Background Depression is a common co-morbidity in asthma, worsening asthma control and impairing patient's quality of life. Previous studies have reported a higher risk of cognitive de cit in depression. However, few research has focused on the cognitive status of asthmatic patients with depression. Evidence showed that in ammation may play an important role in both asthma and depression. Moreover, cerebral white matter injury, which could be induced by in ammation, has been associated with depression. The present study aimed to assess the cognitive function and explore the potential mechanism in patients with asthma, depression and comorbidity. Methods We admitted four groups: Asthma comorbid Depression group (A + D, n = 26), Depression group (D, n = 25), Asthma group (A, n = 33) and Normal controls (N, n = 28). Cognitive function was assessed by Montreal Cognitive Assessment (MoCA). Various in ammatory cytokines were measured, including interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), high-mobility group box 1(HMGB1) and Netrin-1. Cerebral white matter injury was assessed by serum myelin basic protein (MBP) and myelin oligodendrocyte glycoprotein (MOG), and their correlations with cognitive performance were calculated. Results A + D group showed the highest incidence of cognitive de cit with speci c affected cognitive domain. Compared to N group, serum levels of IL-6, HMGB1, Netrin-1, MBP and MOG were signi cantly elevated in A + D group. MOG level was negatively correlated with MoCA score. Conclusion Patients with comorbid condition presented more de nite, severe cognitive de cit and higher level of in ammatory cytokines. Cerebral white matter injury may account for the cognitive de cit in these patients and MOG could be a potential biomarker of this process.