White matter hyperintensities

Federal government websites often end in. The site is secure. White matter hyperintensities WMH of presumed vascular origin, also referred to as leukoaraiosis, are a very common finding on brain magnetic resonance imaging MRI or computed tomography CT in older subjects and in patients with stroke and dementia, white matter hyperintensities. They are associated with cognitive impairment, triple the risk of stroke and double the risk of dementia.

White matter hyperintensities WMHs are lesions in the brain that show up as areas of increased brightness when visualised by T2-weighted magnetic resonance imaging MRI. The prevailing view is that these intensities are a marker of small-vessel vascular disease and in clinical practice, are indicative of cognitive and emotional dysfunction, particularly in the ageing population. This is clearly not true. Although WMH do become more common with advancing age, their prevalence is highly variable. There is strong evidence that WMH are clinically important markers of increased risk of stroke, dementia, death, depression, impaired gait, and mobility, in cross-sectional and in longitudinal studies.

White matter hyperintensities

As such, white matter hyperintensities have been targeted as a surrogate biomarker in intervention trials with older adults. However, it is unclear at what stage of aging white matter hyperintensities begin to relate to cognition and if they may be a viable target for early prevention. In the Dunedin Study, a population-representative cohort followed since birth, we measured white matter hyperintensities in year-old participants using T 2 -weighted magnetic resonance imaging and we assessed cognitive decline from childhood to midlife. Our results demonstrate that a link between white matter hyperintensities and early signs of cognitive decline is detectable decades before clinical symptoms of dementia emerge. Thus, white matter hyperintensities may be a useful surrogate biomarker for identifying individuals in midlife at risk for future accelerated cognitive decline and selecting participants for dementia prevention trials. However, the success of this investment hinges on developing surrogate biomarkers—biological measures that are part of the putative disease pathway and are measurable before the onset of clinical symptoms—so that prevention can target at-risk individuals before cerebral decline has taken hold. Successful surrogate biomarkers would allow clinicians to assess risk, monitor sub-clinical disease progression and intervene before clinically significant dementia symptoms manifest. Research shows that white matter hyperintensities WMHs are one such surrogate biomarker of cognitive decline and ADRD that can be measured in the brains of older adults Cees De Groot et al. While WMHs are uncommon in adults before age 30 Habes et al. In older adults, WMHs are associated with multiple dementia risk factors, including increasing age, hypertension, stroke, brain atrophy and cognitive ability Prins and Scheltens, Longitudinal studies in older adults have reported that the spread of WMHs contributes to elevated risk for ADRD and coincides with age-related cognitive decline Debette and Markus, Consequently, WMHs have been targeted as a surrogate biomarker for dementia prevention trials Debette and Markus, However, these trials have produced mixed results Prins and Scheltens, A limitation of existing trials is that they have targeted older adults in their 60s, 70s and 80s.

Periventricular WMHs can affect cognitive functioning while subcortical WMHs disrupt specific motor functions based on location.

Background: White matter hyperintensities are an important marker of cerebral small vessel disease. This disease burden is commonly described as hyperintense areas in the cerebral white matter, as seen on T2-weighted fluid attenuated inversion recovery magnetic resonance imaging data. Studies have demonstrated associations with various cognitive impairments, neurological diseases, and neuropathologies, as well as clinical and risk factors, such as age, sex, and hypertension. Due to their heterogeneous appearance in location and size, studies have started to investigate spatial distributions and patterns, beyond summarizing this cerebrovascular disease burden in a single metric—its volume. Here, we review the evidence of association of white matter hyperintensity spatial patterns with its risk factors and clinical diagnoses.

White matter provides connections between the different parts of the brain. The brain is made up of a mixture of grey matter and white matter. White matter is found in the deeper tissues known as the subcortical area. If you think of the brain as a computer system, the gray matter is the hardware, and the white matter is the cables connecting the network and transmitting signals. This article discusses white matter in the brain and the conditions that impact it. It also explains the role of white matter disease on memory and dementia. White matter in the brain contains nerve fibers axons , which are surrounded by a protective fatty covering called the myelin sheath. The myelin is what gives white matter its white color. White matter axons connect nerve cells neurons.

White matter hyperintensities

If you've had a brain magnetic resonance imaging MRI , you may be alarmed to hear that it shows small white spots. These white spots may indicate a cause for concern, including strokes or multiple sclerosis MS. However, there are also a variety of explanations that are not alarming, such as vitamin deficiencies or migraines. If you have white spots, or white matter hyperintensities, on your brain MRI, your healthcare provider will determine the cause based on your medical history and doing an exam. Other diagnostic tests may be used to determine the number of spots, their size and appearance, and their location in the brain. This article will look at common causes of white spots on a brain MRI, along with risk factors and treatment options. Spots on a brain MRI are caused by changes in the water content and fluid movement in the brain tissue.

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Analyses reported here were checked for reproducibility by an independent data-analyst, who recreated the code by working from the manuscript and applied it to a fresh dataset. Kim, H. Coevolution of white matter hyperintensities and cognition in the elderly. White matter hyperintensities: Relationship to amyloid and tau burden. While state-of-art non-linear registration methods have demonstrated very good performance, these have yet to be tested in SVD or aging studies. Fourth ventricle, aqueduct, cistern ventral to mesencephalon. Kim, J. Deary IJ. All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. White matter hyperintensities WMH of presumed vascular origin, also referred to as leukoaraiosis, are a very common finding on brain magnetic resonance imaging MRI or computed tomography CT in older subjects and in patients with stroke and dementia. However, the success of this investment hinges on developing surrogate biomarkers—biological measures that are part of the putative disease pathway and are measurable before the onset of clinical symptoms—so that prevention can target at-risk individuals before cerebral decline has taken hold. The pathobiology of vascular dementia.

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Cite this article Prins, N. Progression of cerebral white matter lesions in Alzheimer's disease: a new window for therapy? The clinical importance of white matter hyperintensities on brain magnetic resonance imaging: systematic review and meta-analysis. Again, the methodological approaches differed across studies, hindering a direct comparison. Neurology 51 , — Imaging 21 , — Fast free-form deformation using graphics processing units. Coevolution of white matter hyperintensities and cognition in the elderly. Stroke 28 , — Morphologic, distributional, volumetric, and intensity characterization of periventricular hyperintensities. Effects of systolic blood pressure on white-matter integrity in young adults in the Framingham Heart Study: a cross-sectional study. However, this systematic review covered populations with various diseases, including AD, DEM and PD, for which, at least in part, it is still unclear whether SVD is etiologically involved in the neurodegenerative processes or occurs coincidentally. Pathogenesis of vascular dementia in stroke-prone spontaneously hypertensive rats. The first possibility is that children with lower IQs tend to be born into or seek out environments that lead to higher rates of neurodegeneration e.