Research of risk factors of white matter hyperintensities and its correlation with cognitive function

Chunhua LIANG; Xueqin YAN; Xiaohua XIAO; Tianfu WANG; Yaohui HUANG

doi:10.3969/j.issn.2096-5516.2025.01.004

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Chinese Journal of Alzheimer's Disease and Related Disorders ›› 2025, Vol. 8 ›› Issue (1) : 22-28. DOI: 10.3969/j.issn.2096-5516.2025.01.004

Research of risk factors of white matter hyperintensities and its correlation with cognitive function

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Abstract

Objective:

White Matter Hyperintensities (WMH) is one of the common imaging features of the elderly, it shows high signals on brain MRI T2WI and FLAIR sequences, which is closely related to dementia, stroke and increased mortality. Therefore, this study mainly discusses the risk factors affecting WMH volume, and its correlation with cognitive function.

Methods:

A total of 184 cases of WMH patients admitted to our hospital from January 2020 to December 2022 were collected and divided into the mild WMH group and the severe WMH group according to Fazekas scale. The differences in demographic characteristics, blood lipids, and thyroid function levels between the two groups were compared. ITK-SNAP software was used to calculate WMH volume, and multi-factor regression analysis was conducted to analyze the risk factors affecting WMH volume. The difference of WMH volume between those groups with and without cognitive impairment was compared to evaluate the diagnostic ability of WMH volume for cognitive impairment.

Results:

There were 142 cases in mild WMH group, and 42 cases in severe WMH group. There was high consistency between the Fazekas score and WMH volume (r=0.829, P < 0.001). Patients in the severe WMH group were older, had higher prevalence of hypertension and diabetes, and had lower serum FT3 levels. WMH volume was larger in patients with hypertension and diabetes, and age was positively correlated with WMH volume (r=0.379, P < 0.001), while serum FT3 level was not significantly correlated with WMH volume. After adjusting for confounders, multiple linear analysis results suggested that age and hypertension were independently associated with WMH volume. Among the 184 subjects, 126 patients had cognitive impairment and 58 patients had normal cognition. The WMH volume of the cognitive impairment group was significantly higher than that of the normal cognitive group. The area under the curve (AUC) of WMH for predicting cognitive impairment was 0.685, the best cutoff value of WMH was 3975.77mm³, the sensitivity was 65.10%, and the specificity was 69.00%.

Conclusion:

Age and hypertension were independent risk factors for WMH volume, while diabetes and low FT3 levels were also associated with WMH severity. WMH is closely related to cognitive function, larger WMH volumes correlate with poorer cognitive performance. WMH contributes to the early identification of individuals with cognitive impairment.

Key words

White matter hyperintensity / Hypertension / Age / Thyroid hormone / Cognitive function

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Chunhua LIANG , Xueqin YAN , Xiaohua XIAO , et al . Research of risk factors of white matter hyperintensities and its correlation with cognitive function[J]. Chinese Journal of Alzheimer's Disease and Related Disorders. 2025, 8(1): 22-28 https://doi.org/10.3969/j.issn.2096-5516.2025.01.004

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