MRI-detected White Matter Lesions: Do They Really Matter?

Overview

Journal J Neural Transm (Vienna)

Specialties Neurology
Physiology

Date 2011 Feb 23

PMID 21340713

Citations 28

Authors

Reinhold Schmidt

Anja Grazer

Christian Enzinger

Stefan Ropele

Nina Homayoon

Aga Pluta-Fuerst

Petra Schwingenschuh

Petra Katschnig

Margherita Cavalieri

Helena Schmidt

Christian Langkammer

Franz Ebner

Franz Fazekas

Affiliations

Soon will be listed here.

Abstract

Despite extensive research over the last decades the clinical significance of white matter lesions (WMLs) is still a matter of debate. Here, we review current knowledge of the correlation between WMLs and cognitive functioning as well as their predictive value for future stroke, dementia, and functional decline in activities of daily living. There is clear evidence that age-related WMLs relate to all of these outcomes on a group level, but the inter-individual variability is high. The association between WMLs and clinical phenotypes exists particularly for early confluent to confluent changes, which are ischaemic in aetiology and progress quickly over time. One reason for the variability of the relationship between WMLs and clinic on an individual level is probably the complexity of the association. Numerous factors such as cognitive reserve, concomitant loss of brain volume, and ultrastructural changes have been identified as mediators between white matter damage and clinical findings, and need to be incorporated in the consideration of WMLs as visible markers of these detrimental processes.

Citing Articles

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References

Vernooij M, Ikram M, Vrooman H, Wielopolski P, Krestin G, Hofman A . White matter microstructural integrity and cognitive function in a general elderly population. Arch Gen Psychiatry. 2009; 66(5):545-53. DOI: 10.1001/archgenpsychiatry.2009.5. View

Zlokovic B . Neurovascular mechanisms of Alzheimer's neurodegeneration. Trends Neurosci. 2005; 28(4):202-8. DOI: 10.1016/j.tins.2005.02.001. View

van der Flier W, van Straaten E, Barkhof F, Ferro J, Pantoni L, Basile A . Medial temporal lobe atrophy and white matter hyperintensities are associated with mild cognitive deficits in non-disabled elderly people: the LADIS study. J Neurol Neurosurg Psychiatry. 2005; 76(11):1497-500. PMC: 1739423. DOI: 10.1136/jnnp.2005.064998. View

Pohjasvaara T, Jokinen H, Ylikoski R, Kalska H, Mantyla R, Kaste M . White matter lesions are related to impaired instrumental activities of daily living poststroke. J Stroke Cerebrovasc Dis. 2007; 16(6):251-8. DOI: 10.1016/j.jstrokecerebrovasdis.2007.08.001. View

Fazekas F, Ropele S, Enzinger C, Gorani F, Seewann A, Petrovic K . MTI of white matter hyperintensities. Brain. 2005; 128(Pt 12):2926-32. DOI: 10.1093/brain/awh567. View

Longstreth Jr W, Arnold A, Beauchamp Jr N, Manolio T, Lefkowitz D, Jungreis C . Incidence, manifestations, and predictors of worsening white matter on serial cranial magnetic resonance imaging in the elderly: the Cardiovascular Health Study. Stroke. 2004; 36(1):56-61. DOI: 10.1161/01.STR.0000149625.99732.69. View

Schmidt R, Enzinger C, Ropele S, Schmidt H, Fazekas F . Subcortical vascular cognitive impairment: similarities and differences with multiple sclerosis. J Neurol Sci. 2006; 245(1-2):3-7. DOI: 10.1016/j.jns.2005.06.018. View

Linortner P, Fazekas F, Schmidt R, Ropele S, Pendl B, Petrovic K . White matter hyperintensities alter functional organization of the motor system. Neurobiol Aging. 2010; 33(1):197.e1-9. DOI: 10.1016/j.neurobiolaging.2010.06.005. View

Fazekas F, Kleinert R, Offenbacher H, Schmidt R, Kleinert G, Payer F . Pathologic correlates of incidental MRI white matter signal hyperintensities. Neurology. 1993; 43(9):1683-9. DOI: 10.1212/wnl.43.9.1683. View

10.

van den Heuvel D, Ten Dam V, de Craen A, Admiraal-Behloul F, Olofsen H, Bollen E . Increase in periventricular white matter hyperintensities parallels decline in mental processing speed in a non-demented elderly population. J Neurol Neurosurg Psychiatry. 2006; 77(2):149-53. PMC: 2077562. DOI: 10.1136/jnnp.2005.070193. View

11.

Schmidt R, Ropele S, Ferro J, Madureira S, Verdelho A, Petrovic K . Diffusion-weighted imaging and cognition in the leukoariosis and disability in the elderly study. Stroke. 2010; 41(5):e402-8. DOI: 10.1161/STROKEAHA.109.576629. View

12.

Soderlund H, Nilsson L, Berger K, Breteler M, Dufouil C, Fuhrer R . Cerebral changes on MRI and cognitive function: the CASCADE study. Neurobiol Aging. 2005; 27(1):16-23. DOI: 10.1016/j.neurobiolaging.2004.12.008. View

13.

Fu J, Lu C, Hong Z, Dong Q, Luo Y, Wong K . Extent of white matter lesions is related to acute subcortical infarcts and predicts further stroke risk in patients with first ever ischaemic stroke. J Neurol Neurosurg Psychiatry. 2005; 76(6):793-6. PMC: 1739660. DOI: 10.1136/jnnp.2003.032771. View

14.

Longstreth Jr W, Manolio T, Arnold A, Burke G, Bryan N, Jungreis C . Clinical correlates of white matter findings on cranial magnetic resonance imaging of 3301 elderly people. The Cardiovascular Health Study. Stroke. 1996; 27(8):1274-82. DOI: 10.1161/01.str.27.8.1274. View

15.

Burton E, McKeith I, Burn D, Firbank M, OBrien J . Progression of white matter hyperintensities in Alzheimer disease, dementia with lewy bodies, and Parkinson disease dementia: a comparison with normal aging. Am J Geriatr Psychiatry. 2006; 14(10):842-9. DOI: 10.1097/01.JGP.0000236596.56982.1c. View

16.

Price C, Jefferson A, Merino J, Heilman K, Libon D . Subcortical vascular dementia: integrating neuropsychological and neuroradiologic data. Neurology. 2005; 65(3):376-82. PMC: 2746450. DOI: 10.1212/01.wnl.0000168877.06011.15. View

17.

Garde E, Mortensen E, Rostrup E, Paulson O . Decline in intelligence is associated with progression in white matter hyperintensity volume. J Neurol Neurosurg Psychiatry. 2005; 76(9):1289-91. PMC: 1739790. DOI: 10.1136/jnnp.2004.055905. View

18.

Sachdev P, Wen W, Christensen H, Jorm A . White matter hyperintensities are related to physical disability and poor motor function. J Neurol Neurosurg Psychiatry. 2005; 76(3):362-7. PMC: 1739526. DOI: 10.1136/jnnp.2004.042945. View

19.

Desmond D . Cognition and white matter lesions. Cerebrovasc Dis. 2002; 13 Suppl 2:53-7. DOI: 10.1159/000049151. View

20.

Saczynski J, Jonsdottir M, Sigurdsson S, Eiriksdottir G, Jonsson P, Garcia M . White matter lesions and cognitive performance: the role of cognitively complex leisure activity. J Gerontol A Biol Sci Med Sci. 2008; 63(8):848-54. PMC: 5911380. DOI: 10.1093/gerona/63.8.848. View