Multiple Factors Involved in the Pathogenesis of White Matter Lesions.
White matter lesions (WMLs), also known as leukoaraiosis (LA) or white matter hyperintensities (WMHs), are characterized mainly by hyperintensities on T2-weighted or fluid-attenuated inversion recovery (FLAIR) images. With the aging of the population and the development of imaging technology, the morbidity and diagnostic rates of WMLs are increasing annually. WMLs are not a benign process. They clinically manifest as cognitive decline and the subsequent development of dementia. Although WMLs are important, their pathogenesis is still unclear. This review elaborates on the advances in the understanding of the pathogenesis of WMLs, focusing on anatomy, cerebral blood flow autoregulation, venous collagenosis, blood brain barrier disruption, and genetic factors. In particular, the attribution of WMLs to chronic ischemia secondary to venous collagenosis and cerebral blood flow autoregulation disruption seems reasonable. With the development of gene technology, the effect of genetic factors on the pathogenesis of WMLs is gaining gradual attention.
Department of Neurology, Guangdong Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department, National Key Discipline, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
Jing
J
Lin
Department of Neurology, Guangdong Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department, National Key Discipline, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
Dilong
D
Wang
Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
Linfang
L
Lan
Department of Neurology, Guangdong Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department, National Key Discipline, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
Yuhua
0000-0002-1172-1490
Y
Fan
D000368:Aged; D000375:Aging; D001812:Blood-Brain Barrier; D001921:Brain / Q000473:pathology; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000473:pathology; D002560:Cerebrovascular Circulation; D003072:Cognition Disorders / Q000473:pathology; D003094:Collagen / Q000737:chemistry; D008040:Genetic Linkage; D020022:Genetic Predisposition to Disease; D006801:Humans; D007249:Inflammation; D056784:Leukoencephalopathies / Q000000981:diagnostic imaging* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009422:Nervous System Diseases / Q000473:pathology; D010539:Permeability; D014652:Vascular Diseases / Q000473:pathology; D066127:White Matter / Q000000981:diagnostic imaging* / Q000473:pathology*
D003094:Collagen