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White matter hyperintensities are associated with an increased risk of stroke, dementia and mortality

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Is there an association between white matter hyperintensities (WMHs) and risk of stroke, cognitive decline, dementia and death?


Stroke (defined as an acute onset focal neurological deficit of presumed vascular cause lasting at least 24 h or interrupted by death within 24 h); dementia (DSM-III or -IV criteria); Alzheimer's disease (National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association criteria); vascular dementia (National Institute of Neurological and Communicative Disorders and Stroke and the Association Internationale pour la Rechercheet l'Enseignement en Neurosciences criteria); cognitive decline (defined as worsening performance on repeated neuropsychological tests) and mortality.



Systematic review and meta-analysis.

Data sources

PubMed was searched from 1966 to 23 November 2009.

Study selection and analysis

Prospective longitudinal studies that used MRI and assessed the impact of WMHs on risk of incident stroke, cognitive decline, dementia and death were included. Exclusions: white matter lesions evaluated only by CT; MRI carried out at the end of follow-up rather than at baseline; studies of WMHs in inflammatory or neurodegenerative conditions, autoimmune disorders, monogenic neurodegenerative …

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  • Sources of funding The corresponding author was supported by the European Neurological Society, The Fulbright Commission, Bettencourt-Schueller foundation and the Lilly Foundation.


  • Competing interests None.

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