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  Vol. 44 No. 1, January 1987 TABLE OF CONTENTS
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Cognitive and Neurologic Findings in Demented Patients With Diffuse White Matter Lucencies on Computed Tomographic Scan (Leuko-Araiosis)

Allan Steingart, MD; Vladimir C. Hachinski, MD; Catherine Lau, BScN; Allan J. Fox, MD; Hannah Fox, MBBS; Donald Lee, MB; Domenico Inzitari, MD; Harold Merskey, DM

Arch Neurol. 1987;44(1):36-39.


Abstract

• A series of patients referred to the University of Western Ontario, London, Dementia Study for investigation of possible dementia underwent computed tomographic scans, psychometric testing (Extended Scale for Dementia [ESD]), and neurologic examination. Thirty-nine of the 113 patients studied (ischemic score, ≤4) were found to have leuko-araiosis, which we have defined as patchy or diffuse lucencies in the white matter. Patients with leuko-araiosis had significantly lower mean scores on the ESD, 109.7 ± 61.2, compared with mean scores of 148.5 ± 78.0 in those without. However, only a trend toward lower scores on the ESD was observed when age, sex, education, and infarct were taken into account in the analysis of covariance. Leuko-araiosis was found to be associated with increasing age, hypertension, abnormalities of power in the limbs, and extensor-plantar responses in this sample of patients. In patients with Alzheimer's disease (AD) alone, diagnosed clinically, 29 out of 91 demonstrated leuko-araiosis on computed tomography, but scores on the ESD in this group overall were not significantly different when those with and without leukoaraiosis were compared. In less advanced cases, however, a highly significant trend was evident for leuko-araiosis to be associated with increased dementia in AD. The results are consistent with the hypothesis that leuko-araiosis is associated with dementia in AD, and that this is either most marked or most easily identifiable before the dementia becomes very severe.



Author Affiliations

From the Department of Education and Research, London Psychiatric Hospital (Drs Steingart, H. Fox, and Merskey, and Ms Lau); the Department of Clinical Neurological Sciences, University Hospital (Drs Hachinski, A. Fox, and Lee); the Robarts Research Institute (Drs Hachinski and Merskey, and Ms Lau), London, Ontario; and the Department of Neurology, University of Florence (Italy), Careggi Hospital (Dr Inzitari).


Footnotes

Accepted for publication Sept 17, 1986.

Reprint requests to the Department of Education and Research, London Psychiatric Hospital, 850 Highbury Ave, PO Box 2532, Terminal A, London, Ontario, Canada N6A 4H1 (Dr Merskey).



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