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Presence and progression of white matter hyperintensities and cognition: A meta-analysis
Abstract
OBJECTIVE: We aimed to quantify the effects of white matter hyperintensities (WMHs) on specific cognitive functions with particular attention to WMH progression and localization. METHODS: PubMed (January 1990-July 2013) and bibliographies from included articles were used. Studies that were included (1) used MRI; (2) had a population-based or case-control design with a healthy control group that could be used for analysis; (3) matched/adjusted for age, sex, and education; and (4) addressed ≥1 predefined cognitive domains with ≥1 validated neuropsychological tests. Data were independently extracted by 2 investigators. Pearson r was extracted/calculated and used as the common metric for the effect size across studies. RESULTS: Twenty-three cross-sectional and 14 longitudinal studies were included with a total of 8,685 and 7,731 participants. Presence of WMHs was significantly associated with concurrent cognitive deficits in all examined domains: general intelligence (Fisher z -0.10, 95% confidence interval [CI] -0.19 to -0.04), memory (-0.08, -0.13 to -0.06), processing speed (-0.11, -0.17 to -0.07), attention and executive functions (-0.11, -0.16 to -0.07), and perception/construction (-0.15, -0.21 to -0.07). Similar effect sizes were observed for cognitive decline over time. WMH progression was associated with greater cognitive decline, particularly for general intelligence (Fisher z -0.31, 95% CI -0.5 to -0.02) and attention and executive functions (-0.32, -0.34 to -0.28). CONCLUSIONS: The small but robust and consistent effects of WMHs on all cognitive domains suggest a more global effect on cognition than previously thought. Progression of WMHs was associated with even worse cognitive functioning, most pronounced in attention and executive functioning.
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“Extensive studies have reported the direct effect of WMH on cognitive deficits, both cross‐sectionally and longitudinally. 23 , 29”
From White matter hyperintensity modulates the amyloid‐tau‐cognition association and anti‐amyloid treatment efficacy in asymptomatic older adults (2025) · cites this paper as [29]
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Background
Metadata
- Authors
- Kloppenborg, R. P., Nederkoorn, P. J., Geerlings, M. I., & van den Berg, E.
- Affiliations
- Utrecht University (NL)
- From the Department of Neurology (R.P.K., P.J.N.), Academic Medical Center, Amsterdam; Julius Center for Health Sciences and Primary Care (R.P.K., M.I.G.) and Department of Neurology (R.P.K.), University Medical Center Utrecht; Experimental Psychology (E.v.d.B.), Helmholtz Institute, Utrecht University; and the Department of Neurology (E.v.d.B.), Rudolf Magnus Institute of Neuroscience, University Medical Center, Utrecht, the Netherlands.
- Venue
- Neurology
- Published
- 2014-06-10
- Volume
- 82
- Issue
- 23
- Pages
- 2127-2138
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- OpenAlex
- W2054692171
- Cited by
- 338
- References
- 64
- Citations by year
- 2026: 28 · 2025: 42 · 2024: 43 · 2023: 34 · 2022: 33 · 2021: 39 · 2020: 30 · 2019: 18 · 2018: 19 · 2017: 19 · 2016: 15 · 2015: 15 · 2014: 2
- FWCI
- 2.29
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurology (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Cerebrovascular and genetic disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
- Keywords
- white matter hyperintensities, cognitive decline, cognitive domain, general intelligence, memory, processing speed, attention, executive function, brain MRI
- MeSH terms
- Cognition Disorders, Humans, Disease Progression, Leukoencephalopathies
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