white matter lesions in 40 year old

These abnormalities can also be seen in elderly people and patients with stroke and dementia. Rhrig L, Sperber C, Bonilha L, Rorden C, Karnath HO. Abstract We evaluated brain tissue compartments in 72 healthy volunteers between the ages of 18 and 81 years with quantitative MRI. (C) Association between WMH volume and cognitive decline. White matter lesions (WMLs) or leukoaraiosis indicate small vessel vascular brain disease as well as degenerative or inflammatory processes. This protects the nerve fibres and gives white matter its colour. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. They are associated with subtle functional impairment and higher prevalence of neuropsychiatric disorders. , Erus G, Toledo JB, Zhang T, Bryan N, Launer LJ, et al. Very often, people wont notice any symptoms even if the small vessel disease is severe, but it is wise to ensure that any possible underlying causes are identified to try to prevent the situation getting worse. The only way to tell is to determine if there are co-existing abnormalities in other parts of the brain and this must be incorporated within the context of the clinical condition, they said. is supported by the National Science Foundation Graduate Research Fellowship (Grant No. Axial. I had a followed up lumbar punction which was negative for MS. At the time I experience paresthesia on my right thigh, which are gone now. However, these trials have produced mixed results (Prins and Scheltens, 2015). Please choose an alternative time. During your MRI, several different types of scans, called sequences, are . and transmitted securely. Professor Emsley graduated with an MBChB in 1996 from the University of Manchester. This material may not be published, broadcast, rewritten or redistributed in any form without prior authorization. Unable to load your collection due to an error, Unable to load your delegates due to an error. At baseline, the majority of lesions were found in the supratentorial brain. Published by Oxford University Press on behalf of the Guarantors of Brain. Secondary analyses using the four sub-indexes of adult IQ showed that larger WMH volume was associated with lower scores on processing speed ( = 0.14, 95% CI = 0.20 to 0.07; P<0.001), verbal comprehension ( = 0.14, 95% CI = 0.21 to 0.07; P<0.001) and perceptual reasoning ( = 0.13, 95% CI = 0.19 to 0.06; P<0.001). It is sensible to make sure conditions such as diabetes mellitus and high cholesterol are under control. eCollection 2020. BMC Neurol. The authors declare no competing interests. MRI was performed on 77 cognitively normal (CN) subjects, 50 AD and 13 mixed dementia patients. Other factors such as genetics are likely to play a role. What's more, these two predictors of cognitive performance in old age were independent; they didn't consistently affect scores in the same way. The pathogenesis of many white matter diseases remains poorly understood. S Lesions can disrupt the way your brain works, causing a wide range of symptoms, such as weakness, disruption of one or more senses and confusion. They are considered a marker of small vessel disease. It is known that WMHs predict cognitive decline and risk for ADRD in older adults (Valds Hernndez et al., 2013), but it is not known when WMHs accumulate sufficiently to be associated with early cognitive decline. Genetic and Environmental Effects on the Development of White Matter Hyperintensities in a Middle Age Twin Population. We want you to take advantage of everything Neurology Advisor has to offer. The relevant ethics committees approved each phase of the study, and informed consent was obtained from all participants. Cognitive ability in childhood was assessed using the Wechsler Intelligence Scale for Children Revised (score range, 40160) at ages 7, 9 and 11 with the mean for these three assessments used in analyses (Wechsler, 1974; Moffitt et al., 1993). Periventricular white matter lesions Periventricular white matter changes (3-13 mm from the ventricular surface) are thought to be haemodynamically determined rather than only related to small vessel disease 8. This protects the nerve fibres and gives white matter its colour. White matter disease can be broadly grouped into: demyelinating disorders. First, descriptive statistics was generated for the sample as a whole (Table1). Thus, white matter hyperintensities may be a useful surrogate biomarker for identifying individuals in midlife at risk for future accelerated cognitive decline and selecting participants for dementia prevention trials. Diagnosing Organic Causes of Schizophrenia Spectrum Disorders: Findings from a One-Year Cohort of the Freiburg Diagnostic Protocol in Psychosis (FDPP). FOIA Please login or register first to view this content. The left column presents a raw FLAIR image for three representative participants with low, intermediate