White matter hyperintensities induce distal deficits in the connected fibers

• Main Authors: Cheng, X. (Author), Ding, D. (Author), Dong, Q. (Author), Gao, J.-H (Author), He, J. (Author), Liang, X. (Author), Liang, Z. (Author), Liu, Y. (Author), Nguchu, B.A (Author), Qiu, B. (Author), Wang, X. (Author), Wang, Y. (Author), Wu, J. (Author), Xia, Y. (Author), Yang, L. (Author), Ying, Y. (Author), Zhang, D. (Author), Zhao, Q. (Author)
• Format: Article
• Language: English
• Published: John Wiley and Sons Inc 2021
• Subjects: aged; Aged; Aged, 80 and over; aging; Aging; anticoagulant agent; antidiabetic agent; antihypertensive agent; antilipemic agent; antithrombocytic agent; Article; attention; Attention; axial diffusivity; cingulate gyrus; cognition; computer assisted diagnosis; deep learning; Deep Learning; diagnostic imaging; diffusion tensor imaging; Diffusion Tensor Imaging; diffusion weighted imaging; executive function; Executive Function; female; Female; fractional anisotropy; geriatric patient; health care; human; Humans; Image Interpretation, Computer-Assisted; inferior longitudinal fasciculus; leukoaraiosis; Leukoaraiosis; major clinical study; male; Male; mean diffusivity; microstructural integrity; Mini Mental State Examination; Montreal cognitive assessment; myelinated nerve; nerve cell network; Nerve Fibers, Myelinated; nerve tract; Neural Pathways; neuroimaging; nuclear magnetic resonance imaging; pathology; physiology; priority journal; procedures; pyramidal tract; Pyramidal Tracts; radial diffusivity; Rey auditory verbal learning test; superior longitudinal fasciculus; thalamus anterior nucleus; tractography; trail making test; uncinate fasciculus; very elderly; white matter; White Matter; white matter hyperintensities
• Online Access: View Fulltext in Publisher

 White matter hyperintensities (WMH) are common in elderly individuals and cause brain network deficits. However, it is still unclear how the global brain network is affected by the focal WMH. We aimed to investigate the diffusion of WMH-related deficits along the connecting white matters (WM). Brain magnetic resonance imaging data and neuropsychological evaluations of 174 participants (aged 74 ± 5 years) were collected and analyzed. For each participant, WMH lesions were segmented using a deep learning method, and 18 major WM tracts were reconstructed using automated quantitative tractography. The diffusion characteristics of distal WM tracts (with the WMH penumbra excluded) were calculated. Multivariable linear regression analysis was performed. We found that a high burden of tract-specific WMH was related to worse diffusion characteristics of distal WM tracts in a wide range of WM tracts, including the forceps major (FMA), forceps minor (FMI), anterior thalamic radiation (ATR), cingulum cingulate gyrus (CCG), corticospinal tract (CST), inferior longitudinal fasciculus (ILF), superior longitudinal fasciculus-parietal (SLFP), superior longitudinal fasciculus-temporal (SLFT), and uncinate fasciculus (UNC). Furthermore, a higher mean diffusivity (MD) of distal tracts was linked to worse attention and executive function in the FMI, right CCG, left ILF, SLFP, SLFT, and UNC. The effect of WMH on the microstructural integrity of WM tracts may propagate along tracts to distal regions beyond the penumbra and might eventually affect attention and executive function. © 2021 The Authors. Human Brain Mapping published by Wiley Periodicals LLC.