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PubMed1992

Effects of temperature on evoked electrical activity and anoxic injury in CNS white matter.

Temperature is known to influence the extent of anoxic/ischemic injury in gray matter of the brain. We tested the hypothesis that small changes in temperature during anoxic exposure could affect the degree of functional injury seen in white matter, using the isolated rat optic nerve, a typical CNS white matter tract (Foster et al., 1982). Functional recovery after anoxia was monitored by quantitative assessment of the compound action potential (CAP) area. Small changes in ambient temperature, within a range of 32 to 42 degrees C, mildly affected the CAP of the optic nerve under normoxic conditions. Reducing the temperature to < 37 degrees C caused a reversible increase in the CAP area and in the latencies of all three CAP peaks; increasing the temperature to > 37 degrees C had opposite effects. Functional recovery of white matter following 60 min of anoxia was strongly influenced by temperature during the period of anoxia. The average recovery of the CAP, relative to control, after 60 min of anoxia administered at 37 degrees C was 35.4 +/- 7%; when the temperature was lowered by 2.5 degrees C (i.e., to 34.5 degrees C) for the period of anoxic exposure, the extent of functional recovery improved to 64.6 +/- 15% (p < 0.00001). Lowering the temperature to 32 degrees C during anoxic exposure for 60 min resulted in even greater functional recovery (100.5 +/- 14% of the control CAP area). Conversely, if temperature was increased to > 37 degrees C during anoxia, the functional outcome worsened, e.g., CAP recovery at 42 degrees C was 8.5 +/- 7% (p < 0.00001). Hypothermia (i.e., 32 degrees C) for 30 min immediately following anoxia at 37 degrees C did not improve the functional outcome. Many processes within the brain are temperature sensitive, including O2 consumption, and it is not clear which of these is most relevant to the observed effects of temperature on recovery of white matter from anoxic injury. Unlike the situation in gray matter, the temperature dependency of anoxic injury cannot be related to reduced release of excitotoxins like glutamate, because neurotransmitters play no role in the pathophysiology of anoxic damage in white matter (Ransom et al., 1990a). It is more likely that temperature affects the rate of ion transport by the Na(+)-Ca2+ exchanger, the transporter responsible for intracellular Ca2+ loading during anoxia in white matter, and/or the rate of some destructive intracellular enzymatic mechanism(s) activated by pathological increases in intracellular Ca2+.

Animals↗
PubMed1996

Disorders of the cerebral white matter in children. The spectrum of lesions.

The use of magnetic resonance imaging (MRI) has resulted in the detection of an increasing number of children with an apparently leukodystrophic white matter. Laboratory tests and the clinical presentation, however, often do not correspond to any known entity and the course is sometimes not progressively deteriorating. Such children with white-matter changes and no known diagnosis were the subject of this Swedish multicentre study, in which MRI findings and clinical data from 100 children considered to have white-matter abnormalities were assessed during the period 1992-1995. At re-evaluation of MR images by an established "white-matter group" of neuroradiologists, paediatric neurologists, neurologists and neurochemists, the MRI signal of the white matter was considered normal in eleven children and eleven had mainly a grey matter affection. Of the remaining 78 children with white matter abnormalities, a diagnosis was found in 32, but in 46 children no diagnosis could be established. A progressive downhill course characterised 17, probably representing hitherto undefined types of leukodystrophies. Five children had a relapsing-remitting course, and in 11 it was difficult to establish whether the course was progressive or stationary. The disease was non-progressive in 13. This group of non-leukodystrophic white-matter changes obviously represents maldevelopments of myelin formation, thus dys- or hypomyelination rather than demyelination.

Adolescent↗
PubMed1998

Direct searches for dark matter: recent results.