and high WMH load. Sample sizes for each group from the lowest to the highest WMH volume were 57, 65, 128, 336, 133, 83 and 41. this complication is seen in up to 40 % of patients receiving intrathecal methotrexate [29, 30]. White matter lesions are among the most common incidental findingswhich means the lesions have no clinical significanceon brain scans of people of any age. 3A); individuals with the highest volume (>1.5 SDs above the mean) had childhood IQs that were 4.80 points lower on average than individuals with the lowest volume (<1.5 SDs below the mean). His areas of expertise include vascular neurology, stroke, cerebrovascular disease, late-onset epilepsy, migraine and neurological disorders. Measures of change in IQ were estimated by calculating residualized change scores. A total of 875 (93% of age-45 participants) also completed MRI scanning. P Brain lesions are areas of damaged brain tissue. 40 years) with no typical vascular risk factors and/or with a suggestive family history, clinicians should con-sider a monogenic small-vessel disease (Case 4). Jiang anti-drug messaging, better nutrition) in high-risk children could limit the burden of cognitive decline and ADRD later in life. Your use of this website constitutes acceptance of Haymarket Medias Privacy Policy and Terms & Conditions. Larger WMH volume was associated with lower IQ in childhood ( = 0.08, 95% CI = 0.15 to 0.02; P=0.013; Fig. Of the 875 scanned participants who had at least one MRI scan, 867 had both a T1 image and an FLAIR image that are required to extract WMHs with UBO. M This site needs JavaScript to work properly. The two main types of lesions found in migraineurs include: White matter hyperintensities (WMH): These lesions appear bright white on certain sequences of MRI scans. As the brain ages, it begins to accrue small microbleeds and lesions in white matter that are detectable as WMHs using fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) (Iadecola, 2013). Gray matter reduction is correlated with white matter hyperintensity volume: a voxel-based morphometric study in a large epidemiological sample. White matter hyperintensities (WMH) are very frequent in older adults and associated with worse cognitive performance. Professor Emsley was appointed Consultant Neurologist with special interest in Stroke Neurology at Lancashire Teaching Hospitals NHS Foundation Trust in 2008, and in 2014, he became the Clinical Director for Neurology at the Trust for three years. grey matter or cerebral spinal fluid) based on anatomical location, intensity and cluster size features. Risk factors of white matter hyperintensities in migraine patients. age-matched groups (51-70 years old) with and without white matter lesions with respect to carotid ultrasonography, cerebral blood flow (xenon-133 injection), and cerebrovascular risk . The dataset reported in the current article is not publicly available due to the lack of informed consent and ethical approval but is available from the corresponding author on reasonable request by qualified scientists. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, Reduced coupling between offline neural replay events and default mode network activation in schizophrenia, Cognitive correlates of antisaccade behaviour across multiple neurodegenerative diseases, Uncovering spatiotemporal patterns of atrophy in progressive supranuclear palsy using unsupervised machine learning, Brain-derived neurotrophic factor released from blood platelets prevents dendritic atrophy of lesioned adult central nervous system neurons. NSF DGE-1644868). The first possibility is that children with lower IQs tend to be born into or seek out environments that lead to higher rates of neurodegeneration (e.g. Cureus. 2004 May;22(1):144-54. doi: 10.1016/j.neuroimage.2003.12.027. President Biden had a small skin lesion with cancerous tissue removed from his chest during his physical exam in February and "no further treatment is required," according to the White House . 8600 Rockville Pike Very often the lesions themselves don't cause any noticeable problems. Abnormalities in white matter, known as lesions, are most often seen as bright areas or spots on MRI scans of the brain. A 59-year-old male visiting from Michigan presented to a hospital in Florida with an ischemic stroke with aphasia and acute confusion for two days. Howard R, Cox T, Almeida O, Mullen R, Graves P, Reveley A, Levy R. Biol Psychiatry. This region is a vascular border zone vascularized by non-collateralising ventriculofugal vessels arising from subependymal arteries. PMC These lesions are best visualized as hyperintensities on T2 weighted and FLAIR (Fluid-attenuated inversion recovery) sequences of magnetic resonance imaging. High-resolution structural images were obtained using a T1-weighted MP-RAGE sequence with the following parameters: Repetition Time (TR) = 