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The Association between White Matter Lesions on Magnetic Resonance Imaging and Noncognitive Symptoms
Author(s) -
O'BRIEN JOHN,
PERRY ROBERT,
BARBER ROBERT,
GHOLKAR ANIL,
THOMAS ALAN
Publication year - 2000
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/j.1749-6632.2000.tb06403.x
Subject(s) - hyperintensity , dementia , basal ganglia , white matter , magnetic resonance imaging , depression (economics) , medicine , frontal lobe , pathology , psychology , dementia with lewy bodies , disease , radiology , psychiatry , central nervous system , macroeconomics , economics
A bstract : A number of studies have suggested that cerebral changes, particularly deep white matter lesions (WML) visualized on magnetic resonance imaging(MRI), may be involved in the genesis of late life depression. This has been confirmed in a prospective study which also found a relationship between the presence of WML and poor 3‐year outcome in elderly depressed subjects. Most studies find these lesions to predominate in frontal lobe and basal ganglia, supporting the hypothesis of “fronto‐striatal” dysfunction in depression. To investigate whether WML are associated with mood disturbance in dementia, proton density and T 2 ‐weighted images were obtained in 80 subjects with dementia (dementia with Lewy bodies, n = 27 ; Alzheimer's disease, n = 28 ; vascular dementia, n = 25 ) and 26 age‐matched normal controls. Periventricular lesions (PVL), white matter lesions (WML), and basal ganglia hyperintensities (BG) were visually rated blind to diagnosis using a semiquantitative scale. Frontal WML were associated with higher depression scores in patients with dementia, implying a common pathophysiology of depression irrespective of diagnosis. Further study of the neurobiological basis of WML is needed. This can best be achieved by serial clinical assessment combined with in vivo and in vitro MRI and neuropathological examination.