Symptoms, vascular risk factors and blood-brain barrier function in relation to CT white-matter changes in dementia.
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.
Wallin
A
A
Institute of Clinical Neuroscience, Göteborg University, Mölndal, Sweden. anders.wallin@ms.se
Sjögren
M
M
Edman
A
A
Blennow
K
K
Regland
B
B
D000368:Aged; D000418:Albumins / Q000134:cerebrospinal fluid; D001812:Blood-Brain Barrier / Q000502:physiology*; D020520:Brain Infarction / Q000209:etiology / Q000473:pathology; D002536:Cerebral Arteries / Q000473:pathology* / Q000503:physiopathology; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D003704:Dementia / Q000209:etiology* / Q000473:pathology* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism; D013687:Telencephalon / Q000098:blood supply / Q000473:pathology* / Q000503:physiopathology
D000418:Albumins; D012709:Serum Albumin