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The cerebral WM contains fiber pathways that convey axons linking cerebral cortical areas with each other and with subcortical structures, facilitating the distributed neural circuits that subserve sensorimotor function, intellect, and emotion. Recent neuroanatomical investigations reveal that these neural circuits are topographically linked by five groupings of fiber tracts emanating from every neocortical area: (1) cortico\u2010cortical association fibers; (2) corticostriatal fibers; (3) commissural fibers; and cortico\u2010subcortical pathways to (4) thalamus and (5) pontocerebellar system, brain stem, and\/or spinal cord. Lesions of association fibers prevent communication between cortical areas engaged in different domains of behavior. Lesions of subcortical structures or projection\/striatal fibers disrupt the contribution of subcortical nodes to behavior. Disconnection syndromes thus result from lesions of the cerebral cortex, subcortical structures, and WM tracts that link the nodes that make up the distributed circuits. The nature and the severity of the clinical manifestations of WM lesions are determined, in large part, by the location of the pathology: discrete neurological and neuropsychiatric symptoms result from focal WM lesions, whereas cognitive impairment across multiple domains\u2014WM dementia\u2014occurs in the setting of diffuse WM disease. We present a detailed review of the conditions affecting WM that produce these neurobehavioral syndromes, and consider the pathophysiology, clinical effects, and broad significance of the effects of aging and vascular compromise on cerebral WM, in an attempt to help further the understanding, diagnosis, and treatment of these disorders.<\/jats:p>","DOI":"10.1196\/annals.1444.017","type":"journal-article","created":{"date-parts":[[2009,8,11]],"date-time":"2009-08-11T08:07:53Z","timestamp":1249978073000},"page":"266-309","source":"Crossref","is-referenced-by-count":439,"title":["Cerebral White Matter"],"prefix":"10.1196","volume":"1142","author":[{"given":"Jeremy D.","family":"Schmahmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric E.","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian S.","family":"Eichler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher M.","family":"Filley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2008,10,23]]},"reference":[{"key":"e_1_2_15_2_2","volume-title":"Die historische Entwicklung der experimentellen Gehirn\u2010 und R\u00fcckenmarksphysiologie vor Flourens. 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