Cerebrovascular Lesion Loads and Accelerated Brain Ageing: Insights into the Cognitive Spectrum

INTRODUCTIONWhite matter hyperintensities (WMHs) and cerebral microbleeds are widespread among aging population and linked with cognitive deficits in mild cognitive impairment (MCI), vascular MCI (V-MCI), and Alzheimers disease without (AD) or with a vascular component (V-AD). In this study, we aimed to investigate the association between brain age, which reflects global brain health, and cerebrovascular lesion load in the context of pathological aging in diverse forms of clinically-defined neurodegenerative conditions. METHODSWe computed brain-predicted age difference (brain-PAD: predicted brain age minus chronological age) in the Comprehensive Assessment of Neurodegeneration and Dementia cohort of the Canadian Consortium on Neurodegeneration in Aging including 70 cognitively intact elderly (CIE), 173 MCI, 88 V-MCI, 50 AD, and 47 V-AD using T1-weighted magnetic resonance imaging (MRI) scans. We used a well-established automated methodology that leveraged fluid attenuated inversion recovery MRIs for precise quantification of WMH burden. Additionally, cerebral microbleeds were detected utilizing a validated segmentation tool based on the ResNet50 network, utilizing routine T1-weighted, T2-weighted, and T2* MRI scans. RESULTSThe mean brain-PAD in the CIE cohort was around zero, whereas the four categories showed a significantly higher mean brain-PAD compared to CIE. The brain-PAD was significantly correlated with WMHs in all groups. DISCUSSIONWMHs were associated with faster brain ageing and should be considered as a risk factor which imperils brain health in aging and exacerbate brain abnormalities in the context of neurodegeneration of presumed AD origin. Our findings underscore the significance of novel research endeavors aimed at elucidating the etiology, prevention, and treatment of WMH in the area of brain ageing. HighlightsO_LIWe assessed the association between brain-PAD and cerebrovascular lesion loads in aging and AD. C_LIO_LIThere were noticeably links between brain-PAD and WMH loads. C_LIO_LIThe structure of the ageing brain is associated with WMHs. C_LIO_LIWMH needs to be taken into account as a risk factor that increase the brain age in aging and AD. C_LI