There is abundant evidence for large amounts of unseen matter in the universe. This dark matter, by its very nature, couples feebly to ordinary matter and is correspondingly difficult to detect. Nonetheless, several experiments are now underway with the sensitivity required to detect directly galactic halo dark matter through their interactions with matter and radiation. These experiments divide into two broad classes: searches for weakly interacting massive particles (WIMPs) and searches for axions. There exists a very strong theoretical bias for supposing that supersymmetry (SUSY) is a correct description of nature. WIMPs are predicted by this SUSY theory and have the required properties to be dark matter. These WIMPs are detected from the byproducts of their occasional recoil against nucleons. There are efforts around the world to detect these rare recoils. The WIMP part of this overview focuses on the cryogenic dark matter search (CDMS) underway in California. Axions, another favored dark matter candidate, are predicted to arise from a minimal extension of the standard model that explains the absence of the expected large CP violating effects in strong interactions. Axions can, in the presence of a large magnetic field, turn into microwave photons. It is the slight excess of photons above noise that signals the axion. Axion searches are underway in California and Japan. The axion part of this overview focuses on the California effort. Brevity does not allow me to discuss other WIMP and axion searches, likewise for accelerator and satellite based searches; I apologize for their omission.

Journal Article↗
PubMed2004

Enhancement of the natural organic matter removal from drinking water by nanofiltration.

Finnish surface waters are abundant in natural organic matter. Natural organic matter can be removed from drinking water in a water treatment process by coagulation and filtration. The standard treatment operations are not able to remove the smallest molar mass fraction of organic matter and the intermediate molar mass matter is only partly removed. The removal of residual natural organic matter from drinking water by nanofiltration was evalueted in this study. Three different nanofiltration membranes were compared in filtering six pre-treated surface waters. The total organic carbon content of the feed waters varied from 2.0 to 4.2 mg l(-1). Other water quality parameters measured were conductivity, alkalinity, hardness, UV-absorbance, SUVA, E2/E3 value and molecular size distribution by high-performance size-exclusion chromatography. The natural organic matter removal efficiencies of the membranes were good and varied between 100% and 49%, and between 85% and 47% according to molecular size distribution and total organic carbon measurements, respectively. Removal of different molecular size fractions varied from 100% to 56%, 100% to 54% and 88% to 19%, regarding high molar mass, intermediate molar mass and low molar mass organic matter, respectively. The Desal-5 DL membrane produced the highest natural organic matter removals.

Carbon↗
PubMed1989

Severe nonfluency in aphasia. Role of the medial subcallosal fasciculus and other white matter pathways in recovery of spontaneous speech.

The relationship between location and extent of lesion on CT scan and limitation in spontaneous speech was examined. The severity of spontaneous speech ranged from cases with no speech or only verbal stereotypies (first major group) to those with reduced, hesitant, poorly articulated, agrammatic speech (nonfluent Broca's aphasia, second major group). CT scan analysis revealed no single neuroanatomical area that contained an extensive lesion which could be used to discriminate the most severe cases from the least severe. The two groups were separable, however, on the basis of the CT scan when the extent of the lesion in two subcortical white matter areas were combined: (1) the most medial and rostral portion of the subcallosal fasciculus plus (2) the periventricular white matter near the body of the lateral ventricle, deep to the lower motor/sensory cortex area for the mouth. The most rostral portion of the medial subcallosal fasciculus, located in the lateral angle of the frontal horn (extremely deep to Broca's area), contains projections from the cingulate gyrus (area 24) and the supplementary motor area, to the caudate nucleus. We suggest that one explanation for the more severe limitation in spontaneous speech in the first group is the extensive white matter lesion in these two subcortical pathways had interrupted a large number of connections for (1) initiation and preparation of speech movements, and limbic aspects of speech (lesions in the medial subcallosal fasciculus), and (2) motor execution and sensory feedback for spontaneous speech (lesions in periventricular white matter deep to the motor/sensory cortex area for the mouth). Extensive lesion in only one of these two white matter pathway areas, alone was not sufficient to produce long-lasting severe limitation in spontaneous speech and could not be used to discriminate the two groups on the basis of the CT scans. The patients with less severe limitation in spontaneous speech (nonfluent Broca's aphasia) had less extensive lesion within these two white matter areas combined, and had interrupted a smaller number of these subcortical connections. The sites of the lesions in subcortical white matter in CT scans in Broca's original case who could only produce a verbal stereotypy are similar to those in our first group with the most severe limitation in spontaneous speech. The presence or absence of hemiplegia was not related to severity or recovery of spontaneous speech. Careful examination of lesion extent in these two areas of subcortical white matter on CT scanning appears to be relevant in predicting potential for recovery of spontaneous speech in some stroke patients.

