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73/100

✓ Peer-reviewed alzhub usefulness score 73 out of 100. Getting a diagnosis

Topic: Risk, prevention and care in population studies

Plain-language summary

White matter hyperintensities are frequent on neuroimaging of older people and are a key feature of cerebral small vessel disease. They are commonly attributed to chronic hypoperfusion, although whether low cerebral blood flow is cause or effect is unclear. We systematically reviewed studies that assessed cerebral blood flow in small vessel disease patients, performed meta-analysis and sensitivity analysis of potential confounders. Thirty-eight studies (n = 4006) met the inclusion criteria, including four longitudinal and 34 cross-sectional studies. Most cerebral blood flow data were from grey matter. Twenty-four cross-sectional studies (n = 1161) were meta-analysed, showing that cerebral blood flow was lower in subjects with more white matter hyperintensity, globally and in most grey and white matter regions (e.g. mean global cerebral blood flow: standardised mean difference-0.71, 95% CI -1.12, -0.30). These cerebral blood flow differences were attenuated by excluding studies in dementia or that lacked age-matching. Four longitudinal studies (n = 1079) gave differing results, e.g., more baseline white matter hyperintensity predated falling cerebral blood flow (3.9 years, n = 575); cerebral blood flow was low in regions that developed white matter hyperintensity (1.5 years, n = 40). Cerebral blood flow is lower in subjects with more white matter hyperintensity cross-sectionally, but evidence for falling cerebral blood flow predating increasing white matter hyperintensity is conflicting. Future studies should be longitudinal, obtain more white matter data, use better age-correction and stratify by clinical diagnosis.

What this study adds

Evidence grade: High

This is a pooled review of 4,006 participants. This systematic review and meta-analysis found that cerebral blood flow was lower in subjects with more white matter hyperintensity cross-sectionally, but these differences were attenuated by excluding studies in dementia or that lacked age-matching. Four longitudinal studies gave differing results, so whether low cerebral blood flow is cause or effect remains unclear.

Taken from this record’s own fields, not from reading the paper. The grade is assigned from the abstract’s wording; what that means.

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

APA 7th

Shi, Y., Thrippleton, M. J., Makin, S. D., Marshall, I., Geerlings, M. I., de Craen, A. J. M., et al. (2016). Cerebral blood flow in small vessel disease: A systematic review and meta-analysis. Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism. https://doi.org/10.1177/0271678x16662891

Vancouver

Shi Y, Thrippleton MJ, Makin SD, Marshall I, Geerlings MI, de Craen AJM, et al. Cerebral blood flow in small vessel disease: A systematic review and meta-analysis. Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism. 2016. doi:10.1177/0271678x16662891. PMID: 27496552.

BibTeX

@article{shi2016-27496552,
  author  = {Shi, Y. and Thrippleton, M. J. and Makin, S. D. and Marshall, I. and Geerlings, M. I. and de Craen, A. J. M. and van Buchem, M. A. and Wardlaw, J. M.},
  title   = {{Cerebral blood flow in small vessel disease: A systematic review and meta-analysis}},
  journal = {Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism},
  year    = {2016},
  doi     = {10.1177/0271678x16662891},
  pmid    = {27496552},
  url     = {https://doi.org/10.1177/0271678x16662891}
}

Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.

How to read this study

Design: this is a pooled review. It combines earlier studies, so it is only as good as the studies it pools. Check how many were included, whether they were similar enough to combine, and whether the authors report inconsistency between them.
Size: the record lists 4,006 participants. Ask whether that is enough for the question, and who they were.
Effect: the record gives no effect size, so the summary above cannot say how large any difference was.

What the evidence grade means here

This page is graded high. alzhub.org assigns the grade automatically from keywords in the abstract, not from reading the paper. High means the abstract mentions a randomized design, a meta-analysis or a systematic review. It can add at most 5 of the 100 points in the study score, and it is a label about design, not a verdict on whether the findings are true.

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Key findings

Four longitudinal studies (n = 1079) gave differing results, e.g., more baseline white matter hyperintensity predated falling cerebral blood flow (3.9 years, n = 575); cerebral blood flow was low in regions that developed white matter hyperintensity (1.5 years, n = 40).

Why it matters

This systematic review and meta-analysis found that cerebral blood flow was lower in subjects with more white matter hyperintensity cross-sectionally, but these differences were attenuated by excluding studies in dementia or that lacked age-matching. Four longitudinal studies gave differing results, so whether low cerebral blood flow is cause or effect remains unclear.

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Study details

Study designmeta-analysis
Participants4,006
Evidence strengthHigh

How this study scored 73/100

Published in a peer-reviewed journal, and it is a meta-analysis pooling many studies. Scored zero for effect reported because the record does not state it.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism)
Journal's citation record	3 / 4	Journal of Cerebral Blood Flow & Metabolism: journal h-index 285 (OpenAlex, 2026-10-29)
Study design	12 / 12	A meta-analysis pooling many studies
Strength of evidence	5 / 5	Rated “high” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	1 / 5	2016 — within 20 year(s) of the newest study here
Sample size	3 / 4	4,006 participants
Effect reported	0 / 3	No effect size reported — scores zero (not stated in the record — scored 0)
Studied in people	3 / 3	Studied in people (participant count stated)
Randomized / blinded	0 / 2	A review of other studies — randomization is not credited here
Times cited	6 / 7	Cited 313 times (OpenAlex, 2026-10-10)
Citations per year	4 / 5	26.1 citations a year over 12 year(s) since 2016
Impact for its field and year	3 / 6	Cited 6.0× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	3 / 6	Cited by 15 other studies in this library
Still being cited	3 / 4	Cited 89 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	4 / 4	Last-listed author Joanna Marguerite Wardlaw: h-index 150 (OpenAlex, whole career)
Institution's track record	2 / 3	University of Glasgow: institution h-index 1,600 (OpenAlex)
Multicenter collaboration	2 / 3	OpenAlex lists 7 institution(s) in 3 countries
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 27496552)
Free to read	0 / 2	Behind a paywall — scores zero
Total	73 / 100	—

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