ORIGINAL RESEARCH article
Front. Hum. Neurosci.
Sec. Brain Imaging and Stimulation
Volume 19 - 2025 | doi: 10.3389/fnhum.2025.1633355
This article is part of the Research TopicExploring the complexities of the human nervous system through advanced brain imaging and stimulationView all 6 articles
Vascular Risk Factors and Neuroimaging Heterogeneity Across Different White Matter Hyperintensities Distribution Patterns
Provisionally accepted
- Zhejiang Hospital, Hangzhou, China
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Background: Different white matter hyperintensities (WMHs) distribution patterns exhibit distinct clinical implications, but their underlying mechanisms remain unclear.This study explores vascular risk factors and neuroimaging features to elucidate their heterogeneity.: We retrospectively analyzed WMHs patients who underwent multimodal MRI at Zhejiang Hospital. Neuroimaging features included gray matter volume, white matter microstructure (Fractional anisotropy, FA), and cerebral blood flow (CBF) were assessed. Vascular risk factors and imaging features were compared across four different WMHs distribution patterns (multi-spots, peri-basal ganglia, anterior subcortical (SC) patches, and posterior SC patches). Mediation analysis was performed to explore the role of imaging features on WMHs related cognitive impairment. Results: A total of 163 patients were included in the final analysis. Among the four WMHs distribution patterns, hypertension was significantly more prevalent in patients with anterior SC patches (48 [85.7%] vs. 71 [66.4%], p = 0.008). All WMH distribution patterns except multi-spots exhibited reduced gray matter volume (Bonferroni p < 0.0125). Notably, only patients with anterior SC patches exhibited a reduction in white matter FA (0.342 ± 0.049 vs. 0.370 ± 0.043, p < 0.001). Furthermore, patients with posterior SC patches displayed significantly lower CBF in both gray matter (42.65 ± 11.76 vs. 48.02 ± 10.97, p = 0.003) and white matter (35.25 ± 8.81 vs. 38.86 ± 8.07, p = 0.007). Mediation analysis revealed that white matter microstructural injury mediated the association between anterior SC patches WMHs and cognitive impairment (β = -0.371, Bootstrap 95% CI [-0.939, -0.006]). Conclusion: This study demonstrates heterogeneity in vascular risk factors, gray matter volume, microstructural injury, and hypoperfusion across different WMHs patterns, underscoring the importance of subtype-specific mechanistic and therapeutic research.
Keywords: white matter hyperintensities, vascular risk factors, White matter microstructural injury, cerebral blood flow, heterogeneity, cognitive impairment
Received: 22 May 2025; Accepted: 27 Jun 2025.
Copyright: © 2025 Wang, Zhuang, Fu, Mo, Zhai, Xu and Mou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Caiyun Mou, Zhejiang Hospital, Hangzhou, China
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