Enhanced Regional Homogeneity and Functional Connectivity in Subjects With White Matter Hyperintensities and Cognitive Impairment

OBJECTIVE: White matter hyperintensities (WMH) is an important cause of vascular cognitive impairment (CI). However, a considerable portion of individuals with WMH do not develop CI. The present study aimed to investigate distinctive regional brain activity and connectivity patterns in WMH subjects with and without CI, who displayed comparable WMH burden. METHODS: Fourteen WMH subjects with CI, 16 WMH subjects without CI and 37 healthy subjects underwent multimodal MRI scans and neuropsychological tests. All WMH subjects displayed Fazekas grade 2 of WMH. Regional Homogeneity (ReHo) and functional connectivity (FC) patterns were identified based on resting-state functional MRI data. RESULTS: No significant differences in WMH volume, the number of WMH lesions and brain volume were shown between the 2 WMH groups. In contrast, the WMH with CI group showed higher ReHo in bilateral superior parietal gyrus (SPG)/superior occipital gyrus (SOG) than the WMH without CI group. Compared with the WMH without CI group, the WMH with CI group also displayed higher FC of the left SPG/SOG with frontal regions, and higher FC of the right SPG/SOG with parietal regions. Furthermore, higher FC of the left SPG/SOG with frontal regions were significantly associated with less worse executive dysfunction in WMH with CI subjects, suggesting a compensatory effect. CONCLUSION: Higher local coherence of activities in the SPG/SOG and higher connectivity of the SPG/SOG with parietal and frontal regions are related to CI in WMH subjects. The findings provide novel insights into functional alterations underlying the cognitive variety in WMH subjects.