Journal of Neural Transmission

, Volume 118, Issue 5, pp 673–681 | Cite as

MRI-detected white matter lesions: do they really matter?

  • Reinhold SchmidtEmail author
  • Anja Grazer
  • Christian Enzinger
  • Stefan Ropele
  • Nina Homayoon
  • Aga Pluta-Fuerst
  • Petra Schwingenschuh
  • Petra Katschnig
  • Margherita Cavalieri
  • Helena Schmidt
  • Christian Langkammer
  • Franz Ebner
  • Franz Fazekas
Dementias - Review Article


Despite extensive research over the last decades the clinical significance of white matter lesions (WMLs) is still a matter of debate. Here, we review current knowledge of the correlation between WMLs and cognitive functioning as well as their predictive value for future stroke, dementia, and functional decline in activities of daily living. There is clear evidence that age-related WMLs relate to all of these outcomes on a group level, but the inter-individual variability is high. The association between WMLs and clinical phenotypes exists particularly for early confluent to confluent changes, which are ischaemic in aetiology and progress quickly over time. One reason for the variability of the relationship between WMLs and clinic on an individual level is probably the complexity of the association. Numerous factors such as cognitive reserve, concomitant loss of brain volume, and ultrastructural changes have been identified as mediators between white matter damage and clinical findings, and need to be incorporated in the consideration of WMLs as visible markers of these detrimental processes.


Magnetic resonance imaging MRI White matter lesions Cognition Dementia 



Alzheimer’s disease


Alzheimer’s disease assessment scale


Atherosclerosis risk in communities


Diabetes mellitus type 2


Clinical dementia rating (scale)


Cardiovascular determinants of dementia (study)


Leukoaraiosis and disability (study)


Mild cognitive impairment


Memory and morbidity in Augsburg elderly (study)


Mini mental state examination


Magnetic resonance imaging


Prospective study of Pravastatin in the elderly at risk


Second manifestations of ARTerial disease-MR substudy


White matter hyperintensities


White matter lesions


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Reinhold Schmidt
    • 1
    Email author
  • Anja Grazer
    • 1
  • Christian Enzinger
    • 2
  • Stefan Ropele
    • 2
  • Nina Homayoon
    • 1
  • Aga Pluta-Fuerst
    • 2
  • Petra Schwingenschuh
    • 1
  • Petra Katschnig
    • 1
  • Margherita Cavalieri
    • 1
    • 3
  • Helena Schmidt
    • 2
    • 4
  • Christian Langkammer
    • 2
  • Franz Ebner
    • 5
  • Franz Fazekas
    • 2
  1. 1.Division of Special Neurology, Department of NeurologyMedical University of GrazGrazAustria
  2. 2.Division of General Neurology, Department of NeurologyMedical University of GrazGrazAustria
  3. 3.Department of Clinical and Experimental Medicine, Section of Internal Medicine, Gerontology and GeriatricsUniversity of FerraraFerraraItaly
  4. 4.Institute of Molecular Biology and BiochemistryMedical University of GrazGrazAustria
  5. 5.Division of Neuroradiology, Department of RadiologyMedical University of GrazGrazAustria

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