Alber Jessica, Alladi Suvarna, Bae Hee-Joon, Barton David A, Beckett Laurel A, Bell Joanne M, Berman Sara E, Biessels Geert Jan, Black Sandra E, Bos Isabelle, Bowman Gene L, Brai Emanuele, Brickman Adam M, Callahan Brandy L, Corriveau Roderick A, Fossati Silvia, Gottesman Rebecca F, Gustafson Deborah R, Hachinski Vladimir, Hayden Kathleen M, Helman Alex M, Hughes Timothy M, Isaacs Jeremy D, Jefferson Angela L, Johnson Sterling C, Kapasi Alifiya, Kern Silke, Kwon Jay C, Kukolja Juraj, Lee Athene, Lockhart Samuel N, Murray Anne, Osborn Katie E, Power Melinda C, Price Brittani R, Rhodius-Meester Hanneke F M, Rondeau Jacqueline A, Rosen Allyson C, Rosene Douglas L, Schneider Julie A, Scholtzova Henrieta, Shaaban C Elizabeth, Silva Narlon C B S, Snyder Heather M, Swardfager Walter, Troen Aron M, van Veluw Susanne J, Vemuri Prashanthi, Wallin Anders, Wellington Cheryl, Wilcock Donna M, Xie Sharon Xiangwen, Hainsworth Atticus H
Department of Biomedical and Pharmaceutical Sciences, George & Anne Ryan Institute for Neuroscience, University of Rhode Island, Kingston, RI, USA.
Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Alzheimers Dement (N Y). 2019 Apr 9;5:107-117. doi: 10.1016/j.trci.2019.02.001. eCollection 2019.
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.
脑白质高信号（WMHs）在老年人的脑磁共振成像扫描中经常可见。通常在临床上被解释为脑小血管疾病的替代指标，WMHs与认知障碍和痴呆（包括阿尔茨海默病[AD]）的可能性增加有关。WMHs在认知健康的人群中也可见。在这次学术、临床和制药行业观点的合作中，我们确定了关于WMHs及其与认知、痴呆和AD关系的突出问题。WMHs背后的分子和细胞变化是什么？WMHs的神经病理学相关性是什么？脱髓鞘和炎症在多大程度上存在？将其细分为脑室周围和皮质下WMHs是否有帮助？WMHs在被诊断为AD的人群中意味着什么？发生WMHs的风险因素有哪些？针对WMHs的预防和治疗策略是什么？回答这些问题将改善WMHs和痴呆的预防和治疗。
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