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Aims: This study aimed to analyze the potential association between cognition reserve (CR) components, including education, working activity, and leisure time activity, and cognitive function in subjects with white matter hyperintensities (WMH). The study also explored the role of the frontoparietal control network (FPCN) in such association. Methods: White matter hyperintensities subjects with and without cognitive impairment (CI) were evaluated with multimodal magnetic resonance imaging, neuropsychological testing, and CR survey. FPCN patterns were assessed with dorsolateral prefrontal cortex seed‐based functional connectivity analysis. Results: Education was positively associated with cognitive function in WMH subjects with or without CI, whereas working activity and leisure time activity were positively associated with cognitive function only in those without CI. Similarly, education was associated with bilateral FPCN in both WMH groups, whereas working activity and leisure time activity were associated with bilateral FPCN mainly in the group without CI. Furthermore, FPCN partially mediated the association between education and cognitive function in both WMH groups. Conclusion: Education showed a positive impact on cognitive function in WMH subjects regardless of their cognitive status, whereas working activity and leisure time activity exhibited beneficial effects only in those without CI. The FPCN mediated the beneficial effect of education on cognitive function. [ABSTRACT FROM AUTHOR]

Aims: We aimed to determine whether preprocedural renal function affects the outcome of acute ischemic stroke (AIS) patients with mechanical thrombectomy (MT) and whether this effect is modified by the onset‐to‐reperfusion time (OTR) and mediated by collateral status. Methods: Eligible patients with anterior circulation large vessel occlusion (LVO) who underwent MT between August 2018 and August 2020 were reviewed. The main outcome was good functional outcome [defined as modified Rankin Scale (mRS) of 0–2] at 3 months. Multivariable logistic regression analyses were conducted to explore the relationship between renal function and good functional outcome. A moderation analysis and the Johnson‐Neyman technique were performed to assess the interaction between renal function and OTR to predict the outcome of AIS patients with MT. Results: Among 100 enrolled patients, 36 (36%) exhibited good functional outcome. A decreased preprocedural estimated glomerular filtration rate (pre‐eGFR) was significantly associated with worse functional outcome [adjusted OR, 1.059 (1.012–1.108); p, 0.014], and this effect was partly mediated by collateral circulation. An interaction between OTR and pre‐eGFR on functional outcome was observed (P for interaction, 0.22), and pre‐eGFR only had a significant effect on functional outcome when OTR exceeded 455.8 min. Moreover, the adverse effect of OTR on functional outcome became no longer significant when the pre‐eGFR was higher than 89.0 mL/min/1.73 mL/min/1.73 m². Conclusions: Renal function was related to functional outcome at 3 months, and this relationship could be modified by OTR. The results suggested that reducing OTR and improving collateral circulation may mitigate the adverse effect of reduced kidney function on functional outcome. [ABSTRACT FROM AUTHOR]

Background: Impaired cerebrovascular reactivity (CVR) plays an important role in the pathophysiology of white matter hyperintensities (WMHs). The pathogenesis of CVR in the development of WMH‐related cognitive impairment (CI) remains poorly understood. Purpose: To detect the CVR status in WMH subjects with/without CI by using a resting‐state blood oxygenation level‐dependent (BOLD) approach and to explore the mediating relationships among CVR, WMH, and cognitive level. Study Type: Prospective. Subjects: Subjects with moderate to severe WMH (with CI [WMH‐CI], n = 68; without CI [WMH‐no‐CI, n = 63) as well as normal controls (NCs, n = 87). Field Strength/Sequence: 3.0T with gradient‐recalled echoplanar imaging and 3D fluid‐attenuated inversion recovery. Assessment: The CVR, WMH volume, and cognitive level were assessed. The CVR map was derived using BOLD signal obtained from resting‐state functional MRI data. Statistical Tests: CVR maps were compared among the three groups. Partial correlation analyses were performed to correlate impaired CVR with WMH volume and cognitive test scores. Mediation analysis was conducted to determine whether WMH acted as a mediating factor between CVR and cognitive function. Results: Compared with the NC group, both WMH groups showed reduced CVR in the left hemisphere (P < 0.05). The WMH‐CI group showed further decreased CVR in the left frontal area, when compared with the WMH‐no‐CI group (P < 0.05). In the WMH‐CI group, the lower CVR in left frontal area was a strong indicator of poor performance on general cognition (r = 0.311), executive function (r = 0.362), and information processing speed (r = 0.399) (all P < 0.05). Periventricular WMH (PWMH) volume mediated these correlations, the β and 95% bootstrap confidence intervals were (0.5097, [0.1498,1.1385]), (−0.4081, [−1.0256,‐0.1363]), and (−0.5576, [−1.4666,‐0.1538]), respectively. Data Conclusion: WMH‐CI subjects showed a greater reduction of CVR derived from a resting‐state BOLD approach in the left frontal area than WMH‐no‐CI subjects. Cognition was highly dependent on the integrity of cerebrovascular reactivity and mediated by PWMH burden. Level of Evidence: 4 Technical Efficacy: Stage 2 [ABSTRACT FROM AUTHOR]