Changes in Brain White Matter Could Portend Dementia

New insights into physical changes in the brain offer the possibility of targeted early diagnosis and prevention of vascular dementia.

Researchers at the University Hospital de Santa Maria (Lisbon, Portugal) followed 639 subjects without dementia (aged 65 to 84) and investigated the extent and location of changes in the white matter of their brain during a period of three years; 90 of the subjects developed various forms of dementia during this period, primarily vascular dementia, Alzheimer's dementia, and a mixed form of the two. The researchers were able to demonstrate that periventricular leukoaraiosis-- specific symmetrical changes which can be detected with high resolution magnetic resonance imaging (MRI) in the white matter--was an independent indicator for the development of dementia, and should not be considered just as a symptom of old age. The results of the study were presented at the annual meeting of the European Neurological Society (ENS), held during June 2010 in Berlin (Germany).


"This finding deepens our understanding of vascular dementia. We can hope to build on this so that we are able in future to earlier detect and better prevent this form of mental decline which is so agonizing to those affected and their families,” said lead author and study presenter Bruno Miranda, M.D. "Further studies will demonstrate whether we can help people with leukoaraiosis in deep brain regions by aggressive treatment of the underlying diseases, such as high blood pressure or diabetes, to a better prognosis and prevent or at least delay the outbreak of vascular dementia.”

Vascular dementia develops (in contrast to Alzheimer's dementia) through pathological changes to blood vessels as a result of high blood pressure, diabetes, high blood fat levels, or smoking. While Alzheimer's disease primarily affects memory, vascular dementia causes abnormalities of the so-called executive brain functions, which are reliant on the connectivity of many regions of the brain, such as the ability to judge the cost/benefit relation of an offer and to make appropriate decisions.

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