2400ms; Echo Time (TE) = 1.98ms; 208 sagittal slices; flip angle = 9; Field of View (FOV) = 224mm; matrix = 256256; slice thickness = 0.9mm with no gap (voxel size 0.9mm 0.875mm 0.875mm); and total scan time = 6min and 52s. 3D FLAIR images were obtained with the following parameters: TR = 8000ms; TE = 399ms; 160 sagittal slices; FOV = 240mm; matrix = 232256; slice thickness = 1.2mm (voxel size 0.9mm 0.9mm 1.2mm); and total scan time = 5min and 38s. To identify and extract WMH volume, T1-weighted and FLAIR images for each participant were run through Unidentified Bright Object (UBO) Detector (Jiang et al., 2018), a cluster-based, fully automated, pipeline that uses FMRIBs Automated Segmentation Tool (Zhang et al., 2001) to identify candidate clusters. sharing sensitive information, make sure youre on a federal 3C). damage and/or destruction of previously normally myelinated structures. (A) Distribution of the raw WMH volumes. PMC We used measurements from 23 of the 32 subjects for age-matched statistical . what is a t2 hyperintense liver lesion. In the Dunedin Study, a population-representative cohort followed since birth, we measured white matter hyperintensities in 843 45-year-old participants using T2-weighted magnetic resonance imaging and we assessed cognitive decline from childhood to midlife. https://doi.org/10.1093/braincomms/fcz041, https://sites.google.com/site/dunedineriskconceptpapers/documents, http://creativecommons.org/licenses/by/4.0/, Receive exclusive offers and updates from Oxford Academic. Scanned participants did not differ from other living participants on childhood social economic status (SES) or childhood intelligent quotient (IQ) (see attrition analysis in the Supplementary material). White matter lesions can be seen in a range of neurologic disorders, most often with vascular diseases such as stroke, migraine, and multiple sclerosis (MS). Professor Hedley Emsley is a renowned consultant neurologist practising privately at the Greater Lancashire Hospital in Preston and BMI The Lancaster Hospital in Lancaster. Search for other works by this author on: Department of Medicine, University of Otago, Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Social, Genetic, & Developmental Psychiatry Research Centre, Institute of Psychiatry, Psychology, & Neuroscience, Kings College London, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Center for Genomic and Computational Biology, Duke University. Red: deep white matter hyperintensity (DWMH) clusters; yellow: extended rims or caps that are pathological periventricular WMH (pPVWMH) and both DWMH and pPVWMH are counted as WMHs in the data analysis; green and blue: pencilthin rims (blue) or caps (green), which are not considered as pathological WMHs and thus not included in the analysis). See opinions (14), By Professor Hedley Emsley MR/P005918). The premise and analysis plan for this project were pre-registered on https://sites.google.com/site/dunedineriskconceptpapers/documents. Overall assessment of their patients Units of measurement are denoted next to each variable. For example, brain scans are sometimes done because a patient is seeking reassurance that there is no sinister cause for their headache. Conclusion By means of comparative image analysis and the recognition of characteristic lesion patterns, taking into account anatomical principles and pathophysiological processes, the differential diagnostic classification of cerebral white matter lesions and associated diseases can be significantly facilitated. White matter diseases include a wide spectrum of disorders that have in common impairment of normal myelination, either by secondary destruction of previously myelinated structures (demyelinating processes) or by primary abnormalities of myelin formation (dysmyelinating processes). Sometimes, white matter lesions are caused by inflammation of the brain. areas such as the septum that appear similar to WMHs on FLAIR images). Incidental white matter hyperintensities are common in brains of healthy individuals in their 60s and may be seen as early as the 30s and 40s. 150. In older adults, WMHs are associated with multiple dementia risk factors, including increasing age, hypertension, stroke, brain atrophy and cognitive ability (Prins and Scheltens, 2015). Common Genetic Variation Indicates Separate Causes for Periventricular and Deep White Matter Hyperintensities. Successful surrogate biomarkers would allow clinicians to assess risk, monitor sub-clinical disease progression and intervene before clinically significant dementia symptoms manifest. , Liu T, Zhu W, Koncz R, Liu H, Lee T, et al. 2023 Jan;44(1):171-180. doi: 10.1007/s10072-022-06408-x. White matter lesions are an example of an incidental finding on a brain scan. A. This is typically the case when high blood pressure or diabetes mellitus are thought to be the cause of the brain scan