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Advances in imaging research on the correlation between cerebral small vessel disease-related white matter hyperintensities and cognitive impairment
YANG Jiayi  MAO Haixia  FANG Xiangming 

DOI:10.12015/issn.1674-8034.2026.01.023.


[Abstract] White matter hyperintensities (WMH) are a typical imaging hallmark of cerebral small vessel disease (CSVD). Early-stage WMH may reflect reversible injuries, such as interstitial fluid circulation disorders, whereas advanced WMH indicate permanent lesions like demyelination and axonal loss. CSVD-related WMH are closely correlated with the progression of cognitive impairment. This correlation is manifested not only in the impacts of total WMH burden and spatial distribution on cognitive function, but also in the significant association between WMH and abnormalities in brain microstructure and function. Therefore, WMH may serve as an important imaging mediator for CSVD-related cognitive impairment induced by brain microstructural and functional abnormalities. This review focuses on the pathophysiological mechanisms of CSVD-related WMH, their direct correlation with cognitive impairment, and recent advances in imaging research regarding their multiple associations with underlying brain microstructural and functional injuries of cognitive impairment. The aim is to deepen the understanding of the role and significance of WMH, a core imaging sign of CSVD, in the clinical assessment of CSVD-related cognitive impairment, and to provide objective evidence for further research, diagnosis, and treatment of this condition. Furthermore, this review identifies the limitations in the current research and proposes potential avenues for future investigation.
[Keywords] cerebral small vessel disease；white matter hyperintensities；cognitive impairment；magnetic resonance imaging；radiomics

YANG Jiayi   MAO Haixia   FANG Xiangming*  

Department of Radiology, the Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, China

Corresponding author: FANG X M, E-mail: drfxm@163.com

Conflicts of interest   None.

Received  2025-11-12
Accepted  2025-12-12
DOI: 10.12015/issn.1674-8034.2026.01.023
DOI:10.12015/issn.1674-8034.2026.01.023.

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