What Is White Matter Disease?

Medically Reviewed by Christopher Melinosky, MD on April 14, 2022

White matter disease is the wearing away of tissue in the largest and deepest part of your brain that has a number of causes, including aging. This tissue contains millions of nerve fibers, or axons, that connect other parts of the brain and spinal cord and signal your nerves to talk to one another. A fatty material called myelin protects the fibers and gives white matter its color.

This type of brain tissue helps you think fast, walk straight, and keeps you from falling. When it becomes diseased, the myelin breaks down. The signals that help you do these things can’t get through. Your body stops working like it should, much like a kink in a garden hose makes the water that comes out go awry.

White matter disease happens in older or elderly people. There are ways to prevent or even reverse this condition, but you need to start now.

What Causes It?

Many different diseases, injuries, and toxins can cause changes in your white matter. Doctors point to the same blood vessel problems that lead to heart trouble or strokes:

It may be worse for women. You may also be more likely to get it if you have:

  • Diabetes
  • High cholesterol
  • Parkinson's disease
  • History of stroke

Genetics may also play a role.

What Are the Symptoms?

White matter helps you problem-solve and focus. It also plays an important role in mood, walking, and balance. So when something’s wrong with it, you might notice:

  • Trouble learning or remembering new things
  • A hard time with problem solving
  • Slowed thinking
  • Leaking urine
  • Depression
  • Problems walking
  • Balance issues and more falls

White matter disease is different from Alzheimer's, which affects the brain’s gray matter. If you're having memory problems or a loved one is, a doctor will need to run tests to make a diagnosis.

How Is It Diagnosed?

Advances in medical imaging have made white matter disease easier to spot. A magnetic resonance imaging (MRI) test, which takes pictures of the inside of your brain, can show any damage. Changes to white matter will show up super-bright white (your doctor may call this "hyperintense") on an MRI scan. You may need more tests to rule out other causes.

How Is It Treated?

There isn’t a specific treatment. The goal is to treat the cause of the damage and stop the disease from getting worse. Your doctor may prescribe medicines to lower your blood pressure or cholesterol. If you smoke, you should quit.

Can It Be Prevented?

Age-related white matter disease is progressive, meaning it can get worse. But you can take steps to stop it from spreading. Scientists think you might even be able to repair the damage, if you catch it early.

Keep your blood pressure and blood sugar in check. That can lead to white matter changes. To keep your heart healthy, follow a low-fat, low-salt diet, and get about 2 and a half hours of moderate-intensity exercise each week. Manage diabetes if you have it and keep your cholesterol in check. If you smoke, stop now.

Show Sources


American Physical Therapy Association, Section on Neurology: "White Matter Disease."

Filley, C.M. Therapeutic Advances in Neurological Disorders, September 2012.

HOPES Stanford University: "White Matter and HD."

The Dana Foundation: "Why the White Brain Matters."

Vasquez, B.P. Journal of Neuropsychology, Feb. 24, 2014.

Xiong, Y.Y. Journal of Aging Research, published online Aug. 23, 2011. 

Raz, N. Biochemica et Biophysica Acta (BBA) - Molecular Basis of Disease, March 2012.

Yang, D.W. Alzheimer's & Dementia, July 2010.

Schmahmann, J.D. Annals of the New York Academy of Sciences. October 2008.

UC Davis Health System: "White Matter Matters."

American Heart Association: "How to Prevent Heart Disease at Any Age."

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