The relation between white-matter lesions and cognition
The relation between white-matter lesions and cognition
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DOI：
10.1097/wco.0b013e328172d661
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发表时间：
2007-08-01
影响因子：
4.8
通讯作者：
Inzitari, Domenico
中科院分区：
文献类型：
--
作者：
Pantoni, Leonardo;Poggesi, Anna;Inzitari, Domenico
综述目的：综述近年来脑白质病变与认知功能关系的研究进展，为脑白质病变对认知功能的影响提供了新的证据。新的磁共振技术可能有助于澄清这种效应的意义和程度。随着时间的推移，病变进展的证据也在增加，至少在严重白质病变的患者中是如此，这种进展是老年人认知能力下降的相关因素之一。由于需要延缓或阻止白质病变的进展，一些危险因素的作用得到了澄清，并进行了治疗试验，其中白质病变被用作小血管疾病终点的替代标志物。除了认知影响外，白质病变还导致其他功能表现下降，这使得病变级别较高的个体出现残疾的风险增加。总结白质病变不能被视为仅仅是偶然发现，至少在表现出严重病变的患者中是这样。脑白质病变的发病机制必须进一步阐明，并找到延缓其进展的策略。
Purpose of reviewTo summarize recent findings and developments in the field of the relation between white-matter lesions and cognition.Recent findingsRecent 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 occuring 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.SummaryWhite-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.