{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T08:02:23Z","timestamp":1762070543321,"version":"build-2065373602"},"reference-count":49,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T00:00:00Z","timestamp":1665705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Natural Science Foundation of China","award":["81870859","92049115","81671146","81870937","2016YFC1300500-505","2018YFC1312300-303","ZYG D18009"],"award-info":[{"award-number":["81870859","92049115","81671146","81870937","2016YFC1300500-505","2018YFC1312300-303","ZYG D18009"]}]},{"name":"National Key Research and Development Program of China of the Ministry of Science and Technology of China","award":["81870859","92049115","81671146","81870937","2016YFC1300500-505","2018YFC1312300-303","ZYG D18009"],"award-info":[{"award-number":["81870859","92049115","81671146","81870937","2016YFC1300500-505","2018YFC1312300-303","ZYG D18009"]}]},{"name":"West China Hospital, Sichuan University","award":["81870859","92049115","81671146","81870937","2016YFC1300500-505","2018YFC1312300-303","ZYG D18009"],"award-info":[{"award-number":["81870859","92049115","81671146","81870937","2016YFC1300500-505","2018YFC1312300-303","ZYG D18009"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background and Aims: Recent reports suggest that results from imaging retinal microvascular changes with optical coherence tomography angiography (OCTA) in dementia patients reflect cerebral microcirculation changes that occur during dementia. Macula microvascular impairment has been shown in dementia patients compared to controls, but very little is known about its correlation with radiological visual rating scores associated with dementia. We aimed to explore the association between retinal microvasculature and radiological visual rating in early-onset dementia (EOD) patients. Methods: Swept-source OCTA (SS-OCTA) was used to image the retinal microvasculature of all EOD patients. Automated software in the OCTA tool segmented and measured the densities in the superficial vascular plexus (SVC) and deep vascular plexus (DVC) and foveal avascular zone (FAZ) areas. Radiological visual rating scores were evaluated on all MR images. Results: Medial temporal lobe atrophy (MTA) scores significantly correlated with FAZ area (p = 0.031) in EOD patients after adjusting for risk factors. PWMH correlated with SVC (p = 0.032) while DWMH significantly correlated with SVC (p = 0.007), DVC (p = 0.018) and FAZ (p = 0.001) in EOD patients. Discussion: FAZ changes correlated with MTA scores in EOD patients, while retinal microvasculature correlated with white matter hyperintensity. Our report suggests that microvascular changes in the retina may reflect cortical changes in the brain of EOD patients.<\/jats:p>","DOI":"10.3390\/brainsci12101391","type":"journal-article","created":{"date-parts":[[2022,10,16]],"date-time":"2022-10-16T21:10:10Z","timestamp":1665954610000},"page":"1391","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Microvascular Changes in the Retina Correlate with MRI Markers in Patients with Early-Onset Dementia"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1927-8451","authenticated-orcid":false,"given":"Ziyi","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Neurology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Emergency, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9633-4694","authenticated-orcid":false,"given":"William Robert","family":"Kwapong","sequence":"additional","affiliation":[{"name":"Department of Neurology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuting","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1038\/nrneurol.2009.215","article-title":"The clinical use of structural MRI in Alzheimer disease","volume":"6","author":"Frisoni","year":"2010","journal-title":"Nat. Rev. Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1007\/s13311-021-01146-y","article-title":"Neuropathology of Alzheimer\u2019s Disease","volume":"19","author":"Yachnis","year":"2022","journal-title":"Neurotherapeutics"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Tondelli, M., Wilcock, G.K., Nichelli, P., De Jager, C.A., Jenkinson, M., and Zamboni, G. (2012). Structural MRI changes detectable up to ten years before clinical Alzheimer\u2019s disease. Neurobiol. Aging, 33.","DOI":"10.1016\/j.neurobiolaging.2011.05.018"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"fcac052","DOI":"10.1093\/braincomms\/fcac052","article-title":"Dementia is associated with medial temporal atrophy even after accounting for neuropathologies","volume":"4","author":"Woodworth","year":"2022","journal-title":"Brain Commun."},{"key":"ref_5","first-page":"491","article-title":"Medial temporal lobe atrophy predicts Alzheimer\u2019s disease in patients with minor cognitive impairment","volume":"72","author":"Visser","year":"2002","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1001\/archneur.65.9.1202","article-title":"Measuring Cerebral Atrophy and White Matter Hyperintensity Burden to Predict the Rate of Cognitive Decline in Alzheimer Disease","volume":"65","author":"Brickman","year":"2008","journal-title":"Arch. Neurol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1002\/alz.12410","article-title":"White matter hyperintensity topography in Alzheimer\u2019s disease and links to cognition","volume":"18","author":"Bougacha","year":"2022","journal-title":"Alzheimers Dement."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e439","DOI":"10.1212\/WNL.0000000000008881","article-title":"Imaging markers of small vessel disease and brain frailty, and outcomes in acute stroke","volume":"94","author":"Appleton","year":"2020","journal-title":"Neurology"},{"key":"ref_9","first-page":"5","article-title":"Imaging markers of cerebrovascular pathologies: Pathophysiology, clinical presentation, and risk factors","volume":"5","author":"Raman","year":"2016","journal-title":"Alzheimers Dementia Diagn. Assess. Dis. Monit."