{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T03:58:20Z","timestamp":1773460700466,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,10,25]],"date-time":"2019-10-25T00:00:00Z","timestamp":1571961600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009128","name":"Research for Patient Benefit Programme","doi-asserted-by":"publisher","award":["PB\u2010PG\u20100107\u201011438"],"award-info":[{"award-number":["PB\u2010PG\u20100107\u201011438"]}],"id":[{"id":"10.13039\/501100009128","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000837","name":"University of Nottingham","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000837","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>The interrelation of cognitive performance, cerebrovascular damage and brain functional connectivity (<jats:styled-content style=\"fixed-case\">FC<\/jats:styled-content>) in advanced arteriosclerosis remains unclear. Our aim was to investigate the associations between <jats:styled-content style=\"fixed-case\">FC<\/jats:styled-content>, white matter damage and cognitive impairment in carotid artery disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Seventy\u2010one participants with a recent cerebrovascular event and with written informed consent underwent resting\u2010state functional magnetic resonance imaging and the Addenbrooke's Cognitive Examination \u2013 Revised (<jats:styled-content style=\"fixed-case\">ACE<\/jats:styled-content>\u2010R). Network and inter\u2010hemispheric <jats:styled-content style=\"fixed-case\">FC<\/jats:styled-content> metrics were compared between cognitively normal and impaired subjects, and interrelated with cognition. In order to explore the nature of <jats:styled-content style=\"fixed-case\">FC<\/jats:styled-content> changes, their associations with microstructural damage of related white matter tracts and cognitive performance were investigated, followed by mediation analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Participants with global cognitive impairment showed reduced <jats:styled-content style=\"fixed-case\">FC<\/jats:styled-content> compared to the cognitively intact subjects within the central executive network (<jats:styled-content style=\"fixed-case\">CEN<\/jats:styled-content>), and between hemispheres. Patients with executive dysfunction had decreased <jats:styled-content style=\"fixed-case\">CEN FC<\/jats:styled-content> whilst patients with memory loss demonstrated low <jats:styled-content style=\"fixed-case\">FC<\/jats:styled-content> in both the <jats:styled-content style=\"fixed-case\">CEN<\/jats:styled-content> and the default mode network (<jats:styled-content style=\"fixed-case\">DMN<\/jats:styled-content>). Global performance correlated with connectivity metrics of the <jats:styled-content style=\"fixed-case\">CEN<\/jats:styled-content> hub with <jats:styled-content style=\"fixed-case\">DMN<\/jats:styled-content> nodes, and between hemispheres. Cingulum mean diffusivity (<jats:styled-content style=\"fixed-case\">MD<\/jats:styled-content>) was negatively correlated with <jats:styled-content style=\"fixed-case\">ACE<\/jats:styled-content>\u2010R and <jats:styled-content style=\"fixed-case\">CEN<\/jats:styled-content>\u2013<jats:styled-content style=\"fixed-case\">DMN FC<\/jats:styled-content>. The cingulum <jats:styled-content style=\"fixed-case\">MD<\/jats:styled-content>\u2013cognition association was partially mediated by <jats:styled-content style=\"fixed-case\">CEN<\/jats:styled-content>\u2013<jats:styled-content style=\"fixed-case\">DMN FC<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Long\u2010range functional disconnection of the <jats:styled-content style=\"fixed-case\">CEN<\/jats:styled-content> with <jats:styled-content style=\"fixed-case\">DMN<\/jats:styled-content> nodes is the main feature of cognitive impairment in elderly subjects with symptomatic carotid artery disease. Our findings provide further support for the connectional diaschisis concept of vascular cognitive disorder, and highlight a mediation role of functional disconnection to explain associations between microstructural white matter tract damage and cognitive impairment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.14084","type":"journal-article","created":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T19:42:59Z","timestamp":1568144579000},"page":"352-359","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Large\u2010scale network dysfunction in vascular cognitive disorder supports connectional diaschisis in advanced arteriosclerosis"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9601-7111","authenticated-orcid":false,"given":"D.","family":"Meng","sequence":"first","affiliation":[{"name":"Radiological Sciences Division of Clinical Neuroscience School of Medicine Queen's Medical Centre University of Nottingham Nottingham UK"},{"name":"Sir Peter Mansfield Imaging Centre School of Medicine University of Nottingham Nottingham UK"},{"name":"NIHR Nottingham Biomedical Research Centre Queen's Medical Centre University of Nottingham Nottingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. 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