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WMHs were segmented and categorized by spatial patterns. Thalamic subregions were parcellated using the THalamus Optimized Multi\u2010Atlas Segmentation (THOMAS) framework. Mixed\u2010effects models evaluated the longitudinal effects of WMH progression and plasma A\u03b2 on thalamic subregional volumes.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>CSVD patients exhibited selective atrophy in left medial geniculate nucleus (MGN), mediodorsal\u2010parafascicular (MD\u2010Pf), and lateral geniculate nucleus (LGN), with volumes associated with processing speed and attentional control. Thalamic and basal ganglia WMH burden significantly predicted subregional atrophy. In CSVD, WMH progression dominated longitudinal thalamic degeneration.<\/jats:p><\/jats:sec><jats:sec><jats:title>DISCUSSION<\/jats:title><jats:p>Distinct WMH spatial patterns and vascular factors drive thalamic subregional atrophy in CSVD, contributing to cognitive decline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Highlights<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Patients with cerebral small vessel disease (CSVD) exhibit selective atrophy in thalamic subregions compared to healthy controls (HCs).<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Thalamic white matter hyperintensity (WMH) burden strongly predicts mediodorsal\u2010parafascicular and lateral geniculate nucleus atrophy in patients with CSVD.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Plasma amyloid beta dynamics differentially influence thalamic integrity in CSVD compared to HCs.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec>","DOI":"10.1002\/alz.70553","type":"journal-article","created":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T07:16:07Z","timestamp":1755414967000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Long\u2010term impact of white matter hyperintensities and amyloid beta on thalamic subregions in cerebral small vessel disease: A prospective cohort study"],"prefix":"10.1002","volume":"21","author":[{"given":"Zhenyu","family":"Cheng","sequence":"first","affiliation":[{"name":"Key Laboratory of Endocrine Glucose &amp; Lipids Metabolism and Brain Aging, Ministry of Education; Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan Shandong China"},{"name":"College of Medical Imaging Binzhou Medical University  Yantai Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy Jena University Hospital  Jena Thuringia Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiology Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University  Changping District Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Endocrine Glucose &amp; Lipids Metabolism and Brain Aging, Ministry of Education; 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