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Structural neuroimaging in Altheimer's disease: do white matter hyperintensities matter?
Brickman AM, Muraskin J, Zimmerman ME.. Dialogues in clinical neuroscience, 2009-01-01
Topic: Brain proteins, microglia and lab models
The targeted brain dysfunction that accompanies aging can have a devastating effect on cognitive and intellectual abilities. A significant proportion of older adults experience precipitous cognitive decline that negatively impacts functional activities. Such individuals meet clinical diagnostic criteria for dementia, which is commonly attributed to Alzheimer's disease (AD). Structural neuroimaging, including magnetic resonance imaging (MRI), has contributed significantly to our understanding of the morphological and pathology-related changes that may underlie normal and disease-associated cognitive change in aging. White matter hyperintensities (WMH), which are distributed patches of increased hyperintense signal on T2-weighted MRI, are among the most common structural neuroimaging findings in older adults. In recent years, WMH have emerged as robust radiological correlates of cognitive decline. Studies suggest that WMH distributed in anterior brain regions are related to decline in executive abilities that is typical of normal aging, whereas WMH distributed in more posterior brain regions are common in AD. Although epidemiological, observational, and pathological studies suggest that WMH may be ischemic in origin and caused by consistent or variable hypoperfusion, there is emerging evidence that they may also reflect vascular deposition of beta-amyloid, particularly when they are distributed in posterior areas and are present in patients with AD. Findings from the literature highlight the potential contribution of small-vessel cerebrovascular disease to the pathogenesis of AD, and suggest a mechanistic interaction, but future longitudinal studies using multiple imaging modalities are required to fully understand the complex role of WMH in AD.
Key findings
- A significant proportion of older adults experience precipitous cognitive decline that negatively impacts functional activities.
- Structural neuroimaging, including magnetic resonance imaging (MRI), has contributed significantly to our understanding of the morphological and pathology-related changes that may underlie normal and disease-associated cognitive change in aging.
- Studies suggest that WMH distributed in anterior brain regions are related to decline in executive abilities that is typical of normal aging, whereas WMH distributed in more posterior brain regions are common in AD.
- Although epidemiological, observational, and pathological studies suggest that WMH may be ischemic in origin and caused by consistent or variable hypoperfusion, there is emerging evidence that they may also reflect vascular deposition of beta-amyloid, particularly when they are distributed in posterior areas and are present in patients with AD.
Why it matters
This review discusses white matter hyperintensities seen on MRI, which are common in older adults and have been linked to cognitive decline, with some evidence they may reflect vascular deposition of beta-amyloid. It is a discussion of imaging findings, not a test of any treatment, so it does not show how to cure or prevent Alzheimer's disease.
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Study details
- Study designlongitudinal study
- Evidence strengthModerate
How this study scored 54/100
Published in a peer-reviewed journal, and it is a longitudinal study following the same people over time. Scored zero for sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Dialogues in clinical neuroscience) |
| Journal's citation record | 2 / 4 | Dialogues in Clinical Neuroscience: journal h-index 154 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A longitudinal study following the same people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2009 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 126 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 6.6 citations a year over 19 year(s) since 2009 |
| Impact for its field and year | 3 / 6 | Cited 5.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 4 other studies in this library |
| Still being cited | 2 / 4 | Cited 18 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Molly E. Zimmerman: h-index 52 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Columbia University: institution h-index 1,824 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 19585953) |
| Free to read | 2 / 2 | Free to read |
| Total | 54 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.31887/dcns.2009.11.2/ambrickman
- PubMed: 19585953
- Original source →
- Free full text: Dialogues in Clinical Neuroscience →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Brickman, A. M., Muraskin, J., & Zimmerman, M. E. (2009). Structural neuroimaging in Altheimer's disease: do white matter hyperintensities matter? Dialogues in clinical neuroscience. https://doi.org/10.31887/dcns.2009.11.2/ambrickman
Vancouver
Brickman AM, Muraskin J, Zimmerman ME. Structural neuroimaging in Altheimer's disease: do white matter hyperintensities matter? Dialogues in clinical neuroscience. 2009. doi:10.31887/dcns.2009.11.2/ambrickman. PMID: 19585953.
BibTeX
@article{brickman2009-19585953,
author = {Brickman, A. M. and Muraskin, J. and Zimmerman, M. E.},
title = {{Structural neuroimaging in Altheimer's disease: do white matter hyperintensities matter?}},
journal = {Dialogues in clinical neuroscience},
year = {2009},
doi = {10.31887/dcns.2009.11.2/ambrickman},
pmid = {19585953},
url = {https://doi.org/10.31887/dcns.2009.11.2/ambrickman}
}
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