Impact of cardiometabolic factors and blood beta-amyloid on the volume of white matter hyperintensities in dementia-free subjects with cognitive complaints

Introduction White matter hyperintensities (WMH) in Alzheimer’s disease (AD) have traditionally been associated with cerebrovascular diseases. Amyloid β (Aβ) deposition reportedly contributes to WMHs; however, this relationship remains unclear in dementia-free subjects with cognitive complaints (CC). Here, we explored the relationship between WMHs and cardiometabolic and Aβ blood biomarkers in a community-based cohort of Latin American CC participants. Methods We recruited 112 individuals with CC (69 – 92 YO, 90 females) with available plasma Aβ biomarkers and cardiometabolic markers (systolic – diastolic blood pressure and glycaemia). WMHs were quantified using a lesion segmentation tool based on SPM12 and segmented using the John Hopkins University (JHU) Atlas and ALVIN segmentation for periventricular and subcortical white matter. Linear multiple regression models were fitted to assess total WMH lesions and the segmented tract, using demographics, cardiometabolic, and Aβ blood biomarker measures as independent variables. Results After multiple comparison corrections, diastolic blood pressure was associated with WMHs, specifically in the right anterior thalamic radiation, left cingulum, minor forceps, and subcortical ALVIN segmentation. Glycaemia was associated with WMH volume in forceps major, forceps minor, and right fronto-occipital fasciculi. Conversely, Aβ blood biomarkers and systolic blood pressure showed no association with WMH overall or in specific tracts. Conclusion Our findings suggest that, in dementia-free CC individuals, WMH volume was more related to cardiometabolic factors, whereas Aβ blood biomarkers might be of less relevance. Dementia prevention strategies in individuals might be a useful focus for managing high peripheral vessel resistance and endothelial damage due to hypertension and hyperglycaemia.