Previous studies have linked global burden of age-related white matter hyperintensities (WMHs) to cognitive impairment. We aimed to determine how WMHs in individual white matter connections relate to measures of cognitive function relative to measures of connectivity which do not take WMHs into account. Brain connectivity and WMH-related disconnectivity were derived from 3714 participants of the population-based Rotterdam Study. Connectivity was represented by the structural connectome, which was defined using diffusion tensor data, whereas the disconnectome represented disconnectivity due to WMH. The relationship between (dis)connectivity and cognitive measures was estimated using linear regression. We found that lower disconnectivity and higher connectivity corresponded to better cognitive function. There were many more significant associations with cognitive function in the disconnectome than in the connectome. Most connectome associations attenuated when disconnection was included in the model. WMH-related disconnectivity was especially related to worse executive functioning. Better cognitive speed corresponded to higher connectivity in specific connections independent of WMH presence. We conclude that WMH-related disconnectivity explains more variation in cognitive function than does connectivity. Efficient wiring in specific connections is important to information processing speed independent of WMH presence.

Introduction: Typical brain development is characterized by specific patterns of maturation of functional networks. Cortico-cortical connectivity generally increases, whereas subcortico-cortical connections often decrease. Little is known about connectivity changes amongst different subcortical regions in typical development. Methods: This study examined age- and gender-related differences in functional connectivity between and within cortical and subcortical regions using two different approaches. The participants included 411 six- to ten-year-old typically developing children sampled from the population-based Generation R study. Functional connectomes were defined in native space using regions of interest from subject-specific FreeSurfer segmentations. Connections were defined as: (a) the correlation between regional mean time-series; and (b) the focal maximum of voxel-wise correlations within FreeSurfer regions. The association of age and gender with each functional connection was determined using linear regression. The preprocessing included the exclusion of children with excessive head motion and scrubbing to reduce the influence of minor head motion during scanning. Results: Cortico-cortical associations echoed previous findings that connectivity shifts from short to long-range with age. Subcortico-cortical associations with age were primarily negative in the focal network approach but were both positive and negative in the mean time-series network approach. Between subcortical regions, age-related associations were negative in both network approaches. Few connections had significant associations with gender. Conclusions: The present study replicates previously reported age-related patterns of connectivity in a relatively narrow age-range of children. In addition, we extended these findings by demonstrating decreased connectivity within the subcortex with increasing age. Lastly, we show the utility of a more focal approach that challenges the spatial assumptions made by the traditional mean time series approach.

We present the largest population-based heritability study of the human brain structural connectome, including a pathology-sensitive extension, the disconnectome. The disconnectome maps the effect of white matter lesions throughout the brain. The connectome and disconnectome were generated from diffusion-weighted images of 3255 unrelated subjects from the Rotterdam Study aged between 45 and 99 years. Graph theory measures were derived for both the connectome and disconnectome. Genotypes were used to derive genetic relationship matrices between individuals for heritability analyses. High measures of heritability, from 33% to 51%, were found across all connectivity measures. The disconnectome showed more significantly heritable connectivity measures than the connectome, suggesting that the new proposed measure may reveal additional or complementary information about the genetic architecture of the human brain.

White matter lesions play a role in cognitive decline and dementia. One presumed pathway is through disconnection of functional networks. Little is known about location-specific effects of lesions on functional connectivity. This study examined location-specific effects within anatomically-defined white matter tracts in 1584 participants of the Rotterdam Study, aged 50–95. Tracts were delineated from diffusion magnetic resonance images using probabilistic tractography. Lesions were segmented on fluid-attenuated inversion recovery images. Functional connectivity was defined across each tract on resting-state functional magnetic resonance images by using gray matter parcellations corresponding to the tract ends and calculating the correlation of the mean functional activity between the gray matter regions. A significant relationship between both local and brain-wide lesion load and tract-specific functional connectivity was found in several tracts using linear regressions, also after Bonferroni correction. Indirect connectivity analyses revealed that tract-specific functional connectivity is affected by lesions in several tracts simultaneously. These results suggest that local white matter lesions can decrease tract-specific functional connectivity, both in direct and indirect connections.

Brain connectivity is increasingly being studied using connectomes. Typical structural connectome definitions do not directly take white matter pathology into account. Presumably, pathology impedes signal transmission along fibres, leading to a reduction in function. In order to directly study disconnection and localize pathology within the connectome, we present the disconnectome, which only considers fibres that intersect with white matter pathology. To show the potential of the disconnectome in brain studies, we showed in a cohort of 4199 adults with varying loads of white matter lesions (WMLs) that: (1) Disconnection is not a function of streamline density; (2) Hubs are more affected by WMLs than peripheral nodes; (3) Connections between hubs are more severely and frequently affected by WMLs than other connection types; and (4) Connections between region clusters are often more severely affected than those within clusters.