Adult↗
PubMed2004

Mapping cortical thickness and gray matter concentration in first episode schizophrenia.

We mapped regional changes in cortical thickness and intensity-based cortical gray matter concentration in first episode schizophrenia. High-resolution magnetic resonance images were obtained from 72 (51 male, 21 female) first episode patients and 78 (37 male, 41 female) healthy subjects similar in age. Cortical pattern matching methods allowed comparisons of cortical thickness and gray matter concentration at thousands of homologous cortical locations between subjects in three dimensions. Principal components analyses reduced measures obtained across the cortex to identify global differences in cortical thickness/gray matter concentration. First principal component factor scores showed significant effects of diagnosis, sex and age for both cortical measures. Diagnosis and age effects remained significant after brain size correction. Cortical thickness and gray matter concentration values were highly correlated. Statistical maps showed significant regional gray matter thinning in frontal, temporal and parietal heteromodal association cortices bilaterally in first episode patients. Regional reductions in cortical gray matter concentration were similar but pronounced in the superior temporal lobe. Regional reductions in cortical thickness and gray matter concentration are present at disease onset in brain regions linked with functional disturbances in schizophrenia. Cortical thickness and gray matter concentration mapping produce similar results, although the concentration metric may be influenced by diagnostic differences in extra-cortical cerebrospinal fluid and surface curvature/complexity.

Adult↗
PubMed1998

A model of dry matter partitioning in trees.

In mechanistic growth models, the description of assimilate allocation or dry matter partitioning plays a key role. Although theoretical concepts of allocation exist, they include many parameters that cannot be quantified. Therefore, many growth models use descriptive keys that represent the proportions of dry matter or carbohydrates assigned to each plant component. I have developed a model to describe the dynamic partitioning of dry matter in individual trees, and used it to investigate the effects of growth conditions on the partitioning pattern in Douglas-fir (Pseudotsuga menziesii (Mirb.) Franco) and beech (Fagus sylvatica L.). The model estimates the fractions of total available dry matter that should go to certain plant parts, based on the concept of structural balances. Both mechanistic and allometric relationships between tree components are used to model conditions for the dynamic distribution of dry matter. The model was to used to estimate the effects of dominance position, site conditions, and thinning on growth partitioning. The fractions of the annual current increment of total dry matter gradually changed with tree age, but the changes were relatively small, especially after age 20. Compared with beech, Douglas-fir invested more dry matter in foliage, especially at the cost of the branch and stem components. Trees of average basal area invested more dry matter in branches and less in stem than suppressed trees, and their estimated increase in stem diameter over time generally fitted the yield table data well. Stem diameter development was underestimated at higher ages only in the case of a Douglas-fir tree of average basal area on a poor site. Over time, the proportion of standing biomass in foliage and fine root fractions showed a gradual decline, whereas there was a gradual increase in the proportion of standing biomass in the stem fraction. These age-related changes were attributed to different loss rates among components. Analysis of the effects of thinning revealed that a discontinuous reduction in stem number results in a slow decrease in partitioning to the stem. The most obvious response to thinning consisted in a sharp decrease in partitioning to fine roots and foliage, and an increased investment in branches. Stem diameter growth appeared relatively constant in response to thinning, indicating that it will increase almost linearly with time. I conclude that the model is able to reproduce the development of an individual tree over time, both in terms of stem diameter and biomass. The model is thus suitable for simulating the effects of competition for resources on growth and development of forest stands.

Journal Article↗
PubMed1999

Breakdown of calcium homeostasis in relation to tissue depolarization: comparison between gray and white matter ischemia.

In vitro studies suggest that ischemic injury of cerebral white matter is mediated by nonsynaptic cellular mechanisms, such as Ca2+ entry into axons through reversal of the Na+ -Ca2+ exchanger. The authors investigated extracellular Ca2+ concentration in relation to tissue depolarization (direct current potential) in vivo using ion-selective electrodes in cortical gray and subcortical white matter of alpha-chloralose-anesthetized cats during 120 minutes of global cerebral ischemia. On induction of ischemia, regional CBF, as measured by hydrogen clearance, ceased. The direct current potential decreased rapidly within minutes in gray matter and with little time delay in white matter. Extracellular Ca2+ concentration decreased just as quickly in gray matter. In white matter, in contrast, extracellular Ca2+ increased in the first 20 to 30 minutes, and a delayed and much slower decline, compared with gray matter, was observed thereafter, reaching a minimal level only about 60 minutes after occlusion. Our results suggest that smaller and delayed transmembrane shifts of Ca2+ are correlates of delayed ischemic membrane dysfunction in central white matter tracts, which may be explained by a lack of synaptic mechanisms.

