Over the past three decades, the field ol biomedical engineering has infused the clinical neurosciences with powerful neuroimaging instruments equipped to study directly morphological and functional properties of the aging

brain in vivo. Advances in the acquisition, visualization, and analysis of neuroimaging data selleck compound continue to evolve rapidly, with ongoing development of hardware, software, and conceptual statistical approaches that have already made tremendous scientific contributions. Structural magnetic resonance imaging (MRI) in particular can be used Inhibitors,research,lifescience,medical to examine macrostructural changes-gross differences in tissue volume that reflect volume variability, Inhibitors,research,lifescience,medical parenchymal atrophy, or frank pathology (eg, large-vessel inlarct, tumor); or microstructural changes-fiber tract integrity and pathology that can be altered due to subtle changes in myelin-associated pathology. Several studies have highlighted the importance of gross structural or volumetric

changes in cognitive aging and dementia (for example, see refs 7-11; see ref 12 for review). Small-vessel cerebrovascular disease, visualized as white matter hyperintensities (WMH), Inhibitors,research,lifescience,medical has emerged as a particularly strong correlate of cognitive aging (for review, see ref 13) and is the focus of our discussion here. Characterization and quantification of white matter hyperintensities White matter hyperintensities, sometimes referred to as leukoaraiosis or leukoencephalopathy, are areas of increased lucency visualized Inhibitors,research,lifescience,medical on T2-weighted images. They have enjoyed a rich, albeit capricious, history in clinical practice and in the aging literature, at points considered incidental with little clinical significance Inhibitors,research,lifescience,medical and at points considered a central source of cognitive, motoric, and emotional dysfunction. Initially, WMH were described as “unidentifiable bright objects,” confounding radiologists as either artifact ual or adventitious companions of aging. Indeed, chronological age is the strongest correlate of WMH severity14-16 and

most older adults have some degree of WMH burden. (Figure 1) displays Chlormezanone a typical example of distributed WMH and (Figure 2) shows examples of two elderly individuals, one with mild WMH and one with more severe WMH reconstructed in three dimensions. White matter hyperintensities usually appear in the white matter confluent to the lateral ventricles (ie, “periventricular” WMH), often projecting deep into cortical white matter and grey matter nuclei (ie, “deep” WMH), or as circumscribed punctate spheres in deep cortical tissue. Of note, punctate WMH often appear as isolated lesions on two-dimensional MRI axial slices, but with three-dimensional reconstruction it often becomes evident that they are contained within the same process stemming off the lateral ventricles. Figure 1.