Association of white matter hyperintensities with cognitive impairment.

Abstract

Objective: This study aimed to examine the characteristics of cognitive impairment in individuals with white matter hyperintensities (WMH) and to compare differences in cognitive dysfunction across varying levels of WMH severity.

Methods: A total of 100 participants were randomly recruited from inpatient and outpatient departments of a hospital between November 2018 and December 2022. The cohort included 55 patients with cerebral small vessel disease (CSVD) and 45 control participants without CSVD. Among the CSVD group, 37 individuals had WMH. Cognitive function assessments were conducted for both the WMH and control groups to evaluate the characteristics of WMH-related cognitive dysfunction. Furthermore, cognitive scale scores and fractional anisotropy (FA) values obtained from diffusion tensor imaging (DTI) were compared among patients with varying WMH severity levels to analyze variations in cognitive performance and lesion characteristics across multiple brain regions.

Results: Statistically significant differences were observed between the control and CSVD groups in age, hypertension, diabetes, coronary heart disease, smoking, and physical activity (P < 0.05). The WMH and control groups demonstrated significant differences in the Montreal Cognitive Assessment (MoCA) total score, Digit Span Test (DST)-forward, DST-backward, Color Trail Test (CTT)-A, and CTT-B scores (p < 0.05). Significant differences were also identified between the mild and severe WMH groups (p < 0.05). Analysis of moderate and severe WMH groups indicated significant differences in FA values of the anterior horn of the lateral ventricle (p < 0.05), along with significant differences in age, DST-forward, and CTT-B scores (p < 0.05).

Conclusion: Cognitive impairment in individuals with WMH is predominantly characterized by marked declines in executive function and attention, while memory and language impairments are less pronounced. Severe WMH is associated with greater damage to the anterior horn of the lateral ventricle.