Action Potentials↗
PubMed1997

Particulate matter in the posterior semicircular canal.

The pathoetiology of benign paroxysmal positional vertigo (BPPV) is controversial. Particulate matter within the posterior semicircular canal has been identified intraoperatively in patients with BPPV but has also been reported in non-BPPV patients at the time of translabyrinthine surgery (Parnes LS, McClure JA. Free-floating endolymphatic particles: a new operative finding during posterior semicircular canal occlusion. Laryngoscope 1992;102:988-92; Schuknecht HF, Ruby RRF. Cupulolithiasis. Adv Otorhinolaryngol 1973;20: 434-43; Kveton JF, Kashgarian M. Particulate matter within the membranous labyrinth: pathologic or normal? Am J Otol 1994;15:173-6). The nature of the particulate matter remains unknown. The purpose of this study was to prospectively examine the posterior semicircular canal of patients with and without a clinical history of BPPV for the presence of particulate matter. Seventy-three patients without BPPV symptoms undergoing labyrinthine surgery (vestibular schwannoma excision or labyrinthectomy) and 26 patients with BPPV undergoing the posterior semicircular canal occlusion procedure were compared. Additionally, 70 archived temporal bones without a history of BPPV were examined microscopically for the presence of particulate matter within the lumen of the membranous labyrinth. No particles were observed intraoperatively in any of the 73 patients without a history of BPPV. Particulate matter was observed in 8 of 26 patients at the time of the posterior semicircular canal occlusion procedure for intractable BPPV. Of the 70 temporal bones examined, 31 did not show significant postmortem changes and also did not demonstrate cupulolithiasis or canalithiasis. Particulate matter from within the membranous posterior semicircular canal was removed from one patient at the time of posterior semicircular canal occlusion for intractable BPPV symptoms and was examined by scanning electron microscopy. The particulate matter appeared morphologically consistent with degenerating otoconia. These data show a statistically significant association between the presence of particles within the posterior semicircular canal in this study and the symptom complex of BPPV.

Ear, Inner↗
PubMed2000

Significance of white matter abnormalities in patients with closed head injury.

Neuroimaging in patients with closed head injury (CHI) may frequently reveal abnormalities of white matter. Because white matter abnormalities may be seen in patients aged over 40 years even without CHI, the significance of these abnormalities in patients with CHI is questionable and needs to be assessed in the context of relevance to clinical outcome. The aims of this study were to determine the relative incidence of white matter abnormalities in a group of patients with CHI, and to assess the impact (if any) of these abnormalities on clinical outcome. Sixty-three patients with CHI underwent neuroimaging with magnetic resonance imaging (MRI) and regional cerebral blood flow (rCBF) single photon emission tomography (SPET) approximately 6 months after trauma. Seven patients had white matter abnormalities on MRI scanning. There are no rCBF SPET criteria for defining abnormal perfusion to the white matter. The SPET scans ranged from normal (one patient) and abnormal perfusion to frontal, temporal or parietal lobes in these patients (n = 6). Patients were assessed for outcome after undergoing appropriate rehabilitation programmes with indices of reintegration into the community, activities of daily living, disability, and their cognitive ability to perform tasks. This assessment was conducted 2 years after initial trauma. Of these seven patients with abnormal MRI of the white matter, one performed poorly and six had moderate to good clinical outcome. When individual lobar perfusion is considered, abnormal perfusion to the frontal or temporal lobes was significantly associated with poorer outcome (P < 0.005). In conclusion, white matter abnormalities detected by MRI are frequently associated with cortical perfusion defects identified by SPET (6/7 or 86%). However, when these white matter abnormalities were accompanied by perfusion defects in the frontal and temporal lobes, these were statistically significant in predicting poorer outcome.