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1016\/j.neuron.2013.10.008","article-title":"The Pathobiology of Vascular Dementia","volume":"80","author":"Iadecola","year":"2013","journal-title":"Neuron"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1007\/s10571-015-0308-1","article-title":"Microvascular Dysfunction and Cognitive Impairment","volume":"36","author":"Faraci","year":"2016","journal-title":"Cell Mol. Neurobiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1038\/jcbfm.2015.164","article-title":"The neuropathology and cerebrovascular mechanisms of dementia","volume":"36","author":"Raz","year":"2016","journal-title":"J. Cereb. Blood Flow Metab."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s40662-018-0104-3","article-title":"Emerging Applications of Optical Coherence Tomography Angiography (OCTA) in neurological research","volume":"5","author":"Wang","year":"2018","journal-title":"Eye Vis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1002\/alz.12006","article-title":"Developing retinal biomarkers for the earliest stages of Alzheimer\u2019s disease: What we know, what we don\u2019t, and how to move forward","volume":"16","author":"Alber","year":"2020","journal-title":"Alzheimers Dement."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1136\/jnnp-2020-325347","article-title":"Retinal imaging in Alzheimer\u2019s disease","volume":"92","author":"Cheung","year":"2021","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"100899","DOI":"10.1016\/j.preteyeres.2020.100899","article-title":"Retinal changes in Alzheimer\u2019s disease- integrated prospects of imaging, functional and molecular advances","volume":"82","author":"Gupta","year":"2020","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Vij, R., and Arora, S. (2022). A systematic survey of advances in retinal imaging modalities for Alzheimer\u2019s disease diagnosis. Metab. Brain Dis., 1\u201331.","DOI":"10.1007\/s11011-022-00927-4"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e781","DOI":"10.1111\/aos.14381","article-title":"Retinal microvascular attenuation in mental cognitive impairment and Alzheimer\u2019s disease by optical coherence tomography angiography","volume":"98","author":"Wu","year":"2020","journal-title":"Acta Ophthalmol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1186\/s13195-020-00724-0","article-title":"Retinal microvasculature dysfunction is associated with Alzheimer\u2019s disease and mild cognitive impairment","volume":"12","author":"Chua","year":"2020","journal-title":"Alzheimers Res. Ther."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"572484","DOI":"10.3389\/fnagi.2020.572484","article-title":"Decreased Retinal Vascular Density in Alzheimer\u2019s Disease (AD) and Mild Cognitive Impairment (MCI): An Optical Coherence Tomography Angiography (OCTA) Study","volume":"12","author":"Wang","year":"2021","journal-title":"Front. Aging Neurosci."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Hui, J., Zhao, Y., Yu, S., Liu, J., Chiu, K., and Wang, Y. (2021). Detection of retinal changes with optical coherence tomography angiography in mild cognitive impairment and Alzheimer\u2019s disease patients: A meta-analysis. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0255362"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.jalz.2011.03.005","article-title":"The diagnosis of dementia due to Alzheimer\u2019s disease: Recommendations from the National Institute on Aging-Alzheimer\u2019s association workgroups on diagnostic guidelines for Alzheimer\u2019s disease","volume":"7","author":"McKhann","year":"2011","journal-title":"Alzheimers Dement. J. Alzheimers Assoc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"S7","DOI":"10.1186\/alzrt197","article-title":"Early-onset dementias: Diagnostic and etiological considerations","volume":"5","author":"Masellis","year":"2013","journal-title":"Alzheimers Res. Ther."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"656750","DOI":"10.3389\/fnagi.2021.656750","article-title":"Choriocapillaris Changes Are Correlated With Disease Duration and MoCA Score in Early-Onset Dementia","volume":"13","author":"Zhang","year":"2021","journal-title":"Front. Aging Neurosci."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1016\/S1474-4422(13)70124-8","article-title":"Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration","volume":"12","author":"Wardlaw","year":"2013","journal-title":"Lancet Neurol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"351","DOI":"10.2214\/ajr.149.2.351","article-title":"MR signal abnormalities at 1.5 T in Alzheimer\u2019s dementia and normal aging","volume":"149","author":"Fazekas","year":"1987","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1136\/jnnp.74.10.1371","article-title":"Neuroimaging tools to rate regional atrophy, subcortical cerebrovascular disease, and regional cerebral blood flow and metabolism: Consensus paper of the EADC","volume":"74","author":"Frisoni","year":"2003","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2618","DOI":"10.1007\/s00330-011-2205-4","article-title":"Visual assessment of posterior atrophy development of a MRI rating scale","volume":"21","author":"Koedam","year":"2011","journal-title":"Eur. Radiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1111\/1754-9485.12726","article-title":"Cerebral amyloid angiopathy: Review of clinico-radiological features and mimics","volume":"62","author":"Sharma","year":"2018","journal-title":"J. Med. Imaging Radiat. Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"787775","DOI":"10.3389\/fnagi.2021.787775","article-title":"Macular Microvasculature Is Associated with Total Cerebral Small Vessel Disease Burden in Recent Single Subcortical Infarction","volume":"13","author":"Kwapong","year":"2022","journal-title":"Front. Aging Neurosci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1097\/01.rmr.0000168070.90113.dc","article-title":"Pathological Aging of the Brain","volume":"15","author":"Leite","year":"2004","journal-title":"Top. Magn. Reson. Imaging"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1007\/BF00308809","article-title":"Neuropathological stageing of Alzheimer-related changes","volume":"82","author":"Braak","year":"1991","journal-title":"Acta Neuropathol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/S0197-4580(00)00125-1","article-title":"The role of cerebral ischemia in Alzheimer\u2019s disease","volume":"21","author":"Kalaria","year":"2000","journal-title":"Neurobiol. Aging"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1016\/j.ophtha.2021.02.016","article-title":"OCT Angiography Findings in Preclinical Alzheimer\u2019s Disease: 3-Year Follow-Up","volume":"128","author":"Lin","year":"2021","journal-title":"Ophthalmology"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"3447","DOI":"10.1167\/iovs.19-27028","article-title":"Comparison of Retinal Microvasculature in Patients with Alzheimer\u2019s Disease and Primary Open-Angle Glaucoma by Optical Coherence Tomography Angiography","volume":"60","author":"Zabel","year":"2019","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1001\/jamaophthalmol.2018.3556","article-title":"Association of Preclinical Alzheimer Disease With Optical Coherence Tomographic Angiography Findings","volume":"136","author":"Apte","year":"2018","journal-title":"JAMA Ophthalmol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1097\/WCO.0b013e328172d661","article-title":"The relation between white-matter lesions and cognition","volume":"20","author":"Pantoni","year":"2007","journal-title":"Curr. Opin. Neurol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.1212\/WNL.43.9.1683","article-title":"Pathologic correlates of incidental MRI white matter signal hyperintensities","volume":"43","author":"Fazekas","year":"1993","journal-title":"Neurology"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1002\/alz.12179","article-title":"Retinal imaging in Alzheimer\u2019s and neurodegenerative diseases","volume":"17","author":"Snyder","year":"2021","journal-title":"Alzheimers Dement."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"9372050","DOI":"10.1155\/2017\/9372050","article-title":"Multiple Factors Involved in the Pathogenesis of White Matter Lesions","volume":"2017","author":"Lin","year":"2017","journal-title":"BioMed. Res. Int."},{"key":"ref_41","first-page":"001140","article-title":"What are White Matter Hyperintensities Made of?","volume":"4","author":"Wardlaw","year":"2015","journal-title":"J. Am. Hear Assoc."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"797","DOI":"10.3233\/JAD-180939","article-title":"Deep White Matter Lesions Are Associated with Early Recognition of Dementia in Alzheimer\u2019s Disease","volume":"68","author":"Kasahara","year":"2019","journal-title":"J. Alzheimers Dis."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e93621","DOI":"10.1172\/jci.insight.93621","article-title":"Retinal amyloid pathology and proof-of-concept imaging trial in Alzheimer\u2019s disease","volume":"2","author":"Koronyo","year":"2017","journal-title":"JCI Insight"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.1002\/alz.12320","article-title":"Midlife vascular risk factors and risk of incident dementia: Longitudinal cohort and Mendelian randomization analyses in the UK Biobank","volume":"17","author":"Malik","year":"2021","journal-title":"Alzheimers Dement."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1161\/HYPERTENSIONAHA.121.17283","article-title":"Blood Pressure Levels and Risks of Dementia: A Nationwide Study of 4.5 Million People","volume":"79","author":"Lee","year":"2022","journal-title":"Hypertension"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"afab231","DOI":"10.1093\/ageing\/afab231","article-title":"Diabetes duration and the risk of dementia: A cohort study based on German health claims data","volume":"51","author":"Reinke","year":"2022","journal-title":"Age Ageing"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1001\/jama.2021.4001","article-title":"Association Between Age at Diabetes Onset and Subsequent Risk of Dementia","volume":"325","author":"Amidei","year":"2021","journal-title":"JAMA"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1177\/1358863X20913609","article-title":"Endothelial dysfunction and impaired arterial wall properties in patients with retinal vein occlusion","volume":"25","author":"Gouliopoulos","year":"2020","journal-title":"Vasc. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"srep42201","DOI":"10.1038\/srep42201","article-title":"Detailed Vascular Anatomy of the Human Retina by Projection-Resolved Optical Coherence Tomography Angiography","volume":"7","author":"Campbell","year":"2017","journal-title":"Sci. Rep."}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/12\/10\/1391\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:54:27Z","timestamp":1760144067000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/12\/10\/1391"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,14]]},"references-count":49,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["brainsci12101391"],"URL":"https:\/\/doi.org\/10.3390\/brainsci12101391","relation":{},"ISSN":["2076-3425"],"issn-type":[{"type":"electronic","value":"2076-3425"}],"subject":[],"published":{"date-parts":[[2022,10,14]]}}}