The relation between white-matter lesions and cognition.
OBJECTIVE
To summarize recent findings and developments in the field of the relation between white-matter lesions and cognition.


RESULTS
Recent studies have provided further evidence that white-matter lesions exert a detrimental effect on cognitive profile. New magnetic-resonance techniques may help in clarifying the meaning and extent of this effect. Evidence is also increasing about lesion progression occurring over time, at least in patients with severe white-matter lesions, and this progression is one of the factors related to cognitive decline in the elderly. The need to delay or halt the progression of white-matter lesions has led to clarification of the role of some risk factors and to performance of therapeutic trials where white-matter lesions are used as a surrogate marker for the end point of small-vessel disease. In addition to cognitive effects, white-matter lesions have a role in the decline of other functional performances, and this places individuals with higher-grade lesions at increased risk of developing disability.


CONCLUSIONS
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.
Pantoni
Leonardo
L
Department of Neurological and Psychiatric Sciences, University of Florence, Florence, Italy. pantoni@neuro.unifi.it
Poggesi
Anna
A
Inzitari
Domenico
D
D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000473:pathology; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000209:etiology / Q000473:pathology; D048909:Diabetes Complications; D018450:Disease Progression; D006801:Humans; D049292:Leukoaraiosis / Q000473:pathology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D012196:Review Literature as Topic; D012307:Risk Factors; D013223:Statistics as Topic