Background

White matter hyperintensities of presumed vascular origin (WMH) are one of the imaging features of cerebral small vessel disease. Controversies persist about the effects of WMH on cognitive dysfunction. This meta-analysis aimed to identify the associations of WMH with risks of cognitive impairment and dementia.

Methods

We searched PubMed, EMBASE and Cochrane Library for prospective studies. Primary analyses of cognitive dysfunction and sub-analyses of specific outcomes and study characteristics were conducted using random-effect models.

Results

Thirty-six prospective studies with 19,040 participants were included. WMH at baseline conferred a 14 % elevated risk of cognitive impairment and all-cause dementia (ACD). WMH also conferred 25 % elevated risk of Alzheimer’s disease and 73 % elevated risk of vascular dementia. Risk effects of high-grade WMH and continually increasing WMH (in volume or severity) on ACD were revealed. Periventricular WMH conferred a 1.51-fold excess risk for dementia.

Conclusions

WMH were associated with increased risk of cognitive dysfunction and could become a neuroimaging indicator of dementia.

中文翻译：

---

白质过高和认知障碍和痴呆症的风险：36项前瞻性研究的系统评价和荟萃分析

背景

假定的血管起源（WMH）的白质高信号是脑小血管疾病的影像学特征之一。关于WMH对认知功能障碍的影响仍存在争议。这项荟萃分析旨在确定WMH与认知障碍和痴呆风险的关系。

方法

我们在PubMed，EMBASE和Cochrane库中进行了前瞻性研究。使用随机效应模型对认知功能障碍进行初步分析，并对特定结局和研究特征进行亚分析。

结果

包括36项前瞻性研究，共有19,040名参与者。基线WMH可使认知障碍和全因痴呆（ACD）风险增加14％。WMH还使阿尔茨海默氏病的风险增加了25％，血管性痴呆的风险增加了73％。揭示了高级WMH和WMH（数量或严重性）持续增加对ACD的风险影响。室周WMH导致痴呆的风险增加1.51倍。

结论

WMH与认知功能障碍的风险增加有关，并且可能成为痴呆症的神经影像学指标。