WM Microstructural Damage Mediates Cognitive Decline in MetS With CSVD

Background: Metabolic syndrome (MetS) is associated with cerebral small vessel disease (CSVD) and cognitive impairment. Objective: To evaluate whether white matter (WM) microstructural damage mediates the relationship between cerebral small vessel disease (CSVD) severity and cognitive impairment in patients with MetS. Design/Participants: Cross-sectional study involving patients with MetS. Methods: Participants underwent cognitive testing and diffusion tensor imaging (DTI). MetS subjects were stratified into those with and without CSVD. Cognitive testing and diffusion tensor imaging (DTI) were performed. Results: 170 participants (75 MetS, 95 controls) aged 50 to 80 years underwent cognitive testing and DTI. Patients with MetS and CSVD demonstrated significantly worse cognitive performance, particularly in executive function and processing speed (trail making test-B, Stroop color word test), compared to both MetS-only and control groups. DTI revealed reduced fractional anisotropy (FA more...