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Advances in multimodal MRI research on HHcy-associated cognitive impairment
PENG Cailiang  WANG Yang  ZHAO Bin  LI Xiaoling 

DOI:10.12015/issn.1674-8034.2026.05.022.


[Abstract] Hyperhomocysteinemia (HHcy) is an independent risk factor for cognitive impairment (CI). The pathological mechanisms by which HHcy induces CI involve synergistic damage to brain microcirculation and neural function through multiple pathways, including oxidative stress, vascular endothelial dysfunction, and neuroinflammation. The core clinical manifestations include elevated serum homocysteine (Hcy) levels and decline in multiple cognitive domains such as memory, language, executive function, visuospatial ability, and perceptual skills. Current MRI studies on HHcy-associated CI primarily utilize multimodal techniques, including voxel-based morphometry, diffusion tensor imaging, arterial spin labeling, magnetic resonance spectroscopy, and resting-state functional MRI. These approaches systematically reveal gray matter atrophy in cognition-related brain regions, impaired white matter microstructural integrity, reduced regional cerebral blood flow, neuronal metabolic disturbances, and abnormal functional connectivity within the default mode network. This review aims to systematically review relevant literature, integrate the above multimodal MRI data to elucidate early imaging biomarker characteristics of HHcy-associated CI, clarify its underlying neuromodulatory mechanisms, point out the limitations of existing studies and outline future research directions, thereby optimizing individualized clinical diagnosis and treatment strategies and providing research support.
[Keywords] hyperhomocysteinemia；cognitive impairment；magnetic resonance imaging；multimodal；structural magnetic resonance imaging；functional magnetic resonance imaging

PENG Cailiang1, 2   WANG Yang2, 3   ZHAO Bin4*   LI Xiaoling3*  

1 Third Department of Cardiovascular Disease, the First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin 150040, China

2 Graduate School, Heilongjiang University of Chinese Medicine, Harbin 150040, China

3 Department of CT and MRI, the First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin 150040, China

4 Rehabilitation Center, the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin 150001, China

Corresponding author: ZHAO B, E-mail: 521zhaobin@163.com LI X L, E-mail: lixiaoling1525@163.com

Conflicts of interest   None.

Received  2026-01-31
Accepted  2026-04-17
DOI: 10.12015/issn.1674-8034.2026.05.022
DOI:10.12015/issn.1674-8034.2026.05.022.

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