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Meta-Analysis
. 2023 Jan;19(1):194-207.
doi: 10.1002/alz.12642. Epub 2022 Mar 23.

White matter hyperintensities and longitudinal cognitive decline in cognitively normal populations and across diagnostic categories: A meta-analysis, systematic review, and recommendations for future study harmonization

Austyn D Roseborough  1 , Lorenzo Saad  1 , Maren Goodman  2 , Lauren E Cipriano  3 , Vladimir C Hachinski  4 , Shawn N Whitehead  1
Affiliations
Meta-Analysis

White matter hyperintensities and longitudinal cognitive decline in cognitively normal populations and across diagnostic categories: A meta-analysis, systematic review, and recommendations for future study harmonization

Austyn D Roseborough et al. Alzheimers Dement. 2023 Jan.

Abstract

Introduction: The primary aim of this paper is to improve the clinical interpretation of white matter hyperintensities (WMHs) and provide an overarching summary of methodological approaches, allowing researchers to design future studies targeting current knowledge gaps.

Methods: A meta-analysis and systematic review was performed investigating associations between baseline WMHs and longitudinal cognitive outcomes in cognitively normal populations, and populations with mild cognitive impairment (MCI), Alzheimer's disease (AD), and stroke.

Results: Baseline WMHs increase the risk of cognitive impairment and dementia across diagnostic categories and most consistently in MCI and post-stroke populations. Apolipoprotein E (APOE) genotype and domain-specific cognitive changes relating to strategic anatomical locations, such as frontal WMH and executive decline, represent important considerations. Meta-analysis reliability was assessed using multiple methods of estimation, and results suggest that heterogeneity in study design and reporting remains a significant barrier.

Discussion: Recommendations and future directions for study of WMHs are provided to improve cross-study comparison and translation of research into consistent clinical interpretation.

Keywords: cognitive impairment; dementia; small vessel disease; white matter disease; white matter hyperintensity.

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References

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