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69/100

✓ Peer-reviewed alzhub usefulness score 69 out of 100. Prevention and risk

Topic: Risk, prevention and care in population studies

However, some individuals have subtle symptoms associated with acute MRI lesions. We found associations between worse white matter hyperintensity (WMH) severity and apathy (OR 1·41, 95% CI 1·05-1·89) and the adjusted SMD in apathy score between WMH severities was 0·38 (95% CI 0·15-0·61). Worse WMH severity was also associated with delirium (adjusted OR 2·9, 95% CI 1·12-7·55) and fatigue (unadjusted OR 1·63, 95% CI 1·20-2·22). WMHs were not consistently associated with subjective memory complaints (OR 1·34, 95% CI 0·61-2·94) and unadjusted SMD for WMH severity between these groups was 0·08 (95% CI -0·31 to 0·47). Overall heterogeneity varied from 0% to 79%.

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APA 7th

Clancy, U., Gilmartin, D., Jochems, A. C. C., Knox, L., Doubal, F. N., & Wardlaw, J. M. (2021). Neuropsychiatric symptoms associated with cerebral small vessel disease: a systematic review and meta-analysis. The lancet. Psychiatry. https://doi.org/10.1016/s2215-0366(20)30431-4

Vancouver

Clancy U, Gilmartin D, Jochems ACC, Knox L, Doubal FN, Wardlaw JM. Neuropsychiatric symptoms associated with cerebral small vessel disease: a systematic review and meta-analysis. The lancet. Psychiatry. 2021. doi:10.1016/s2215-0366(20)30431-4. PMID: 33539776.

BibTeX

@article{clancy2021-33539776,
  author  = {Clancy, U. and Gilmartin, D. and Jochems, A. C. C. and Knox, L. and Doubal, F. N. and Wardlaw, J. M.},
  title   = {{Neuropsychiatric symptoms associated with cerebral small vessel disease: a systematic review and meta-analysis}},
  journal = {The lancet. Psychiatry},
  year    = {2021},
  doi     = {10.1016/s2215-0366(20)30431-4},
  pmid    = {33539776},
  url     = {https://doi.org/10.1016/s2215-0366(20)30431-4}
}

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Key findings

However, some individuals have subtle symptoms associated with acute MRI lesions.
We found associations between worse white matter hyperintensity (WMH) severity and apathy (OR 1·41, 95% CI 1·05-1·89) and the adjusted SMD in apathy score between WMH severities was 0·38 (95% CI 0·15-0·61).
Worse WMH severity was also associated with delirium (adjusted OR 2·9, 95% CI 1·12-7·55) and fatigue (unadjusted OR 1·63, 95% CI 1·20-2·22).
WMHs were not consistently associated with subjective memory complaints (OR 1·34, 95% CI 0·61-2·94) and unadjusted SMD for WMH severity between these groups was 0·08 (95% CI -0·31 to 0·47).
Overall heterogeneity varied from 0% to 79%.

Why it matters

This review found that worse white matter hyperintensity severity was associated with apathy, delirium and fatigue, but not consistently with subjective memory complaints. It describes symptom associations with a marker of small vessel disease and does not test any treatment or prevention.

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Study details

Study designsystematic review
Participants21
Evidence strengthHigh

How this study scored 69/100

Published in a peer-reviewed journal, and it is a systematic review of all the studies on the question. Scored zero for effect reported because the record does not state it.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (The lancet. Psychiatry)
Journal's citation record	2 / 4	The Lancet Psychiatry: journal h-index 216 (OpenAlex, 2026-10-29)
Study design	12 / 12	A systematic review of all the studies on the question
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	3 / 5	2021 — within 6 year(s) of the newest study here
Sample size	1 / 4	21 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)
Randomised / blinded	0 / 2	A review of other studies — randomisation is not credited here
Times cited	5 / 7	Cited 157 times (OpenAlex, 2026-10-10)
Citations per year	4 / 5	22.4 citations a year over 7 year(s) since 2021
Impact for its field and year	3 / 6	Cited 3.9× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	2 / 6	Cited by 6 other studies in this library
Still being cited	3 / 4	Cited 90 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	1 / 3	University of Edinburgh: institution h-index 1,378 (OpenAlex)
Multi-centre collaboration	2 / 3	OpenAlex lists 5 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 33539776)
Free to read	0 / 2	Behind a paywall — scores zero
Total	69 / 100	—

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