We performed fixel-based analysis, which implements the Multi-Shell Multi-Tissue Constrained Spherical Deconvolution method, to investigate the effect of metabolic syndrome (MetS) on fiber-specific white matter (WM) integrity and assess its association with MetS-related components or cognitive or motor functions. Our findings provide evidence of WM degeneration, as reflected by reduced microstructural fiber density and macrostructural fiber bundle cross-section, in regions associated with cognitive and motor functions in MetS. We also observed reduced fiber density in the corticospinal tract in preMetS. Finally, our findings clarified visceral fat accumulation, insulin resistance, and arterial stiffness as risk factors for WM alterations in MetS.
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