[White matter changes and cognitive performance in aging]

In this paper we review the main magnetic resonance studies to show a possible relationship between changes in the white matter of the brain or leukoaraiosis, and the neuropsychological profile of elderly persons without dementia.

The articles published to date show contradictory data, and in nearly half the cases reviewed no clear relationship could be established between leukoaraiosis and conduct. However, by using sensitive cognitive tests it is possible to detect and association between the presence and degree of change in the white matter and decline in frontal function such as speed of processing information, visuomotor function, verbal fluency, classification and mental sequences. Other cognitive areas such as language, memory or visuospatial, visuoconstructive and visuoperceptive functions appear less frequently related to the presence or intensity of lesions of the white matter of the brain. From a neuropsychological point of view, periventricular localization of the leukoaraiosis seems to be more important than subcortical localization.

The neuropsychological functions most frequently associated with the presence of leukoaraiosis are those dependent on the frontal lobes, and are a disconnection favoured by the presence of the white matter of the brain, the most probable underlying physiopathological mechanism. Although there is evidence showing a genetic effect in the appearance of the white matter of the brain, study of the genes associated with cognitive deterioration in normal ageing has not given conclusive findings.