The influence of white matter hyperintensities severity on functional brain activity in cerebral small vessel disease: An rs-fMRI study

OBJECTIVE: To investigate relationships between the severity of white matter hyperintensities (WMH), functional brain activity, and cognition in cerebral small vessel disease (CSVD) based on resting-state functional magnetic resonance imaging (rs-fMRI) data. METHODS: A total of 103 subjects with CSVD were included. The amplitude of low frequency fluctuations (ALFF), regional homogeneity (ReHo), functional connectivity (FC) and their graph properties were applied to explore the influence of WMH burden on functional brain activity. We also investigated whether there are correlations between different functional brain characteristics and cognitive assessments. Finally, we selected disease-related rs-fMRI features in combination with ensemble learning to classify CSVD patients with low WMH load and with high WMH load. RESULTS: The high WMH load group demonstrated significantly abnormal functional brain activity based on rs-MRI data, relative to the low WMH load group. ALFF and graph properties in specific brain regions were significantly correlated with patients’ cognitive assessments in CSVD. Moreover, altered rs-fMRI signal can help predict the severity of WMH in CSVD patients with an overall accuracy of 92.23%. CONCLUSIONS: This study provided a comprehensive analysis and evidence for a pattern of altered functional brain activity under different WMH load in CSVD based on rs-fMRI data, enabling accurately individual prediction of status of WMH.