Objectives White matter hyperintensities (WMH) are abnormalities in brain imaging that contribute to cognitive decline and diseases. This study aimed to build WMH probability maps (WPMs) and normative data of WMH volume from a Chinese aging cohort, to offer valuable insights for diagnosis. Materials and methods We developed WPMs from a comprehensive dataset across six age groups (20–29, 30–39, 40–49, 50–59, 60–69, and 70–79 years), encompassing 735 participants. WMH segmentation was performed with a deep learning approach, and the resulting masks were registered to the standard space for WPM construction. We explored how WMH volume changed with age and established normative data for different age groups. Additionally, we examined whether WMH volume moderates the relationship between aging and cognitive decline. The practical utility of WPMs was then validated with a separate patient cohort with mild cognitive impairment and Alzheimer’s disease. Results WPMs and the normative data of WMH volume were constructed for six age groups. As age increased, both the likelihood and spatial coverage of WMH grew. All types of WMH (total, periventricular, and deep white matter hyperintensities) quadratically increased with age. Deep white matter hyperintensities moderated the decline of general cognitive abilities related to aging. The two patient groups had significantly higher ratios of abnormal WMH than typical aging adults. Conclusion We successfully built WPMs and WMH normative data for Chinese adults and demonstrated their clinical diagnostic values. Key Points <Emphasis Type="BoldItalic">Question</Emphasis> Current diagnostic tools lack population-specific references for white matter hyperintensities (WMH)in Chinese aging adults, limiting accurate discrimination between pathological neurodegeneration and typical aging patterns. <Emphasis Type="BoldItalic">Findings</Emphasis> These Chinese WMH probability maps show quadratic age-related growth, with deep WMH moderating cognitive decline. Mild cognitive impairment/Alzheimer’s Disease (MCI/AD) patients exhibited significantly higher WMH volumes. <Emphasis Type="BoldItalic">Clinical relevance</Emphasis> These population-specific WMH references enable clinicians to quantitatively identify abnormal aging and early neurodegeneration in Chinese patients, addressing the critical need for ethnically tailored diagnostic tools in Alzheimer’s disease and vascular cognitive impairment. Graphical Abstract

Probabilistic maps of white matter hyperintensity in a Chinese aging cohort and application for clinical diagnosis

期刊论文
发表日期：

2025年10月25日

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Xinyi Cai,
Xiao Luo,
Lianghu Guo,
Yi Gu,
Qing Yang,
Yao Li,
Minming Zhang,
Jinsong Wu,
Qiang He,
Xu Zhang,
Peiyu Huang,
Han Zhang

摘要

Objectives

White matter hyperintensities (WMH) are abnormalities in brain imaging that contribute to cognitive decline and diseases. This study aimed to build WMH probability maps (WPMs) and normative data of WMH volume from a Chinese aging cohort, to offer valuable insights for diagnosis.

Materials and methods

We developed WPMs from a comprehensive dataset across six age groups (20–29, 30–39, 40–49, 50–59, 60–69, and 70–79 years), encompassing 735 participants. WMH segmentation was performed with a deep learning approach, and the resulting masks were registered to the standard space for WPM construction. We explored how WMH volume changed with age and established normative data for different age groups. Additionally, we examined whether WMH volume moderates the relationship between aging and cognitive decline. The practical utility of WPMs was then validated with a separate patient cohort with mild cognitive impairment and Alzheimer’s disease.

Results

WPMs and the normative data of WMH volume were constructed for six age groups. As age increased, both the likelihood and spatial coverage of WMH grew. All types of WMH (total, periventricular, and deep white matter hyperintensities) quadratically increased with age. Deep white matter hyperintensities moderated the decline of general cognitive abilities related to aging. The two patient groups had significantly higher ratios of abnormal WMH than typical aging adults.

Conclusion

We successfully built WPMs and WMH normative data for Chinese adults and demonstrated their clinical diagnostic values.

Key Points

Question Current diagnostic tools lack population-specific references for white matter hyperintensities (WMH)in Chinese aging adults, limiting accurate discrimination between pathological neurodegeneration and typical aging patterns.

Findings These Chinese WMH probability maps show quadratic age-related growth, with deep WMH moderating cognitive decline. Mild cognitive impairment/Alzheimer’s Disease (MCI/AD) patients exhibited significantly higher WMH volumes.

Clinical relevance These population-specific WMH references enable clinicians to quantitatively identify abnormal aging and early neurodegeneration in Chinese patients, addressing the critical need for ethnically tailored diagnostic tools in Alzheimer’s disease and vascular cognitive impairment.

Graphical Abstract