Deep and Periventricular White Matter Hyperintensity Segmentation and Their Relationship with Cognitive Decline and Vessel Hemodynamics

Motivation: Specific roles of periventricular (PWMH) and deep white matter hyperintensities (DWMH) in cognitive decline are not fully understood. Goal(s): To clarify their correlations with cognition and vascular dynamics using different segmentation methods. Approach: WMHs were segmented into PWMH and DWMH using two methods. Lesion volumes and counts were correlated with cognitive scores and arterial pulsatility indices. Results: PWMH lesion counts showed strong correlations with cognitive decline and vascular pulsatility across methods. Counts were more predictive than volumes, especially for PWMH. Impact: By clarifying PWMH's specific association with cognitive decline, our study emphasizes the importance of considering PWMH lesion counts in clinical assessments, potentially improving early diagnosis and management of cognitive impairment in the elderly.