Disrupted white matter functional connectivity in post-stroke cognitive impairment: Insights from resting-state fMRI

Post-stroke cognitive impairment (PSCI) significantly impacts patients' quality of life following a stroke. Its effects on white matter functional networks remain unclear. This study used resting-state functional MRI to examine alterations in white matter functional connectivity and spontaneous activity in this condition. Resting-state functional MRI data were acquired from PSCI (n = 21), non-PSCI (PSNCI, n = 16), and healthy subjects (HSs, n = 29). A clustering analysis was employed to identify white matter functional networks. Functional connectivity and the amplitude of low-frequency fluctuation within these networks were compared across groups. Correlation analyses assessed their relationships with neuropsychological scores. Sixteen stable white matter networks were identified. Both patient groups showed reduced functional connectivity between the inferior longitudinal fasciculus and anterior cingulum compared to HSs. PSCI patients also exhibited decreased functional connectivity between the anterior and posterior cingulum compared to HSs. Furthermore, the amplitude of low-frequency fluctuation in the posterior cingulum was lower in PSCI group than in PSNCI group. These altered metrics showed correlations with neuropsychological performance across multiple cognitive domains. This study identified alterations in functional connectivity and spontaneous activity within specific WM networks in PSCI, which were associated with cognitive performance. These findings suggest that white matter functional abnormalities may be involved in the neural mechanisms underlying PSCI and could inform future research on early identification.