Altered structural networks in neuromyelitis optica spectrum disorder related with cognition impairment and clinical features

Objective To investigate the topological properties alterations of white matter (WM) network in neuromyelitis optica spectrum disorder (NMOSD) patients and its correlation with clinical and cognitive performance. Methods Forty-eight NMOSD patients and fifty healthy controls (HC) underwent DTI and 3D-T1 scan on a 3.0 T MRI and clinical data and cognitive scales were collected. Structural networks were constructed and analyzed by using graph theory. The network metrics between-group comparisons were examined by using GRETNA. Differences in network parameters between two groups and grouped patients according to disease duration (DD) were compared to examine the impact of DD on WM network. The relationships between the network characteristics and clinical data and cognitive performances were also analyzed by partial correlation analysis. Results The NMOSD patients exhibited decreased global and local network efficiency and increased characteristic path length, which were pronounced more in long DD patients. Furthermore, altered nodal efficiencies were observed in several brain regions, which were mainly distributed in default mode and visual systems. The Expanded Disability Status Scale was positively related to nodal shortest path. NMOSD patients showed decreased cognitive performance in attention, short-term memory and verbal memory, which were associated with significantly decreased degree centrality, nodal efficiency and increased nodal shortest path of several brain regions (all p<0.05). Conclusions This study illustrated the relationship between WM disruption and cognitive impairment in NMOSD patients, which advance the understanding of disrupted WM networks and provide insight into subtle WM pathology to cognitive impairment in NMOSD.