author={Michael J. O’Sullivan},
  journal={Practical Neurology},
  pages={26 - 38}
  • M. O’Sullivan
  • Published 1 January 2008
  • Medicine, Psychology
  • Practical Neurology
Leukoaraiosis describes diffuse white matter abnormalities on CT or MR brain scans, often seen in the normal elderly and in association with vascular risk factors such as hypertension, or in the context of cognitive impairment. The term was introduced to avoid confusing an imaging appearance with a specific pathology. Neurologists often come across this appearance, but its significance is sometimes uncertain. The effects on cognitive function and gait are insidious and can be difficult to… 
sTWEAK is a leukoaraiosis biomarker associated with neurovascular angiopathy
An increased frequency and intensity of LA is confirmed in symptomatic patients with neurovascular pathology compared with asymptomatic subjects, and its association with circulating serum levels of soluble tumor necrosis factor‐like weak inducer of apoptosis (sTWEAK) is confirmed.
Leukoaraiosis and acute ischemic stroke
The present review of the literature on the mechanism and the effect of LA on the prognosis of patients with acute ischemic stroke found that some experts have contrary beliefs.
Silent brain infarction: a quiet predictor of future stroke
  • O. Bang
  • Psychology
    Precision and Future Medicine
  • 2018
Diffusion tensor imaging revealed different pathological processes of white matter hyperintensities
The pathological heterogeneity in WMH is explored by using diffusion tensor imaging (DTI) to provide a new insight into the future research and may represent the effects of severe demyelination within the frontal periventricular WMH.
Role of age-related alterations of the cerebral venous circulation in the pathogenesis of vascular cognitive impairment.
The role of cerebral veins in the pathogenesis of VCID is discussed, including blood-brain barrier disruption, neuroinflammation, exacerbation of neurodegeneration, development of cerebral microhemorrhages of venous origin, altered production of cerebrospinal fluid, impaired function of the glymphatics system, and dysregulation of cerebral blood flow are explored.
Fiber Connectivity Density in Cerebral Small-Vessel Disease Patients With Mild Cognitive Impairment and Cerebral Small-Vessel Disease Patients With Normal Cognition
Cognitively normal CSVD patients already have disruptions of structural connectivity, and the extent and intensity of connectivity disruptions in frontal and parietal areas may underlie the mechanism of cognitive impairment in CSVD.
Claudin-1 and Claudin-3 as Molecular Regulators of Myelination in Leukoaraiosis Patients
It is demonstrated that the abnormal expression of claudin-1 and claudIn-3 regulates the pathological progression of leukoaraiosis by governing the viability and myelination of oligodendrocytes.
Abnormal Interactions of the Salience Network, Central Executive Network, and Default-Mode Network in Patients With Different Cognitive Impairment Loads Caused by Leukoaraiosis
The multi-model analysis of the FC changes in LA patients with different cognitive status by three network models is helpful for the further understanding of the cognitive changes in those patients.
Neuroimaging markers of chronic fatigue in older people: a narrative review
It is suggested that hippocampus damage and potentially loss of function in basal ganglia networks could play a role on chronic fatigue during aging and further studies are needed to assess the associations of fatigue with white matter alterations.
Impact of 25-Hydroxy Vitamin D on White Matter Hyperintensity in Elderly Patients: A Systematic Review and Meta-Analysis
This meta-analysis aimed to investigate the presence of an association between serum 25-hydroxy vitamin D [25(OH)D] levels and white matter hyperintensity (WMH), and showed that the results were robust.


Binswanger's disease: a review.
To better define the clinical features associated with the characteristic white matter lesions of BD, the international literature from 1912 to the present was reviewed for pathologically verified cases accompanied by relatively complete clinical descriptions.
Cognitive and neurologic findings in demented patients with diffuse white matter lucencies on computed tomographic scan (leuko-araiosis).
The results are consistent with the hypothesis that leuko-araiosis is associated with dementia in AD, and that this is either most marked or most easily identifiable before the dementia becomes very severe.
Normal-appearing white matter in ischemic leukoaraiosis: A diffusion tensor MRI study
Changes in the normal-appearing white matter were demonstrated in 30 patients with ischemic leukoaraiosis compared with 17 age-matched control subjects, and correlated with executive dysfunction assessed by the Wisconsin Card Sorting Test.
Cerebral White Matter Changes (Leukoaraiosis), Stroke, and Gait Disturbance
This work sought to determine if leukoaraiosis is a predictor of gait disturbance after accounting for cerebral atrophy and stroke in patients with a high prevalence of cerebrovascular disease.
Amyloid Angiopathy–Related Vascular Cognitive Impairment
Data from patients with CAA-related intracerebral hemorrhage suggesting associations of CAA with radiographic white matter abnormalities and cognitive impairment highlight the importance of elucidating the effects of vascular amyloid on cerebrovascular function and of developing therapeutic strategies for this potentially widespread form of microvascular cognitive impairment.
Subcortical arteriosclerotic encephalopathy: CT spectrum and pathologic correlation.
Assessment of the frequency of subcortical arteriosclerotic encephalopathy, to gauge the reliability of CT in making this diagnosis, and the strength of the correlation between SAE and arterial hypertension found the pattern of diminished attenuation in the white matter was periventricular in 16 patients.
Diffusion tensor MRI correlates with executive dysfunction in patients with ischaemic leukoaraiosis
The findings support the role of white matter damage and disruption ofwhite matter connections in the pathogenesis of cognitive impairment in cerebral small vessel disease.
A white matter disorder in dementia of the Alzheimer type: A pathoanatomical study
In cases of Alzheimer's presenile and senile dementia, Alzheimer's disease (AD) andsenile dementia of the Alzheimer type (SDAT), respectively, a lesion that has the character of an incomplete infarction confined to the white matter is observed.
Patterns of cerebral blood flow reduction in patients with ischemic leukoaraiosis
Hypoperfusion may be an early feature in the development of periventricular lesions in ILA and may play a direct pathogenic role, and Serial studies are now needed to determine whether these changes herald the appearance of new lesions and represent ‘at risk’ white matter, and whether pharmacological agents can restore perfusion of normal-appearing white matter.
What is the significance of leukoaraiosis in patients with acute ischemic stroke?
The results provide further evidence that LA is related primarily to small-vessel disease.