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

Eur Neurol. 2000;44(4):229-35. doi: 10.1159/000008242.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

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

Substances

  • Albumins
  • Serum Albumin