The relation between white-matter lesions and cognition

Pantoni, Leonardo; Poggesi, Anna; Inzitari, Domenico

doi:10.1097/wco.0b013e328172d661

Cited by 135 publications

(119 citation statements)

References 45 publications

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“…However, the sole presence of WMH cannot be considered as a factor of cognitive deterioration. Rather, it is likely that a threshold in white matter lesion load exists, beyond which cognitive decline is caused, and that this threshold can vary depending on host factors and the presence of concomitant lesions [23]. Although cognitive dysfunction represents an exclusion criterion in the diagnosis of MSA, several studies reported frontal lobe-associated cognitive dysfunction in patients with MSA, by means of comprehensive neuropsychological testing [26,27].…”

Section: Discussionmentioning

confidence: 99%

White matter hyperintensities in patients with multiple system atrophy

et al. 2009

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Recent studies have reported that the majority of patients with multiple system atrophy (MSA) had hypertensive heart disease. However, the effect of autonomic failure on the brain in MSA has not been studied. We consecutively enrolled 63 patients with MSA and selected 63 age-and sex-matched healthy subjects. We performed a comparative analysis of cerebrovascular lesions between the patients with MSA and the control subjects and analyzed predisposing factors for cerebrovascular lesions in the patients with MSA. There was no significant difference in lacune and territorial infarcts between the patients with MSA and the control subjects. The median grading score of white matter hyperintensity (WMH) was significantly higher in the patients with MSA (1.0, interquartile range 0.5-2.0) than the control subjects (0.0, interquartile range 0.0-1.0; P \ 0.01). In the patients with MSA, there was strong correlation between the grading score of WMH and supine systolic blood pressure (r = 0.529, P \ 0.001) after adjusting for age. Multiple linear regression analysis showed that age and supine systolic blood pressure was significantly and independently correlated with the grading score of WMH. The present study demonstrates that patients with MSA had more severe WMH and that supine systolic pressure is a major contributing factor for the severity of WMH, suggesting that patients with MSA have target-organ damage of the brain.

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Section: Discussionmentioning

confidence: 99%

White matter hyperintensities in patients with multiple system atrophy

et al. 2009

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“…First, WML is associated with reduced cognitive functioning in MCI. It is widely accepted that a severe grade of WML has a detrimental impact on cognitive functioning including executive function, attention, processing speed, and global cognition (Jokinen, Lipsanen, & Schmidt, 2012;Meier et al, 2012;Pantoni, Poggesi, & Inzitari, 2007;Prins & Scheltens, 2015;Xiong & Mok, 2011). Second, the location or the spatial distribution of the WML has a differential impact on cognitive functioning.…”

Section: Discussionmentioning

confidence: 99%

Imaging and neuropsychological correlates of white matter lesions in different subtypes of Mild Cognitive Impairment: A systematic review

Lam

Yiend

Lee

2017

NRE

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“…Hypertension is a major risk factor for cerebral small vessel disease (cSVD),2 which in turn leads to brain damage that can be made visible on brain MRI. These imaging markers of cSVD are strongly associated with cognitive function 3, 4, 5, 6. Other types of hypertensive organ damage, such as cardiac and renal damages, have also been linked to lower cognitive function or increased risk of cognitive impairment 7, 8, 9, 10, 11…”

Section: Introductionmentioning

confidence: 99%

Hypertensive organ damage predicts future cognitive performance: A 9‐year follow‐up study in patients with hypertension

Uiterwijk

Staals

Huijts

et al. 2018

J of Clinical Hypertension

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Hypertension is associated with cognitive deficits, probably caused by cerebral small vessel disease. The authors examined whether additional presence of cardiac and renal organ damages, and their combined presence, are associated with future cognitive performance. In 78 patients with essential hypertension (mean age 51.2 ± 12.0 years), brain damage was determined by MRI features, cardiac damage by left ventricular mass index (LVMI), and renal damage by estimated glomerular filtration rate (eGFR) and albuminuria. At 9‐year follow‐up, neuropsychological assessment was performed. LVMI was associated with future lower cognition (P = 0.032), independent of age, sex, premorbid cognition, and brain damage, but eGFR and albuminuria were not. The presence of 2 or 3 types of organ damage compared to none was associated with future lower cognition. Increasing number of hypertensive organ damages, and cardiac damage independently of brain damage, might indicate a more severe hypertensive disease burden and could help to identify patients at risk of cognitive problems.

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The relation between white-matter lesions and cognition

Abstract: White-matter lesions cannot be considered as mere incidental findings, at least in patients who show severe lesions. The pathogenesis of white-matter lesions must be clarified further and strategies found to delay their progression.

Cited by 135 publications

References 45 publications

White matter hyperintensities in patients with multiple system atrophy

White matter hyperintensities in patients with multiple system atrophy

Imaging and neuropsychological correlates of white matter lesions in different subtypes of Mild Cognitive Impairment: A systematic review

Hypertensive organ damage predicts future cognitive performance: A 9‐year follow‐up study in patients with hypertension

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