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Recent Advances in Leukoaraiosis: White Matter Structural Integrity and Functional Outcomes after Acute Ischemic Stroke

  • Stroke (JF Meschia, Section Editor)
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Abstract

Leukoaraiosis, a radiographic marker of cerebral small vessel disease detected on T2-weighted brain magnetic resonance imaging (MRI) as white matter hyperintensity (WMH), is a key contributor to the risk and severity of acute cerebral ischemia. Prior investigations have emphasized the pathophysiology of WMH development and progression; however, more recently, an association between WMH burden and functional outcomes after stroke has emerged. There is growing evidence that WMH represents macroscopic injury to the white matter and that the extent of WMH burden on MRI influences functional recovery in multiple domains following acute ischemic stroke (AIS). In this review, we discuss the current understanding of WMH pathogenesis and its impact on AIS and functional recovery.

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Acknowledgments

Ona Wu is supported in part by the National Institutes of Health (P50NS051343, R01NS082285, R01NS086905, and NIBIB P41EB015896). Natalia S. Rost is supported by the NIH-NINDS R01NS082285 and R01NS086905.

Contributors

M.R.E. planned the review and prepared the first draft. All authors commented on the first draft and on subsequent versions of the review. N.S.R. provided critical review and organizational guidance as well as expertise on WMH background sections. O.W. provided critical review and specific expertise on advanced imaging techniques.

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Authors and Affiliations

  1. Harvard Medical School, Boston, MA, USA

    Mark R. Etherton, Ona Wu & Natalia S. Rost

  2. Massachusetts General Hospital, Boston, MA, USA

    Mark R. Etherton & Natalia S. Rost

  3. J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, 175 Cambridge Street, Suite 300, Boston, MA, 02114, USA

    Mark R. Etherton, Ona Wu & Natalia S. Rost

  4. Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA

    Ona Wu

Authors
  1. Mark R. Etherton
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  2. Ona Wu
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  3. Natalia S. Rost
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Corresponding author

Correspondence to Natalia S. Rost.

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Conflict of Interest

Mark R. Etherton declares that he has no conflict of interest.

Ona Wu reports grants and non-financial support from Genentech and personal fees from Penumbra. In addition, Dr. Wu has a patent on delay-compensated calculation of tissue blood flow (US Patent 7,512,435, 31 Mar 2009), with royalties paid from General Electric, Siemens, Olea Medical, and Imaging Biometrics.

Natalia S. Rost reports personal fees from Genzyme, CardioNet, Merck, Omniox, Broadview Ventures, and Daiichi Sankyo.

Human and Animal Rights and Informed Consent

All subjects in this article provided informed consent, and the studies were conducted under the Institutional Review Board approval.

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This article is part of the Topical Collection on Stroke

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Etherton, M.R., Wu, O. & Rost, N.S. Recent Advances in Leukoaraiosis: White Matter Structural Integrity and Functional Outcomes after Acute Ischemic Stroke. Curr Cardiol Rep 18, 123 (2016). https://doi.org/10.1007/s11886-016-0803-0

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  • DOI: https://doi.org/10.1007/s11886-016-0803-0

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