changes. White matter lesions affect the white matter . By continuing to use our site, you consent to the use of these cookies. The repeatability of R 1 dispersion imaging parameters measured on a 26-year-old healthy female are reported in Supplementary Table S2. Using K-nearest neighbours algorithms, clusters in the MRI images are classified as WMHs or non-WMHs (i.e. Standardized methods to examine such pathology and its determinants will help inform strategies for their prevention, which is an important component of a healthy ageing agenda. body mass index, smoking, primary-care visits) and the NZ census on educational attainment. Table 1 shows the prevalence of . The nerve fibers are composed of axons, which transmit electrical signals that help neurons communicate with one another. In a mouse study, scientists at the University of Southern California (USC) in Los Angeles reveal how damage to cells called pericytes can trigger white matter disease, which is associated with. A review of literature]. The authors suggested that these abnormalities might be of ischaemic origin, secondary to atherosclerosis or vasculitis. Incidental Findings on Brain MRI. A 75-year-old woman with complaints of memory impairment. With the wide use of brain MRI, white matter hyperintensity (WMH) is frequently observed in clinical patients. Top Magn Reson Imaging. With other imaging techniques, a white matter lesion may appear as a black hole, which indicates damage to the axons. In the below slideshow, Drs Lange, Melisaratos, and Schiess shared a collection of MRI findings from their clinical practice to illustrate a selection of MS mimics. Methods: Sixty volunteers from a tertiary headache center were . Bookshelf Coker People who have mild forms of microvascular ischemic brain disease may have no symptoms. February 27, 2023 alexandra bonefas scott No Comments . White matter lesions (WMLs) are areas of abnormal myelination in the brain. These findings demonstrate that the link between WMHs and early signs of cognitive decline is detectable decades before clinical symptoms of ADRD typically emerge. Prevalence, incidence, and risk factors of lacunar infarcts in a community sample. In a population-representative birth cohort of individuals now in midlife, we found that WMHs are (i) common, (ii) associated with cognitive abilities in childhood and midlife and (iii) associated with cognitive decline from childhood to midlife. Prefer email?Sign-up for our email newsletter. These changes were found in only 16% of healthy controls. Alijanpourotaghsara A, Strelnikov D, Piroska M, Szalontai L, Forgo B, Jokkel Z, Persely A, Hernyes A, Kozak LR, Szabo A, Maurovich-Horvat P, Tarnoki AD, Tarnoki DL. e.g. Close more info about Differentiating Multiple Sclerosis Mimics on MRI. Maillard The right column presents UBO labelling (red) of WMHs in the raw images from the left column. All statistical analyses were done using R (v.3.4.5). official website and that any information you provide is encrypted More recent MRI technology has enabled doctors to study them more carefully and to recognize them as indicators of illness. White matter disease, or leukoaraiosis, involves the degeneration of white matter in the brain. M. D C Support for these hypotheses would provide novel evidence that WMHs could be a surrogate biomarker of risk in the general population as early as midlife, allowing for earlierand potentially more effectiveinterventions for cognitive decline and ADRD. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). They found a rather high prevalence, roughly 40%-80 in persons . This study aims to examine the correlation of WMHs with migraine features and explore the relationship between WMHs and migraine prognosis. Epub 2020 Jun 10. Deterioration of the white matter happens with ageing and can be seen on brain scans as white matter lesions (abnormal areas). This site needs JavaScript to work properly. After providing informed consent, 40 adults aged 62 to 82 years (n = 17 MCI) were included in this study. High blood pressure (hypertension ) is a very common cause. The lesions are not confined to white matter tracts and may also involve central grey matter. They also can occur in genetic diseases, toxic disorders, infections, inflammatory conditions, metabolic disturbances, traumatic brain injury, cancer, neoplasia, and hydrocephalus. To view unlimited content, log in or register for free. The effectiveness of a treatment for a particular disease may be assessed by monitoring its influence on white matter lesions. Due to their compounding growth during aging, WMHs may be especially useful for selecting individuals in midlife who are at the highest risk for future cognitive decline and who may most benefit from early prevention. Hum Brain Mapp. The nerve fibres are surrounded by a fatty material called myelin. "However, in many cases, the white