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KMID : 0960920020010010029
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Dementia and Neurocognitive Disorders
2002 Volume.1 No. 1 p.29 ~ p.33
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Clinical Significance and Risk Factor Analysis of Cerebral White Matter Changes
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Lee Ae-Young
Sohn Eun-Hee
Kim Tae-Woo
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Abstract
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Background: Cerebral white matter changes can be observed frequently in Alzheimer’s disease or healthy elderly as well as vascular dementia. The clinical significance and injury mechanism of celebral white matter changes have not been clarified.
Objectives: To evaluate the significance of cerebral white matter changes in elderly patients.
Methods: We assessed cognitive function and radiological features in patients with white matter changes to evaluate the effect of cerebral white matter changed and cortical and central brain atrophy on cognition. Grading of white matter changes was measured by the Scheltens scale. The cortical atrophy was graded with visual inspection by two independent neurologists and the central atrophy was assessed with ventricular indices. The cognitive status was evaluated with Mini-Mental State examination and the modified Mini-Mental State examination.
Results: Identified risk factors for white matter changes were older age, hypertension, and female gender. The degree of cerebral white matter changes was significantly associated with cognitive disturbances and their main effect on
cognition was fluency and attention deficits. There was no difference in the severity of cortical atrophy between the two groups. Visual rating for cortical atrophy and measurement of ventricular indices showed good intra- and inter-observer reliability.
Conclusion: Our results support the hypothesis that cerebral white matter changes contribute to congnitive disturbances, especially frontal lobe dysfunctions in elderly irrespective of cortical brain atrophy.
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KEYWORD
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White matter changes, Scheltens scale, Cortical atrophy
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