Complementary MR measures of white matter and their relation to cardiovascular health and cognition

Abstract

Magnetic Resonance Imaging (MRI) offers many ways to non-invasively estimate the properties of white matter (WM) in the brain. In addition to the various metrics derived from diffusion-weighted MRI, one can estimate total WM volume from T1-weighted MRI, WM hyper-intensities from T2-weighted MRI, myelination from the T1:T2 ratio, or from the magnetisation-transfer ratio (MTR). Here we utilise the presence of all of these MR contrasts in a population based life-span cohort of 650 healthy adults [CamCAN cohort] to identify the latent factors underlying the covariance of 11 commonly-used WM metrics. Four factors were needed to explain 89% of the variance, which we interpreted in terms of 1) fibre density / myelination, 2) free-water / tissue damage, 3) fibre-crossing complexity and 4) microstructural complexity. These factors showed distinct effects of age and sex. To test the validity of these factors, we related them to measures of cardiovascular health and cognitive performance. Specifically, we ran path analyses 1) linking cardio-vascular measures to the WM factors, given the idea that WM health is related to cardiovascular health, and 2) linking the WM factors to cognitive measure, given the idea that WM health is important for cognition. Even after adjusting for age, we found that a vascular factor related to pulse pressure predicted the WM factor capturing free-water / tissue damage, and that several WM factors made unique predictions for fluid intelligence and processing speed. Our results show that there is both complementary and redundant information across common MR measures of WM, and their underlying latent factors may be useful for pinpointing the differential causes and contributions of white matter health in healthy aging.