Activities of Daily Living↗
PubMed2004

Evolution of the dark matter distribution at the galactic center.

Annihilation radiation from neutralino dark matter at the Galactic center (GC) would be greatly enhanced if the dark matter were strongly clustered around the supermassive black hole (SBH). The existence of a dark matter "spike" is made plausible by the observed, steeply rising stellar density near the GC SBH. Here the time-dependent equations describing gravitational interaction of the dark matter with the stars are solved. Scattering of dark matter particles by stars would substantially lower the dark matter density near the GC SBH over 10 Gyr, due both to kinetic heating and to capture of dark matter particles by the SBH. This evolution implies a decrease by several orders of magnitude in the observable flux of annihilation products compared with models that associate a steep, dark matter spike with the SBH.

Journal Article↗
PubMed2005

Putaminal gray matter volume decrease in panic disorder: an optimized voxel-based morphometry study.

Our study aimed to identify gray matter volume differences between panic disorder patients and healthy volunteers using optimized voxel-based morphometry. Gray matter volume was compared between 18 panic subjects and 18 healthy volunteers. Panic disorder severity scale (PDSS) and Zung self-rating anxiety scale (Z-SAS) were administered. Gray matter volumes of bilateral putamen were decreased in panic subjects relative to healthy comparison subjects (corrected P < 0.05). Decreased gray matter volume was also observed in the right precuneus, right inferior temporal gyrus, right inferior frontal gyrus, left superior temporal gyrus, and left superior frontal gyrus at a less conservative level of significance. PDSS score negatively correlated with gray matter volume in the left putamen, right putamen, right inferior frontal gyrus, and left superior frontal gyrus in panic subjects. The duration of illness negatively correlated with left putaminal gray matter volume. There was also a negative correlation between gray matter volume in right putamen and Z-SAS score in panic subjects. The current study reports a putaminal gray matter volume decrease in panic subjects, which may be related to the clinical severity of panic disorder.

Adult↗
PubMed2001

Central role of microglia in neonatal excitotoxic lesions of the murine periventricular white matter.

Periventricular leukomalacia (PVL) is the main cause of neurologic handicap in pre-term infants. The understanding of cellular and molecular mechanisms leading to white matter damage is critical for development of innovative therapeutic strategies for PVL. The pathogenesis of PVL remains unclear but possibly involves glutamate excitotoxicity as an important molecular pathway. We previously described a neonatal mouse model of excitotoxic white matter lesion mimicking human PVL. In the present study, we used this experimental tool to investigate the cellular populations and the glutamate receptor subtypes involved in excitotoxic white matter lesions. Combined immunohistochemical, electron microscopic, and cell death detection data revealed that microglial activation and astrocytic death were the primary responses of white matter to excitotoxic insult. In vitro experiments suggested that microglia activated by ibotenate released soluble factors that kill astrocytes. The use of selective agonists and antagonists of glutamate receptors revealed that N-methyl-D-aspartate (NMDA) receptor activation was essential and sufficient to produce cystic white matter lesions. NMDA receptor immunohistochemistry labeled microglial cells in the neonatal periventricular white matter. The developing white matter displayed a window of sensitivity to excitotoxic damage that was paralleled by the transient presence of NMDA receptor-expressing white matter cells. Assuming that similar pathophysiologic mechanisms are present in human pre- term infants, microglia and NMDA receptors could represent key targets for treatment of PVL.

Animals↗
PubMed2001

Prolonged gray matter disease without demyelination caused by Theiler's murine encephalomyelitis virus with a mutation in VP2 puff B.

