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Cerebral white matter hyperintensities in the prediction of cognitive decline and incident dementia

Marion Mortamais1, Sylvaine Artero, Karen Ritchie

  • 1Inserm, Unité 1061, Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital , Montpellier , France.

International Review of Psychiatry (Abingdon, England)
|January 16, 2014
PubMed

Insights

Cerebral white matter hyperintensities (WMH) predict dementia risk in the general population but not in mild cognitive impairment (MCI) patients. Factors like age and cognitive reserve influence this association, highlighting WMH as potential early dementia predictors.

Area of Science:

  • Neurology
  • Neuroimaging
  • Cognitive Science

Background:

  • Cerebral white matter hyperintensities (WMH) on MRI are used to assess cerebrovascular disease burden.
  • The link between WMH and cognitive decline is inconsistent in existing literature.

Purpose of the Study:

  • To review longitudinal studies on the association between WMH and cognitive outcomes.
  • To investigate WMH's role in dementia risk and cognitive decline in general and MCI populations.

Main Methods:

  • Systematic review of PubMed database (January 1990 - March 2013).
  • Inclusion of longitudinal studies examining WMH association with dementia risk (general population), MCI conversion, and cognitive decline.

Main Results:

  • WMH associated with all dementia types in the general population, but not in MCI patients.
  • Results for global cognitive decline were discrepant.
  • WMH show potential as early dementia risk predictors, modulated by cognitive reserve, age, and lesion location.

Conclusions:

  • WMH may indicate early dementia risk, but the association is complex and influenced by various factors.
  • WMH may reflect more than just vascular burden, potentially including co-occurring morbidities.
  • Further research is needed to clarify WMH's role in vascular risk and the efficacy of WMH-targeted interventions.

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