Cerebrospinal fluid synaptic markers are associated with global white matter microstructure in cognitively unimpaired participants

Higher CSF levels of synaptic markers NPTX2, GluA4, and VGF were associated with better white matter integrity, including global cortical, medial temporal, and cerebellar tracts, which in turn was associated with better cognitive performance. These results support the view that synaptic proteins may contribute to cognitive resilience among older adults, possibly via better white matter microstructure. Longitudinal studies are needed to assess the impact of these proteins on white matter microstructure and their relationship with cognition.