Brain white matter: A substrate for resilience and a substance for subcortical small vessel disease

Farzaneh A. Sorond*, Philip B. Gorelick

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Age-related brain white matter disease is a form of small vessel disease (SVD) that may be associated with lacunar and other small subcortical infarcts, cerebral microbleeds, and perivascular spaces. This common form of cerebrovascular disease may manifest clinically as cognitive impairment of varying degrees and difficulty with mobility. Whereas some persons show cognitive decline and mobility failure when there are brain white matter hyperintensities (WMH) and acute stroke, others recover, and not everyone with brain white matter disease is disabled. Thus, repair or compensation of brain white matter may be possible, and furthermore, certain vascular risks, such as raised blood pressure, are targets for prevention of white matter disease or are administered to reduce the burden of such disease. Vascular risk modification may be useful, but alone may not be sufficient to prevent white matter disease progression. In this chapter, we specifically focus on WMH of vascular origin and explore white matter development, plasticity, and enduring processes of myelination across the health span in the context of experimental and human data, and compare and contrast resilient brain white matter propensity to a diseased white matter state. We conclude with thoughts on novel ways one might study white matter resilience, and predict future healthy cognitive and functional outcomes.

Original languageEnglish (US)
Article number193
JournalBrain Sciences
Issue number8
StatePublished - Aug 2019


  • Adaptive myelination
  • Aging
  • Brain magnetic resonance imaging (MRI)
  • Cognition
  • Gait
  • Oligodendrocyte progenitor cells
  • Oligodendrocytes
  • Small vessel disease
  • White matter

ASJC Scopus subject areas

  • General Neuroscience


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