title: Clinical characteristics in subcortical ischemic white matter disease.
abstract: BACKGROUND
  Vascular white matter lesions (WML) represent one of the main neuroimage findings in individuals older than 65 years and its clinical significance is still partially understood.
  
  
  OBJECTIVE
  To describe and analyze the clinical profile of a high severity sample with WML focusing on the frontal executive control.
  
  
  METHODS
  Outpatients (n=20) with high severity WML evaluated with magnetic resonance imaging were selected using the Fazekas scale.
  
  
  RESULTS
  Most patients (n=17; 85%) presented an altered Trail Making Test ratio (section B/section A); on verbal fluency, 15 individuals (75%) performed below the cutoff score. Apathy (5.9 +/- 4.65) and depression (3.05+/-3.67) were frequent as assessed by the Neuropsychiatric Inventory. The impairment in functional activities strongly correlated with apathy (r=0.814, p<0.001) and verbal fluency (r=0.744, p<0.001).
  
  
  CONCLUSIONS
  Executive dysfunction, apathy, and ratio depression were the main characteristics found. Extension of WML may have distinct impact on the clinical picture, but further studies with methodological adjustments are necessary to provide more definitive conclusions.
authors: Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, RJ, Brazil. gsalves123@hotmail.com
authors: Gilberto Sousa
authors: GS
authors: Alves
authors: Carlos Eduardo de Oliveira
authors: CE
authors: Alves
authors: Maria Elisa de Oliveira
authors: ME
authors: Lanna
authors: Letice
authors: L
authors: Ericeira-Valente
authors: Felipe Kenji
authors: FK
authors: Sudo
authors: Denise
authors: D
authors: Moreira
authors: Eliasz
authors: E
authors: Engelhardt
authors: Jerson
authors: J
authors: Laks
mesh_terms: D000368:Aged; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D003430:Cross-Sectional Studies; D015140:Dementia, Vascular / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D056344:Executive Function / Q000502:physiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000209:etiology*; D009483:Neuropsychological Tests; D012720:Severity of Illness Index