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• Clinical Article •
Correlation study between brain structural changes and cognitive function in patients with Alzheimer's disease
TIAN Xin  FAN Lihua  WEI Wei  JIANG Mao  YU Nan  ZHOU Feng  ZHENG Yunsong  CHEN Jing 

DOI:10.12015/issn.1674-8034.2025.12.007.


[Abstract] Objective To investigate the alterations in gray matter structure and their correlation with cognitive function in patients with Alzheimer's disease (AD) using voxel-based morphometry (VBM) and surface-based morphometry (SBM).Materials and Methods Sixty-one participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database were enrolled, comprising 32 AD patients and 29 healthy controls (HC). Morphological metrics, including gray matter volume, cortical thickness, and cortical complexity (local gyrification index, fractal dimension, and sulcal depth), were derived using VBM and SBM pipelines. Regional values from brain areas exhibiting significant intergroup differences were extracted and correlated with cognitive scale scores using Pearson's analysis.Results Whole-brain structural analysis indicated that the AD group had significantly lower total gray matter volume (P = 0.021) and higher cerebrospinal fluid volume (P = 0.011) than the HC group. VBM identified gray matter reduction in the AD group within the left hippocampus, right parahippocampal gyrus, bilateral middle and inferior temporal gyri, and the left mid-cingulate gyrus (voxel-level FWE-corrected P < 0.001). SBM revealed statistically significant group differences in cortical thickness and local gyrification index (cluster-level FWE-corrected P < 0.05). Cortical thinning was observed in the bilateral inferior parietal lobules and bilateral middle, superior, and inferior temporal gyri, whereas the local gyrification index was elevated in the left middle and inferior temporal gyri. No significant between-group differences were detected in fractal dimension or sulcal depth (FWE-uncorrected P > 0.05). Cognitive assessment confirmed marked differences in Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR) scores (P < 0.001). In the AD group, MMSE scores correlated positively with left hippocampal volume, right parahippocampal gyrus volume, and cortical thickness of the right precuneus and left middle temporal gyrus. Conversely, CDR scores were negatively correlated with volumes of the left hippocampus and right parahippocampal gyrus.Conclusions VBM and SBM analyses effectively identified characteristic gray matter atrophy in the limbic system and association cortices of Alzheimer's disease patients, which was significantly correlated with the severity of cognitive impairment. Furthermore, the study revealed an increased local gyrification index in the left temporal lobe. This finding deviates from the conventional model of linear degenerative changes, suggesting that the local gyrification index holds promise as a novel neuroimaging biomarker for detecting microstructural alterations in AD.
[Keywords] Alzheimer's disease；morphometric analysis；magnetic resonance imaging；brain structure alterations；cortical complexity；cognitive function

TIAN Xin1   FAN Lihua1   WEI Wei1   JIANG Mao2   YU Nan1, 2   ZHOU Feng3   ZHENG Yunsong1, 2   CHEN Jing1*  

1 Department of Medical Imaging, Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xianyang 712000, China

2 School of Medical Technology, Shaanxi University of Traditional Chinese Medicine, Xianyang 712046, China

3 Department of Scientific Research, Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xianyang 712000, China

Corresponding author: CHEN J, E-mail: 345717558@qq.com

Conflicts of interest   None.

Received  2025-10-15
Accepted  2025-12-05
DOI: 10.12015/issn.1674-8034.2025.12.007
DOI:10.12015/issn.1674-8034.2025.12.007.

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