{
  "abstract": "The frequent coexistence of white matter hyperintensities (WMHs) and β-amyloid (Aβ) pathology in cognitively unimpaired older adults complicates interpretation of vascular and neurodegenerative imaging findings. This narrative review synthesizes topographical, microstructural, and network-level evidence in cognitively unimpaired aging, distinguishing biomarker-characterized samples from supportive mixed or symptomatic cohorts. WMHs have heterogeneous etiologies. Posterior and some periventricular patterns are associated with cerebral Aβ in several cohorts, but lobar location and distance from the ventricles are overlapping classifications, and vascular associations are not confined to frontal or deep lesions. Independent and additive cognitive associations are more consistently reported than interactions. Longitudinal executive-function interactions reported in a dissertation and related abstract remain preliminary and non-independent. Some longitudinal studies associate baseline Aβ with subsequent WMH accrual, but findings are not uniform and do not establish causation. APOE-related findings vary with age, population, and amyloid burden. Diffusion MRI detects tissue abnormalities beyond visible lesions, although microstructural and disconnectome measures require prospective validation before they can improve individual prognosis. Anti-amyloid trial evidence identifies MRI safety considerations; effects on chronic WMH progression remain uncertain.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Medical Sciences, School of Medicine, Iran University of Medical Sciences, Tehran, Iran",
    "School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran",
    "Department of Advanced Medical and Surgical Sciences, MRI Research Center (DAMSS), University of Campania “Luigi Vanvitelli”, Naples, Italy",
    "Neurology Unit, First Division of Neurology and Neurophysiopathology, AOU University of Campania “Luigi Vanvitelli”, Naples, Italy",
    "Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada",
    "Montreal Neurological Institute, McConnell Brain Imaging Centre, McGill University, Montreal, QC, Canada",
    "Ludmer Centre for Neuroinformatics and Mental Health, Montreal, QC, Canada",
    "Pacific Parkinson’s Research Centre (PPRC), Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada",
    "Division of Neurology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada",
    "0Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institute, Stockholm, Sweden"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 17,
  "authors": [
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        0
      ],
      "name": "Sana Mohammadi"
    },
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        1
      ],
      "name": "Sana Mohammadi"
    },
    {
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        2
      ],
      "name": "Minoo Sharbafshaaer"
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    {
      "affs": [
        3
      ],
      "name": "Minoo Sharbafshaaer"
    },
    {
      "affs": [
        2
      ],
      "name": "Maria Agnese Pirozzi"
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    {
      "affs": [
        3
      ],
      "name": "Maria Agnese Pirozzi"
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        2
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      "name": "Francesca Trojsi"
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        3
      ],
      "name": "Francesca Trojsi"
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    {
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        4
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      "name": "Sadegh Ghaderi"
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    {
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        5
      ],
      "name": "Sadegh Ghaderi"
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    {
      "affs": [
        6
      ],
      "name": "Sadegh Ghaderi"
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    {
      "affs": [
        4
      ],
      "name": "Yasser Iturria-Medina"
    },
    {
      "affs": [
        5
      ],
      "name": "Yasser Iturria-Medina"
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    {
      "affs": [
        6
      ],
      "name": "Yasser Iturria-Medina"
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    {
      "affs": [
        7
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      "name": "Seyed-Mohammad Fereshtehnejad"
    },
    {
      "affs": [
        8
      ],
      "name": "Seyed-Mohammad Fereshtehnejad"
    },
    {
      "affs": [
        9
      ],
      "name": "Seyed-Mohammad Fereshtehnejad"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0d0hvecddxd0r.bib",
  "cited_by": 0,
  "doi": "10.3389/fnagi.2026.2005174",
  "fulltext_url": "https://www.frontiersin.org/articles/10.3389/fnagi.2026.2005174/full",
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  "landing_url": "https://doi.org/10.3389/fnagi.2026.2005174",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
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      "lcc",
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  "pdf_url": "https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2026.2005174/pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-26",
  "publisher": "Frontiers Media S.A.",
  "ris": "https://research.draconitic.com/paper/0d0hvecddxd0r.ris",
  "sources": [
    {
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2738|Dementia and Cognitive Impairment Research",
      "subfield": "psychiatry"
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  "title": "White matter hyperintensities and amyloid pathology in cognitively unimpaired aging: topographical, microstructural, and network-level evidence",
  "title_text": "White matter hyperintensities and amyloid pathology in cognitively unimpaired aging: topographical, microstructural, and network-level evidence",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T14:21:15Z",
  "url": "https://research.draconitic.com/paper/0d0hvecddxd0r",
  "venue": "Frontiers in Aging Neuroscience",
  "versions": []
}