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White matter lesions and brain atrophy: more than shared risk factors? A systematic review

Auke P A Appelman1, Lieza G Exalto, Yolanda van der Graaf

  • 1Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.

Cerebrovascular Diseases (Basel, Switzerland)
|July 3, 2009
PubMed
Abstract

Insights

White matter lesions (WML) and brain atrophy are common in the elderly. Most studies show a link between WML and brain atrophy, but more research is needed to see if this connection is independent of shared risk factors.

Area of Science:

  • Neurology
  • Radiology
  • Geriatrics

Background:

  • White matter lesions (WML) and brain atrophy are frequently observed in elderly individuals via MRI.
  • Shared vascular risk factors are a potential explanation for the co-occurrence of WML and brain atrophy.
  • White matter integrity disturbances may play a role in the development of brain atrophy.

Purpose of the Study:

  • To systematically review studies examining the relationship between WML and brain atrophy on MRI.
  • To assess if the association between WML and brain atrophy is independent of shared risk factors.

Main Methods:

  • A comprehensive literature search was conducted on PubMed for studies published between 1980 and October 2007.
  • Inclusion criteria included original studies using MRI, specified assessment methods for WML and brain atrophy, and a minimum of 20 participants.
  • Data extracted included study population characteristics, imaging methods, and adjusted variables.

Main Results:

  • Out of 48 reviewed studies, 37 reported a significant association between WML and brain atrophy.
  • The observed relationship was consistent across different study populations (clinic-based vs. population-based).
  • Only 10 studies adjusted for shared risk factors, with 9 of these confirming an association.

Conclusions:

  • A majority of studies indicate an association between white matter lesions and brain atrophy.
  • Further investigation is required to determine if this association persists independently of shared risk factors.

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