ALFF ratios in bilateral orbital inferior frontal gyrus and frontal middle gyrus (bilateral, two-tailed P<0.005, alphsim corrected, cluster size>93). Additionally, CBF/fALFF ratios were increased in bilateral temporal fusiform gyrus (bilateral, two-tailed P<0.005, alphsim corrected, cluster size>53) in MCI. Furthermore, in the MCI group, the left orbital inferior frontal gyrus CBF/ALFF ratio was negatively correlated with CRIq, MoCA, and AVLT scores (r=-0.417, P=0.007; r=-0.336, P=0.034; r=-0.378, P=0.016).Conclusions Individuals with higher cognitive reserve (CR) exhibit better cognitive function. Among patients with mild cognitive impairment (MCI), those with higher CR show a lower left orbitofrontal cortex CBF/ALFF ratio, indicating neurovascular uncoupling. This uncoupling is associated with more severe brain pathology, yet these individuals maintain good cognitive function. This suggests that neurovascular coupling and uncoupling might be potential neural mechanisms through which CR influences cognitive function in MCI patients.
[Keywords] mild cognitive impairment；functional magnetic resonance imaging；magnetic resonance imaging；neurovascular coupling；cognitive reserve

YANG Wenxia1, 2   ZHOU Liang1, 2   XU Lili1, 2   LÜ Zixin3, 4   HU Wanjun1, 2   LIU Yang1, 2   LI Darui1, 2   ZHANG Jing1, 2, 3*  

1 Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou 730030, China

2 Second Clinical School, Lanzhou University, Lanzhou 730030, China

3 Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou 730030, China

4 Department of Magnetic Resonance, Lanzhou University Second Hospital Xigu Hospital, Lanzhou 730060, China

Corresponding author: ZHANG J, E-mail: ery_zhangjing@lzu.edu.cn

Conflicts of interest   None.

Received  2024-05-16
Accepted  2024-09-10
DOI: 10.12015/issn.1674-8034.2024.09.008
Cite this article as: YANG W X, ZHOU L, XU L L, et al. Correlation of cognitive reserve, neurovascular coupling and cognitive function in patients with mild cognitive impairment[J]. Chin J Magn Reson Imaging, 2024, 15(9): 41-46, 52. DOI:10.12015/issn.1674-8034.2024.09.008.

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