Determinants of cerebral white matter lesions: A longitudinal population based MRI study

W hite matter lesions are frequently found on cerebral magnetic resonance imaging scans of elderly non-demented and demented people. l-4 The pathogenesis of white matter lesions is largely unknown. However age and high diastolic and systolic blood pressure levels and indicators of atherosclerosis have consistently been reported as risk factors for white matter lesions, regardless of their location.2-s Many other, especially vascular, risk factors have been associated with white matter lesions, but these relations were mostly not consistent throughout studies. There is growing evidence that white matter lesions play an important role in the development of cognitive decline and dementia.4 .6 -8 The white matter can be distinguished into two separate anatomical regions, namely the peri ventricular white matter (a strip of white matter adjacent to the lateral ventricles) and the subcortical white matter (the white mattcr just underneath the gray matter). Only a few studies have distinguished between these two locations and have reported on their determinants separately.9,10 Yet it may be that different risk factors underlie white matter lesions at different locations, or that lesions in different locations may have different cognitive consequences.

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