matter. despite the sometimes extensive white matter lesions and the wide range of associated symptoms, in some particular cases, patients may be asymptomatic. ], The relationship between WMH volumes and the distance from the lateral ventricles, using (, Spatial distribution of WMHs. MRI differential diagnosis of suspected multiple sclerosis. Additionally, careful assessment of the so-called MRI red flags, such as the presence of infarcts, microbleeds, meningeal enhancement, and calcifications, among others, are very helpful in suggesting a diagnosis other than MS, according to research published in the Handbook of Clinical Neurology.3. We chose the UBO pipeline because of its high reliability in our data (testretest ICC = 0.87) and its out-of-sample performance (Jiang et al., 2018). Vasculitic autoimmune diseases such as systemic lupus erythematosus(SLE) and Sjgrens syndrome can also result in white matter abnormalities on MRI. Consequently, WMHs have been targeted as a surrogate biomarker for dementia prevention trials (Debette and Markus, 2010). You may be attended by another doctor who is member of the Team. Before becoming a fellow of the Royal College of Physicians of London (FRCP) in 2012, he obtained both the Certificate of Completion of Training (CCT) in neurology and a postgraduate certificate in clinical education in 2008 (PGCTLCP with distinction). Scenario 5: Patient with a lung mass and brain lesions. Encephale. His areas of expertise include vascular neurology, stroke, cerebrovascular disease, late-onset epilepsy, migraine and neurological disorders. White matter hyperintensities are common in MRIs of asymptomatic individuals, and their prevalence increases with age from approximately 10% to 20% in those approximately 60 years old to close to 100% in those older than 90 years. Preparation for kNN classification feature, Preparation for kNN classification feature space: ( a ) A candidate WMH cluster, Some kNN classification results. Given that prevention of damage is often more efficacious than reversal of damage (Sperling et al., 2014; Moffitt et al., 2017), particularly in the brain, our results suggest that lifestyle and pharmaceutical interventions aimed at slowing the progression of WMHs in midlife may be promising complements to interventions in older adults. Longitudinal studies in older adults have reported that the spread of WMHs contributes to elevated risk for ADRD and coincides with age-related cognitive decline (Debette and Markus, 2010). Register now at no charge to access unlimited clinical news with personalized daily picks for you, full-length features, case studies, conference coverage, and more. . 2020 Sep 14;10(9):691. doi: 10.3390/diagnostics10090691. White matter is found throughout the central nervous system, but much of it lies in the interior of the brain, between the cerebral cortex and deep gray matter structures such as the thalamus and basal ganglia. While WMHs are uncommon in adults before age 30 (Habes et al., 2016), they are detectable in <90% of individuals by age 65 (Longstreth et al., 1996). , Manolio TA, Arnold A, Burke GL, Bryan N, Jungreis CA, et al. . 8600 Rockville Pike White matter hyperintensities (WMHs) are brain lesions that appear as regions of enhanced brightness on T2-weighted magnetic resonance imaging (MRI). Accessibility There are many possible causes, including vitamin deficiencies, infections, migraines, and strokes. eCollection 2021 Oct. Endres D, Matysik M, Feige B, Venhoff N, Schweizer T, Michel M, Meixensberger S, Runge K, Maier SJ, Nickel K, Bechter K, Urbach H, Domschke K, Tebartz van Elst L. Diagnostics (Basel). An official website of the United States government. White matter hyperintensities are of presumed vascular origin and are frequently observed in older adults as well as in patients with AD (Brickman, Muraskin, & Zimmerman, 2009; Dadar et al., 2015). (/?<0.002) was detected in the 51-70-year-old group with WMLs (Table 1). Analyses reported here were checked for reproducibility by an independent data-analyst, who recreated the code by working from the manuscript and applied it to a fresh dataset. Epub 2006 Nov 13. , Moffitt TE, Silva PA. Prins 2). However, their significance and correlation to migraine disease burden remain unclear. BMI = body mass index. , Viqar F, Zimmerman ME, Narkhede A, Tosto G, Benzinger TLS, et al. MS lesions, known as plaques, may form in CNS white matter in any location;. government site. This kind of damage happens because of brain injuries or medical conditions. Urinary incontinence. , Mormino E, Johnson K. Valds Hernndez AJR:151,August1988 MAOFWHITE MATTER DISEASE 363 Fig.6.