White Matter Hyperintensities in Relation to Cognition and Amyloid Burden in a South Korean Cohort With Subjective Cognitive Decline

Objective: To assess the impact of regional white matter hyperintensity (WMH) volume on cognitive function in individuals with subjective cognitive decline (SCD) and investigate its relationship with amyloid burden. Methods: A cohort study in South Korea focused on predicting progression from SCD to cognitive impairment or dementia. Demographic and clinical data were analyzed, stratified by WMH severity in SCD. Statistical comparisons were made among quartiles of WMH volume. Multiple regression analyses explored associations between regional WMH volume, standardized uptake value ratio (SUVR), and cognitive function. Results: Examining 120 SCD patients, 78.3% had negative amyloid PET scans. Higher WMH volume quartiles correlated with older age, increased diabetes prevalence, and elevated SUVR in the precuneus and cuneus region. Higher WMH was linked to poorer processing speed and executive functions. Significant associations were found between posterior periventricular WMH volume and precuneus/cuneus SUVR values. Conversely, posterior deep WMH volume correlated with age and Framingham Score, not regional amyloid burden. Conclusion: This study suggests that WMH and amyloid burden independently influence cognitive function in SCD patients. Notably, a significant association was observed between amyloid burden and regional WMH volumes. These findings underscore the distinct roles of WMH and amyloid burden in cognitive decline among individuals with SCD.