Evidence map›Paper›PMID 20660506›Full record

SynthesisBMJ (Clinical research ed.)2010

The clinical importance of white matter hyperintensities on brain magnetic resonance imaging: systematic review and meta-analysis.

Stéphanie Debette, H S Markus

2 registry-linked trialsAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 1,211 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1,211citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04456348 unknown statusnot on this mapstarted 2020, after this paper: background citation

Association Between Gait Features Assessed by Artificial Intelligent System and Cognitive Function Decline in the Patients of Silent Cerebrovascular Disease: A Multicenter Prospective Cohort Study

TypeobservationalSponsorShanghai Zhongshan HospitalRan2020 to 2021Enrolled1,600ConditionsSilent StrokeArmsthere is no intervention
NCT04457908 naunknown statusnot on this mapstarted 2020, after this paper: background citation

the Effectiveness and Cost Effectiveness in Screening Gait Disorder of Silent Cerebrovascular Disease Assisted by Artificial Intelligent System and Clinical Doctors - A Randomized Parallel-controlled Study

TypeinterventionalSponsorShanghai Zhongshan HospitalRan2020 to 2020Enrolled1,000ConditionsSilent StrokeArmsintelligent assessment
3 · Its place in the literature

Who cites it

1,211 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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  14. Determinants of post-stroke cognitive impairment in patients with periodontal disease.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2025
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  15. Cardiac Biomarkers, Subclinical Brain Vascular Changes, and Cognitive Decline: Post Hoc Analysis of the SPRINT Trial.The journals of gerontology. Series A, Biological sciences and medical sciences · 2025
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1,151 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

2 authors.

Stéphanie DebetteClinical Neuroscience, St George's University of London, London. sdebette@bu.edu
H S Markus

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo review the evidence for an association of white matter hyperintensities with risk of stroke, cognitive decline, dementia, and death.

designSystematic review and meta-analysis. DATA SOURCES: PubMed from 1966 to 23 November 2009. STUDY SELECTION: Prospective longitudinal studies that used magnetic resonance imaging and assessed the impact of white matter hyperintensities on risk of incident stroke, cognitive decline, dementia, and death, and, for the meta-analysis, studies that provided risk estimates for a categorical measure of white matter hyperintensities, assessing the impact of these lesions on risk of stroke, dementia, and death. DATA EXTRACTION: Population studied, duration of follow-up, method used to measure white matter hyperintensities, definition of the outcome, and measure of the association of white matter hyperintensities with the outcome. DATA SYNTHESIS: 46 longitudinal studies evaluated the association of white matter hyperintensities with risk of stroke (n=12), cognitive decline (n=19), dementia (n=17), and death (n=10). 22 studies could be included in a meta-analysis (nine of stroke, nine of dementia, eight of death). White matter hyperintensities were associated with an increased risk of stroke (hazard ratio 3.3, 95% confidence interval 2.6 to 4.4), dementia (1.9, 1.3 to 2.8), and death (2.0, 1.6 to 2.7). An association of white matter hyperintensities with a faster decline in global cognitive performance, executive function, and processing speed was also suggested.

conclusionWhite matter hyperintensities predict an increased risk of stroke, dementia, and death. Therefore white matter hyperintensities indicate an increased risk of cerebrovascular events when identified as part of diagnostic investigations, and support their use as an intermediate marker in a research setting. Their discovery should prompt detailed screening for risk factors of stroke and dementia.

Indexed as

Cerebrovascular DisordersCognition DisordersDementia, VascularDisease ProgressionHumansLongitudinal StudiesMagnetic Resonance AngiographyMicrocirculationPrognosisRisk FactorsStroke

Identifiers

PMID20660506
PMCPMC2910261

What OpenQuestion holds

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Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.