AbstractBackgroundIn the SoUth Korean study to PrEvent cognitive impaiRment and protect BRAIN health through lifestyle intervention in at‐risk elderly people (SUPERBRAIN), we evaluated the impact of a 24‐week facility‐based multidomain intervention (FMI) and home‐based MI (HMI) on white matter integrity.MethodTotally, 152 participants, aged 60‐79 years without dementia, were randomly assigned to the FMI, HMI, or control groups. Among them, 55 participants (20 FMI, 19 HMI, and 16 controls) underwent brain MRI at baseline and 24 weeks. The dtifit tool was used to fit the diffusion tensor model and computed diffusion scalar maps for fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD). Individual FA, MD, AD, and RD at baseline were compared among groups using one‐way analyses of covariance (ANCOVA) with age, sex, years of education, and imaging site effects added as covariates of no interest. In addition, to compare changes in the FA, MD, AD, and RD from baseline to the study endpoint, we used two statistical analyses. First, ROI‐wise paired t‐tests were used to analyze longitudinal changes in white matter integrity for control and intervention group. The statistical significance level was set at bonferroni corrected p‐value < 0.05. And then, significant brain image measures in previous paired t‐test were compared between each group pair (FMI vs. control; HMI vs. control; FMI+HMI vs. control) using ANCOVA with changes as dependent variables and age, sex, education, and site as covariates.ResultThe FA, MD, AD, and RD at each ROI at the baseline were not different among groups after bonferroni correction. In cingulum regions, the FA and AD were increased and the MD and AD were decreased significantly in the intervention group. The AD in right uncinate fasciculus was also increased in intervention group. Finally, among the significant regions in paired t‐test, compared with the control group, the FMI, HMI, and intervention group yielded significantly more beneficial effects on the AD of the cingulum regionsConclusionThe change of white matter integrity in the intervention group suggests that multidomain lifestyle intervention may be beneficial through structural neuroplastic changes in highly complex tract.