Theiler's murine encephalomyelitis virus (TMEV) is divided into two subgroups based on neurovirulence. During the acute phase, DA virus infects cells in the gray matter of the central nervous system (CNS). Throughout the chronic phase, DA virus infects glial cells in the white matter, causing demyelinating disease. Although GDVII virus also infects neurons in the gray matter, infected mice developed a severe polioencephalomyelitis, and no virus is detected in the white matter or other areas in the CNS in rare survivors. Several sequence differences between the two viruses are located in VP2 puff B and VP1 loop II, which are located near each other, close to the proposed receptor binding site. We constructed a DA virus mutant, DApBL2M, which has the VP1 loop II of GDVII virus and a mutation at position 171 in VP2 puff B. While DApBL2M virus replicated less efficiently than DA virus during the acute phase, DApBL2M-induced acute polioencephalitis was comparable to that in DA virus infection. Interestingly, during the chronic phase, DApBL2M caused prolonged gray matter disease in the brain without white matter involvement in the spinal cord. This is opposite what is observed during wild-type DA virus infection. Our study is the first to demonstrate that conformational differences via interaction of VP2 puff B and VP1 loop II between GDVII and DA viruses can play an important role in making the transition of infection from the gray matter in the brain to the spinal cord white matter during TMEV infection.

Amino Acid Sequence↗
PubMed2006

Bilateral grey-matter increase in the putamen in primary blepharospasm.

BACKGROUND: Primary blepharospasm is a focal dystonia characterised by excessive involuntary closure of the eyelids. The pathophysiology of primary blepharospasm is unresolved. AIM: To pinpoint grey-matter changes that are associated with primary blepharospasm. METHODS: 16 right-handed patients with primary blepharospasm (mean age 67.4 (SD 4.3) years; 12 women) were compared with 16 healthy volunteers matched for sex and age. High-resolution T1-weighted magnetic resonance imaging of each participant was obtained and analysed by voxel-based morphometry, a method to detect regionally specific differences in grey matter between patients and control group. To evaluate whether the identified grey-matter changes were correlated with the duration of primary blepharospasm or botulinum neurotoxin treatment (BoNT), separate regression analyses were carried out. RESULTS: In patients with primary blepharospasm, grey-matter increase in the putamina was observed, whereas regression analyses did not indicate a correlation between grey-matter increases and the duration of primary blepharospasm or BoNT. Grey-matter decrease was detected in the left inferior parietal lobule; here regression analyses of grey-matter decrease showed a significant (p = 0.013) correlation of grey-matter decrease with the duration of BoNT. CONCLUSIONS: The data suggest structural changes in primary blepharospasm and point to a crucial role of the putamen for the pathophysiology of this focal dystonia.

Aged↗
PubMed1981

Using computed tomography of the brain to correlate low white-matter attenuation with early gestational age in neonates.

Computed tomographic brain scans of the newborn exhibit relatively greater lucency of white matter compared to the mature patient. This study correlated the x-ray attenuation of white matter with gestational age in 23 neonates, both premature and term. The gray-white matter attenuation difference was calculated and plotted versus advancing gestational age. An inverse correlation was found between the gray-white matter density difference and advancing gestational age. Statistical analysis revealed that this phenomenon is due to increasing white matter density in the first months of life with the gray matter showing no significant variation with advancing age. The low attenuation value of white matter in the perinatal period and its subsequent increase is a normal phenomenon; it correlates with the greater water and lower protein content of premyelinated white matter initially, followed by subsequent water loss and protein gain with myelination. Since transient cerebral edema due to hypoxia exhibits similar low attenuation with CT, it is difficult to exclude this entity in the premature infant group where accurate neurologic evaluation is hard to obtain.

Brain↗
PubMed1992

Alterations in brain phosphorus metabolite concentrations associated with areas of high signal intensity in white matter at MR imaging.

Areas of high signal intensity in white matter are identified on brain magnetic resonance (MR) imaging studies in 25%-50% of elderly subjects. The authors used phosphorus-31 MR spectroscopy to characterize the metabolic status of hemispheric white matter brain volumes in 30 elderly subjects with white matter areas of high signal intensity at MR imaging. Compared with white matter volumes with no or minimal areas of high intensity, white matter volumes with extensive areas of high intensity evidenced a 26% decrease in the adenosine triphosphate (ATP)/inorganic phosphate (Pi) ratio (P = .03) and a 21% decrease in the ATP concentration (P = .05), with the Pi level unchanged. A pilot P-31 spectroscopic imaging study in a subject with a large, coalescing white matter area of high signal intensity demonstrated large reductions in metabolite concentrations in the high-signal-intensity area. These results suggest that extensive white matter areas of high signal intensity indicate a process that affects white matter cellular energy metabolism.

Adenosine Triphosphate↗
PubMed2000

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.

Aged↗