Tractography of the external capsule and cognition: A diffusion MRI study of cholinergic fibers

Exp Gerontol. 2020 Feb;130:110792. doi: 10.1016/j.exger.2019.110792. Epub 2019 Nov 25.


Introduction: White matter changes (WMC) in the cholinergic tracts contribute to executive dysfunction in the context of cognitive aging. WMC in the external capsule have been associated with executive dysfunction. The objectives of this study were to: 1) Characterize the lateral cholinergic tracts (LCT) and the superior longitudinal fasciculus (SLF). 2) Evaluate the association between diffusion measures within those tracts and cognitive performance.

Methods: Neuropsychological testing and high angular resolution diffusion imaging (HARDI) of 34 healthy elderly participants was done, followed by anatomically constrained probabilistic tractography reconstruction robust to crossing fibers. The external capsule was manually segmented on a mean T1 image then merged with an atlas, allowing extraction of the LCT. Diffusion tensor imaging (DTI) and HARDI-based measures were obtained.

Results: Correlations between diffusion measures in the LCT and the time of completion of Stroop (left LCT radial and medial diffusivity), the Symbol Search score (right LCT apparent fiber density) and the motor part of Trail-B (left LCT axial and radial diffusivity) were observed. Correlations were also found with diffusion measures in the SLF. WMC burden was low, and no correlation was found with diffusion measures or cognitive performance.

Discussion: DTI and HARDI, with isolation of strategic white matter tracts for cognitive functions, represent complimentary tools to better understand the complex process of brain aging.

Keywords: Cholinergic tract; Cognition; HARDI; Superior longitudinal fasciculus; Tractography.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cholinergic Fibers / pathology*
  • Cognition*
  • Diffusion Tensor Imaging*
  • External Capsule / diagnostic imaging*
  • Female
  • Humans
  • Male
  • Neuropsychological Tests
  • White Matter / diagnostic imaging