The Next Target to Fight Dementia: White Matter Disease

Jan 26, 2018

Brain scientists have found that white matter disease chips away at memory by shrinking the brain, and contributing to dementia more than initially thought.

Assistant Professor Walter SwardfagerAssistant Professor Walter Swardfager

“These findings highlight that the role of white matter disease in dementia has been under-appreciated,” says  Walter Swardfager, lead investigator of a new study and an assistant professor in the Department of Pharmacology and Toxicology. . “This may help to direct the next generation of treatment strategies.”

White matter hyperintensities (WMH) are bright spots on MRI scans – tissue in the brain that is wearing away due to effects of aging and vascular risk factors on the brain’s small vessels.

The research, published in the February 2018 issue of the journal Neurology, showed that individuals with extensive small vessel disease had profound shrinking of the temporal lobe, an important brain region that is instrumental to learning and memory function.

The study included over 700 participants of the Sunnybrook Dementia Study led by. Sandra E. Black, the Brill Chair in Neurology in the Deparmtent of Medicine.  The researchers’ analyses showed that shrinkage of the temporal lobe explained how WMH were associated with memory problems.

WMH was associated with poorer verbal recall, specifically due to temporal lobe shrinkage and poorer verbal learning. WMH also contributed to deficits in recognition memory – the most sensitive and specific cognitive sign of Alzheimer’s disease - in people with Alzheimer’s disease, and across other late-life dementia syndromes including post-stroke dementia.

Large vessel strokes increase the risk of dementia substantially, and similarly, small vessel disease is very often a “silent” contributor to cognitive decline and dementia. Since they contribute to brain shrinkage and memory problems, it is important to consider vascular brain disease as a “root cause” that can set the stage for dementia, stress the researchers.

“More work needs to be done to show how white matter imaging markers can be used to predict cognitive decline in Alzheimer’s disease as well as stroke,” says Swardfager, also a scientist at Sunnybrook Research Institute. “It is now important for research to focus on the biological bases for white matter disease, and how it affects brain tissue at the molecular level, so that new treatments can be designed to protect the brain from damage.”

The study was funded by the Canadian Institutes of Health Research, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Alzheimer Society of Canada, Heart and Stroke Foundation of Canada, the Physicians Services Incorporated Foundation, Alzheimer’s Association Research Grant Program and Brain Canada.

The research team is a collaboration of scientists from Sunnybrook Research Institute, University of Toronto, University Health Network Toronto Rehabilitation Institute, Universidade Federal De São Paulo, McMaster University, and Rotman Research Institute at Baycrest.

Oct 3 – Dec 12
Introducing Narrative-Based Medicine – Part One
Course | 6:00pm–8:00pm
Oct 16 – Jun 18
CPD Foundations
Workshop/Seminar | 12:00pm–1:30pm
14 – 18
Psychiatry Refresher Program
| 9:00am–5:00pm
Jan 16 Deepening Narrative Competence - Part Two
Course | 6:00pm–8:00pm
18 – 19
Inaugural Joint Cardiovascular-Diabetes Symposium
Symposium | 8:00am–5:15pm
Jan 24 Mindfest
Other | 10:00am–2:00pm
Jan 29 Best Practices in Applying to Summer Research, Jobs and Graduate School
Workshop/Seminar | 10:00am–11:00am


UofT Medicine
“A medical diagnosis can make you feel alone, because a map with names that you can’t understand on an unknown road…
UofT Medicine
RT : Let us congratulate RSI doctoral student, for receiving this year’s President's Award for the Outstan…
UofT Medicine
RT : Reduced staffing and lack of follow-up care could mean the December holiday period is a more vulnerable time for pa…

UofTMed Magazine

Have we lost the art of dying?

Sign up for your free digital copy.
Back to Top