# Silent yet impaired: Hidden memory processing deficits in asymptomatic individuals with moderate‐to‐severe white matter hyperintensities

## TL;DR

People with moderate-to-severe white matter hyperintensities show hidden memory issues even if they seem cognitively normal.

## Contribution

This study reveals hidden visual short-term memory deficits in asymptomatic individuals with white matter hyperintensities.

## Key findings

- Individuals with msWMH showed deficits in face-memory processing and altered neural oscillations.
- Microstructural damage in specific brain tracts mediates the impact on cognition via theta oscillations.
- Theta oscillations may serve as a preclinical target for intervention in white matter disease.

## Abstract

White matter hyperintensities (WMHs) are strongly associated with cognitive decline and dementia, but whether asymptomatic individuals with moderate‐to‐severe WMHs (msWMHs) are truly cognitively intact, particularly in visual short‐term memory (VSTM), remains unclear.

Electroencephalography and diffusion tensor imaging (DTI) was obtained from 45 msWMH patients and 38 normal controls during an occluded‐face delay‐matching task.

Individuals with msWMH showed systematic deficits in face‐memory processing across encoding, maintenance, and retrieval, accompanied by reduced theta power and synchronization, altered alpha power, and disrupted theta–gamma coupling. DTI further revealed microstructural damage, particularly in the inferior fronto‐occipital fasciculus (IFOF), superior longitudinal fasciculus (SLF), and inferior longitudinal fasciculus (ILF), which mediated the effects on global cognition via encoding‐related theta oscillations.

These findings indicate that individuals with msWMH already show hidden VSTM deficits. Theta oscillations mediate the link between tract integrity and global cognition, highlighting a potential preclinical intervention target.

Asymptomatic individuals with moderate‐to‐severe white matter hyperintensities (msWMHs) already show visual short‐term memory (VSTM) deficits.Electroencephalography revealed abnormal neural oscillations during encoding, maintenance, and retrieval stages.Damage to the inferior fronto‐occipital fasciculus (IFOF), superior longitudinal fasciculus (SLF), and inferior longitudinal fasciculus (ILF) affects cognition via theta oscillations.Theta activity mediates structure ‐ function coupling and may serve as a preclinical intervention target.

Asymptomatic individuals with moderate‐to‐severe white matter hyperintensities (msWMHs) already show visual short‐term memory (VSTM) deficits.

Electroencephalography revealed abnormal neural oscillations during encoding, maintenance, and retrieval stages.

Damage to the inferior fronto‐occipital fasciculus (IFOF), superior longitudinal fasciculus (SLF), and inferior longitudinal fasciculus (ILF) affects cognition via theta oscillations.

Theta activity mediates structure ‐ function coupling and may serve as a preclinical intervention target.