-A, MRimage2500/80 shows diffuse confluent highsignalthroughout whitematter in 4-year-old boywithmetachromatic leukodystro- 1995 Jul 15;38(2):86-91. doi: 10.1016/0006-3223(94)00248-2. He has several other professional responsibilities including his roles as a co-chair of the Association of British Neurologists Stroke Advisory Group and clinical advisor to the Neurology Intelligence Collaborative. Genetic factors, alone or in interaction with environmental factors, appear to be important. Relationship between partial white matter lesion volumes and cognitive performance in the 3 year follow-up. and 36-year-old men. Over time these exposures may lead to negative health outcomes, such as higher risk for cardiovascular disease, brain damage and higher blood pressure, which contribute to increased WMH volume in midlife. Neuroimage. Magnetic resonance (MR) imaging has become the primary imaging modality in patients with leukodystrophy and plays an important role in the identification, localization, and characterization of underlying white matter abnormalities in affected patients. Find the best specialist in Neurology in your location: White matter lesions explained by a neurologist, Professor Emsley was appointed Consultant Neurologist with special interest in Stroke Neurology at Lancashire Teaching Hospitals NHS Foundation Trust in 2008, and in. The 60-year-old father of the main resident of the home got into a confrontation with the four suspects outside around 4:40 a.m. As the confrontation escalated, the suspects shot the man in the head. Would you like email updates of new search results? Some studies have found that white matter lesions tend to be seen on the majority of brain scans in older adults but are far less frequently seen on brain scans in younger people. White matter hyperintensities (WMHs) are a frequent finding on T2-weighted MRI of the brain in elderly individuals, but their prevalence and severity in younger asymptomatic populations is less well studied. Department of Psychology & Neuroscience, Duke University. A Diffeomorphic Anatomical Registration through Exponentiated Lie template of 55years or younger was used to best approximate the age of our cohort (Ashburner, 2007), and a grey matter mask was applied to decrease the chance of false positives. It is indicated that ENKL should be recognized as one of the rare causes of RPD and early testing for EBVDNA in cerebrospinal fluid and imaging of cauda equina would be useful diagnostic tools. R The microstructural abnormalities of cingulum was related to patients with mild cognitive impairment: a diffusion kurtosis imaging study. Ideally, it is good to be aware of the possibility of incidental findings being identified before having a brain scan. Signs and symptoms of white matter disease include: Memory problems. , Brady M, Smith S. Alzheimers disease and related dementias, Oxford University Press is a department of the University of Oxford. Epub 2005 Oct 25. Longitudinal studies have shown that WMHs tend to grow and expand from existing lesions and that higher baseline volumes predict faster accumulation of WMHs and more rapid cognitive decline in older adults (Maillard et al., 2012; Prins and Scheltens, 2015). Little is known about the links between WMH and vascular risk factors, cortical -amyloid (A) load, and cognition in cognitively unimpaired adults across the entire lifespan, especially in young and middle-aged adults. Summary: Tracy dArbeloff, Maxwell L Elliott, Annchen R Knodt, Tracy R Melzer, Ross Keenan, David Ireland, Sandhya Ramrakha, Richie Poulton, Tim Anderson, Avshalom Caspi, Terrie E Moffitt, Ahmad R Hariri, White matter hyperintensities are common in midlife and already associated with cognitive decline, Brain Communications, Volume 1, Issue 1, 2019, fcz041, https://doi.org/10.1093/braincomms/fcz041. Cees De Groot White matter is made up of tracts, or bundles, each of which contains millions of nerve fibers that connect gray matter regions throughout the central nervous system. The average IQ in childhood and adulthood in each of these is plotted to illustrate the increasing severity of cognitive decline as WMH volume increases. results of a one-year exercise intervention. problems . Changes in mood . White matter lesions (WMLs) or leukoaraiosis indicate small vessel vascular brain disease as well as degenerative or inflammatory processes. Brain lesions and cerebral functional impairment in migraine patients. TE Neurology. Please enable it to take advantage of the complete set of features! For further information, read our Privacy Policy. . Background White matter hyperintensities (WMHs) are frequently detected in migraine patients. It is sensible to make sure that treatable conditions such as high blood pressure are recognised and treated in case the white matter lesions are due to this. However, it is unclear at what stage of aging white matter hyperintensities begin to relate to cognition and if they may be a viable target for early prevention. , De Leeuw F-E, Oudkerk M, Van Gijn J, Hofman A, Jolles J, et al.

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