White matter hyperintensities in vascular contributions to cognitive impairment and dementia (VCID): Knowledge gaps and opportunities

Jessica Alber(University of Rhode Island), Suvarna Alladi(National Institute of Mental Health and Neurosciences), Hee‐Joon Bae(Seoul National University Bundang Hospital), David A. Barton(The University of Melbourne), Laurel Beckett(Department of Public Health), Joanne M. Bell(Syneos Health (United States)), Sara E. Berman(University of Wisconsin–Madison), Geert Jan Biessels(University Medical Center Utrecht), Sandra E. Black(Sunnybrook Health Science Centre), Isabelle Bos(Maastricht University), Gene L. Bowman(Harvard University), Emanuele Brai(Culham Science Centre), Adam M. Brickman(Columbia University), Brandy L. Callahan(Allen Institute for Brain Science), Roderick A. Corriveau(Allen Institute for Brain Science), Silvia Fossati(New York University), Rebecca F. Gottesman(Johns Hopkins University), Deborah Gustafson(State University of New York), Vladimir Hachinski(Western University), Kathleen M. Hayden(Wake Forest University), Alex M. Helman(University of Kentucky), Timothy M. Hughes(Wake Forest University), Jeremy D. Isaacs(St George's, University of London), Angela L. Jefferson(Vanderbilt University Medical Center), Sterling C. Johnson(University of Wisconsin–Madison), Alifiya Kapasi(Alzheimer's Association), Silke Kern(University of Gothenburg), Jay C. Kwon(Changwon National University), Juraj Kukolja(Helios Universitätsklinikum Wuppertal), Athene Lee(Brown University), Samuel N. Lockhart(Wake Forest University), Anne M. Murray(Berman Center for Outcomes and Clinical Research), Katie E. Osborn(Vanderbilt University Medical Center), Melinda C. Power(Milken Institute), Brittani R. Price(University of Kentucky), Hanneke Rhodius‐Meester(Amsterdam Neuroscience), Jacqueline A. Rondeau(Montclair State University), Allyson Rosen(Stanford University), Douglas L. Rosene(Boston University), Julie A. Schneider(Rush University Medical Center), Henrieta Scholtzova(New York University), C. Elizabeth Shaaban(University of Pittsburgh), Nárlon Cássio Boa Sorte Silva(London Health Sciences Centre), Heather M. Snyder(Alzheimer's Association), Walter Swardfager(Sunnybrook Health Science Centre), Aron M. Troen(Hebrew University of Jerusalem), Susanne J. van Veluw(Harvard University), Prashanthi Vemuri(Mayo Clinic), Anders Wallin(University of Gothenburg), Cheryl L. Wellington(Vancouver Coastal Health), Donna M. Wilcock(University of Kentucky), Sharon X. Xie(University of Pennsylvania), Atticus H. Hainsworth(St George's, University of London)
Alzheimer s & Dementia Translational Research & Clinical Interventions
January 1, 2019
10.1016/j.trci.2019.02.001
Cited by 441Open Access
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Abstract

White matter hyperintensities (WMHs) are frequently seen on brain magnetic resonance imaging scans of older people. Usually interpreted clinically as a surrogate for cerebral small vessel disease, WMHs are associated with increased likelihood of cognitive impairment and dementia (including Alzheimer's disease [AD]). WMHs are also seen in cognitively healthy people. In this collaboration of academic, clinical, and pharmaceutical industry perspectives, we identify outstanding questions about WMHs and their relation to cognition, dementia, and AD. What molecular and cellular changes underlie WMHs? What are the neuropathological correlates of WMHs? To what extent are demyelination and inflammation present? Is it helpful to subdivide into periventricular and subcortical WMHs? What do WMHs signify in people diagnosed with AD? What are the risk factors for developing WMHs? What preventive and therapeutic strategies target WMHs? Answering these questions will improve prevention and treatment of WMHs and dementia.

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