The relationship between cerebral white-matter lesions (WML) and cognitive performance has been one of the most controversial issues since the first descriptions of these changes by neuroimaging techniques in the early 1980s. Some of the aspects of this complex interaction have been summarized in recent review papers or editorials.1-4 In this chapter, I will focus on some of the most burning questions in the field:
1) Do WML cause or contribute to the occurrence of dementia? 2) What is the contribution of WML to specific types of mental impairment,
such as Alzheimer’s disease (AD) and vascular dementia (VaD)? 3) Is there a role for WML in mild cognitive impairment and in predicting
dementia onset? 4) Can WML be considered a surrogate marker of a specific form of
dementia or cognitive impairment?