The mediating effect of alexisomia between childhood abuse and depression/stress in a sample of Lebanese adults: A cross-sectional study.

Vascular dementia (VAD), the second most common form of dementia globally after Alzheimer's disease (AD) (), is clinically characterized by stepwise progression. Globally, over 50 million individuals are affected by dementia, and VAD accounts for 33% of all cases (). Cognitive deterioration in VAD, which generally occurs concomitant with mood disturbances, such as depression and anxiety, has a profound impact on the quality of life and imposes a substantial burden on societal healthcare resources. VAD is a major public health challenge (). Early detection and diagnosis of, along with achieving a clear understanding of its pathogenesis are critical for mitigating disease progression. Recent advancements in neuroimaging techniques, have emerged as an indispensable tools for the comprehensive evaluation of individuals presenting with VAD. Magnetic resonance imaging (MRI) is a non-invasive, region-specific method used to quantitatively analyze volume changes in different brain regions which has been employed to analyze structural abnormalities in VAD (). Brain volume in key brain regions have also been observed in neurodegenerative diseases. According to one prior study, hypothalamic atrophy is evident in early stages AD. Results from a population-based study have demonstrated that hippocampal atrophy is the significant radiological feature in patients with VAD (). Previous pathological studies have shown that the volume of hippocampal neurons in the cornu ammonis (CA) 1, CA2 and CA4 regions were reduced in patients with VAD (; ). Iron is essential for numerous physiological processes in the brain including neurotransmitter synthesis, mitochondrial function, and myelin sheath formation. Recently, iron concentrations in the deep gray matter of the brain have garnered considerable attention in research on neurodegenerative disease-related cognitive impairment (; ). The assessment of iron deposition based on MRI has gained widespread application owing to its non-invasive nature. Although conventional T2-weighted or susceptibility weighted imaging (SWI) has certain applications in the assessment of iron deposition, it is difficult to conduct an accurate quantitative evaluation of iron deposition. Quantitative Susceptibility Mapping (QSM) is a sophisticated methodological advancement that, enables the derivation of quantitative data pertaining to the magnetic susceptibility of brain tissue via the reconstruction of a susceptibility map (; ). This method has been widely applied to assess iron deposition in various diseases. Iron deposition due to QSM is correlated with cerebral vascular degeneration and cognitive decline (; ). A recent study reported that iron deposition may be related to cognitive dysfunction in subcortical vascular mild cognitive impairment (); however whether iron deposition is genuinely associated with vascular dementia remains to be investigated.