White matter hyperintensities (WMH) are common in elderly individuals and cause brain network deficits. However, it is still unclear how the global brain network is affected by the focal WMH. We aimed to investigate the diffusion of WMH‐related deficits along the connecting white matters (WM). Brain magnetic resonance imaging data and neuropsychological evaluations of 174 participants (aged 74 ± 5 years) were collected and analyzed. For each participant, WMH lesions were segmented using a deep learning method, and 18 major WM tracts were reconstructed using automated quantitative tractography. The diffusion characteristics of distal WM tracts (with the WMH penumbra excluded) were calculated. Multivariable linear regression analysis was performed. We found that a high burden of tract‐specific WMH was related to worse diffusion characteristics of distal WM tracts in a wide range of WM tracts, including the forceps major (FMA), forceps minor (FMI), anterior thalamic radiation (ATR), cingulum cingulate gyrus (CCG), corticospinal tract (CST), inferior longitudinal fasciculus (ILF), superior longitudinal fasciculus‐parietal (SLFP), superior longitudinal fasciculus‐temporal (SLFT), and uncinate fasciculus (UNC). Furthermore, a higher mean diffusivity (MD) of distal tracts was linked to worse attention and executive function in the FMI, right CCG, left ILF, SLFP, SLFT, and UNC. The effect of WMH on the microstructural integrity of WM tracts may propagate along tracts to distal regions beyond the penumbra and might eventually affect attention and executive function.

中文翻译：

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白质高信号导致连接纤维的远端缺陷

白质高信号 (WMH) 在老年人中很常见，会导致大脑网络缺陷。然而，目前尚不清楚全球大脑网络如何受到焦点 WMH 的影响。我们旨在调查 WMH 相关缺陷沿连接白质 (WM) 的扩散。收集并分析了 174 名参与者（74±5 岁）的脑磁共振成像数据和神经心理学评估。对于每位参与者，使用深度学习方法分割 WMH 病变，并使用自动定量纤维束成像重建 18 个主要 WM 束。计算远端 WM 束的扩散特征（排除 WMH 半影）。进行了多变量线性回归分析。我们发现，束特异性 WMH 的高负荷与广泛的 WM 束中远端 WM 束较差的扩散特性有关，包括大钳 (FMA)、小钳 (FMI)、前丘脑放射 (ATR)、扣带回（CCG）、皮质脊髓束（CST）、下纵束（ILF）、上纵束-顶叶（SLFP）、上纵束-颞（SLFT）和钩状束（UNC）。此外，远端束的较高平均扩散率 (MD) 与 FMI、右侧 CCG、左侧 ILF、SLFP、SLFT 和 UNC 中较差的注意力和执行功能有关。WMH 对 WM 束微结构完整性的影响可能会沿束传播到半影以外的远端区域，并可能最终影响注意力和执行功能。