Fig. 4.

Free water and blood–brain barrier disruption (BBBD) are associated with cognitive performance. A) Higher mean free water in the white matter hyperintensity (WMH) penumbra (standardized Beta = -0.34; p = 0.008) was associated with worse performance on the Montreal Cognitive Assessment (MoCA). B) Greater BBBD in the WMH penumbra (std Beta = -0.32, p = 0.014) was also associated with lower MoCA score. Dashed line shows predicted MoCA score derived from a multivariable linear regression model, in which both mean FW (std Beta = -0.36, p = 0.005) and mean BBBD (std Beta = -0.30, p = 0.028) in the WMH penumbra were independently associated with MoCA score while covarying for age, sex, race, education, and MRI site as a random effect. Gray area reflects 95 % confidence intervals.