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October 1991

Clinical Correlates of White-Matter Changes on Magnetic Resonance Imaging Scans of the Brain

Author Affiliations

From the Departments of Clinical Neurological Sciences (Drs Mirsen, Lee, Fox, and Hachinski), Psychiatry, (Drs Diaz and Merskey), and Radiology (Drs Lee and Fox), the University of Western Ontario, London, and the Clinical Trials Resources Group, John P. Robarts Research Institute, London, Ontario (Ms Wong). Dr Mirsen is now with the Cooper Hospital/University Medical Center of the University of Medicine and Dentistry of New Jersey/Robert Wood Johnson School of Medicine, Camden, NJ. Dr Hachinski is a career investigator with the Heart and Stroke Foundation of Ontario.

Arch Neurol. 1991;48(10):1015-1021. doi:10.1001/archneur.1991.00530220031015

• We report our observations on the clinical and radiologic correlates of changes in cerebral white matter based on 94 subjects undergoing magnetic resonance imaging in a prospective study of dementia. Periventricular hyperintensity occurred twice as often in patients with Alzheimer's disease as in healthy control subjects. Within the control group, the presence of periventricular hyperintensity correlated significantly with one measure of cerebral atrophy and with the presence of changes in the adjoining deep white matter. The significance of white-matter changes distinct from the ventricles (leuko-araiosis) remains unsettled. Leuko-araiosis on the magnetic resonance imaging scan, unlike its correlate on the computed tomographic scan, was not shown to relate to cognitive decline or to the presence of focal abnormalities on neurologic examination. This is likely to reflect the heterogeneity of the changes detected with magnetic resonance imaging and their limited extent in our subjects.