Symptoms, vascular risk factors and blood-brain barrier function in relation to CT white-matter changes in dementia.

Abstract

The aim was to study the frequently found white-matter changes on computerized tomography (CT) in patients with dementia and to relate these changes to clinical regional brain symptomatology, vascular factors, albumin ratio [indicator of blood-brain barrier (BBB) function] and other CT changes. The study included 85 patients, average age 71 +/- 8, with Alzheimer's disease (n = 56) and vascular dementia (n = 29), who underwent CT (Siemens Somatome DR 1) of the brain. They were inpatients in a psychiatric department specialized in dementia investigations. The degree of CT white-matter changes (absence, mild-moderate, severe) was the basis for the division of the patients into three groups. As the patients without white-matter changes were significantly younger than those with such changes, all statistical analyses were controlled for age. Subcortical symptomatology was significantly more frequent in the group with severe white-matter changes, whereas the reverse was true for parietal symptomatology. Diabetes mellitus, hypertension, ischemic cardiac disease and lacunas were significantly more common in patients with white-matter changes, whereas the frequency of transient ischemic attack/stroke episodes did not differ significantly between the groups. The albumin ratio was significantly higher in the groups with white-matter changes and highest in the group with severe white-matter changes. The findings indicate that white-matter changes in demented patients are at least partially an age- and stroke-independent disease manifestation of the vascular system and is associated with a specific symptom pattern. BBB dysfunction may be the link between the vasculature and the tissue damage.

• Authors: A Wallin, M Sjögren, A Edman, K Blennow, B Regland
• Journal: European neurology (Eur Neurol) Vol. 44 Issue 4 Pg. 229-35 ( 2000) ISSN: 0014-3022 [Print] Switzerland
• PMID: 11096223 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright 2000 S. Karger AG, Basel

Chemical References

• Albumins
• Serum Albumin

Topics

• Aged
• Albumins (cerebrospinal fluid)
• Blood-Brain Barrier (physiology)
• Brain Infarction (etiology, pathology)
• Cerebral Arteries (pathology, physiopathology)
• Cerebrovascular Disorders (complications, pathology, physiopathology)
• Dementia (etiology, pathology, physiopathology)
• Disease Progression
• Female
• Humans
• Male
• Nerve Fibers, Myelinated (pathology)
• Risk Factors
• Serum Albumin (metabolism)
• Telencephalon (blood supply, pathology, physiopathology)