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Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 24, 2025
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Summary

Mild behavioral impairment (MBI) is linked to increased white matter hyperintensities (WMH) volume, suggesting cerebral small vessel disease contributes to MBI. Lesions in posterior superior brain regions are specifically associated with MBI, highlighting the importance of lesion location.

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Area of Science:

  • Neurology
  • Neuroimaging
  • Gerontology

Background:

  • Mild behavioral impairment (MBI) presents neuropsychiatric symptoms in cognitively healthy individuals and predicts dementia.
  • White matter hyperintensities (WMH), a marker of cerebral small vessel disease, are associated with dementia risk.
  • This study investigates the link between specific WMH lesion locations and MBI.

Purpose of the Study:

  • To determine if specific white matter hyperintensities (WMH) lesion locations are associated with mild behavioral impairment (MBI).
  • To explore the role of cerebral small vessel disease in the development of MBI.

Main Methods:

  • Analysis of 125 WMH lesions in 27 cognitively healthy participants from the Alzheimer's Disease Neuroimaging Initiative.
  • WMH lesions segmented from T2-FLAIR images and spatially clustered.
  • Multiple linear mixed-effects models used to assess the relationship between WMH characteristics and MBI scores/syndrome, adjusting for covariates.

Main Results:

  • Significant association found between MBI syndrome, MBI score, and total WMH lesion volume (p < 0.001 and p < 0.017, respectively).
  • WMH lesions in MBI-positive individuals were more common in posterior superior brain regions (MNI z- and y-coordinates, p < 0.0001).
  • A cluster including the right lingual gyrus, right calcarine gyrus, corpus callosum, and inferior occipitofrontal fasciculus showed a significant link with MBI syndrome (p < 0.020).

Conclusions:

  • Increased WMH lesion volume associated with MBI syndrome suggests cerebral small vessel disease involvement in MBI.
  • Distinct WMH lesion localization in posterior superior brain regions is important for understanding MBI's neurobiological basis.
  • Spatially resolved WMH analyses are crucial for clarifying MBI's underlying mechanisms.