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Association between White Matter Hyperintensities Burden and Cognitive Function in Adult Asymptomatic Moyamoya
Jun Shen1, Ziwei Xu1, Zhengxin Liu1
1Department of Neurology, Huadong Hospital of Fudan University, Shanghai 200040, China.
Abstract:
White matter hyperintensities (WMH) caused by chronic cerebral hypoperfusion are common in Moyamoya disease (MMD) patients, but WMH burden with comprehensive cognition in adult asymptomatic MMD remains unknown. This study tried to investigate the association between the WMH burden and cognitive function in adult asymptomatic MMD. Sixty-four adult asymptomatic MMD patients without surgical revascularization were enrolled in this study and underwent a 3T MRI scan and complete cognitive tests from 2021 to 2022. WMH volume was extracted with brain anatomical analysis using the diffeomorphic deformation (BAAD) toolbox, which works on SPM 12 software. Multivariable linear regression analysis was performed to assess the association between WMH burden and cognitive function in asymptomatic MMD. Firstly, our data showed that lower education levels and higher WMH burden were strongly related to global cognitive impairment after adjusting for other variables. Secondly, WMH severity was significantly associated with several domains of neurocognitive function, including memory, semantic memory, and executive function. Finally, when stratified by sex, the female participants with WMH severity had lower cognitive performance in all areas than male participants. These results suggest that WMH burden was highly correlated with global cognition, memory, semantic memory, and executive function in asymptomatic MMD. Especially in female participants, the relationship became more evident.
Insights
White matter hyperintensities (WMH) in asymptomatic Moyamoya disease (MMD) are linked to cognitive decline, particularly in women. Higher WMH burden impacts memory and executive function.
Area of Science:
- Neurology
- Neuroimaging
- Cognitive Neuroscience
Background:
- White matter hyperintensities (WMH) are common in Moyamoya disease (MMD) due to chronic cerebral hypoperfusion.
- The relationship between WMH burden and cognitive function in adult asymptomatic MMD patients is not well understood.
Purpose of the Study:
- To investigate the association between WMH burden and cognitive function in adult asymptomatic MMD patients.
- To explore potential sex differences in this association.
Main Methods:
- Sixty-four adult asymptomatic MMD patients underwent 3T MRI and comprehensive cognitive tests.
- WMH volume was quantified using the Brain Anatomical Analysis using the Diffeomorphic Deformation (BAAD) toolbox.
- Multivariable linear regression analysis was used to assess the association between WMH burden and cognitive function.
Main Results:
- Higher WMH burden and lower education levels were associated with global cognitive impairment.
- WMH severity correlated significantly with memory, semantic memory, and executive function.
- Female participants with WMH severity showed lower cognitive performance across all domains compared to males.
Conclusions:
- WMH burden is strongly associated with global cognition, memory, semantic memory, and executive function in asymptomatic MMD.
- This association is more pronounced in female MMD patients.
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