Cerebral white matter changes in deficit and non-deficit subtypes of schizophrenia

Background: Cerebrovascular pathologies and hypertension could play a vital role in Alzheimer disease (AD) progression. However, whether cerebrovascular pathologies and hypertension accelerate the AD progression through an independent or interaction effect is unknown. Objective: To investigate the effect of the interactions of cerebrovascular pathologies and hypertension on AD progression. Method: A retrospective longitudinal study was conducted to compare AD courses in patients with different severities of cerebral White Matter Changes (WMCs) in relation to hypertension. Annual comprehensive psychometrics were performed. WMCs were rated using a rating scale for Age-related WMCs (ARWMC). Results: In total, 278 patients with sporadic AD were enrolled in this study. The mean age of the patients was 76.6 ± 7.4 years, and 166 patients had hypertension. Among AD patients with hypertension, those with deterioration in clinical dementia rating-sum of box (CDR-SB) and CDR had significantly severe baseline ARWMC scales in total (CDR-SB: 5.8 vs. 3.6, adjusted P = 0.04; CDR: 6.4 vs. 4.4, adjusted P = 0.04) and frontal area (CDR-SB: 2.4 vs. 1.2, adjusted P = 0.01; CDR: 2.4 vs. 1.7, adjusted P < 0.01) compared with those with no deterioration in psychometrics after adjustment for confounders. By contrast, among AD patients without hypertension, no significant differences in ARWMC scales were observed between patients with and without deterioration. Conclusion: The effect of cerebrovascular pathologies on AD progression between those with and without hypertension might differ. An interaction but not independent effect of hypertension and WMCs on the progression of AD is possible.

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Serial Clinical and MRI Study of Diffuse Cerebral White Matter Changes in Multiple Sclerosis

Imaging of Brain Metabolism Spine and Cord Interventional Neuroradiology Free Communications ◽

10.1007/978-3-642-74337-5_119 ◽

1989 ◽

pp. 419-423 ◽

Cited By ~ 1

Author(s):

M. Brainin ◽

Th. Reisner ◽

E. Maida ◽

A. Neuhold ◽

L. Wicke ◽

...

Keyword(s):

Multiple Sclerosis ◽

White Matter ◽

Cerebral White Matter ◽

White Matter Changes ◽

Mri Study

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098 A case of delayed post-hypoxic leukoencephalopathy complicating drug overdose

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2019-anzan.86 ◽

2019 ◽

Vol 90 (e7) ◽

pp. A32.1-A32

Author(s):

Min Fong ◽

Nicholas Rigby ◽

Paul Pun ◽

Roger Mitchell ◽

Daniel Schweitzer ◽

...

Keyword(s):

White Matter ◽

Single Case ◽

Neuropsychiatric Symptoms ◽

Bipolar Affective Disorder ◽

Cerebral White Matter ◽

High Signal ◽

White Matter Changes ◽

Hypoxic Event ◽

Diffusion Weighted Images ◽

Single Case Report

IntroductionDelayed post-hypoxic leukoencephalopathy (DPHL) is a syndrome characterised by neurological deterioration following a period of recovery after an initial hypoxic event with striking white-matter change on magnetic resonance imaging. We present a case characterised by insidious onset and a fluctuating course of cognitive and neuropsychiatric symptoms.MethodsSingle case report.ResultsA 61 year old lady, with a background history of previously well managed bipolar affective disorder, was found unresponsive following an intentional overdose of temazepam and tramadol. She was hypotensive, hypoxic and required ventilatory and inotropic support. Following extubation, the patient had residual left-sided weakness and MRI confirmed a right frontal watershed infarction. A three week period of clinical improvement was followed by marked deterioration firstly with fluctuating mood and other neuropsychiatric symptoms which progressed to severe impairment of cognition and alertness. There was generalised slowing on the EEG and the CSF was unremarkable. Repeat neuroimaging undertaken on day 41 of the admission, revealed new symmetric and confluent cerebral white matter changes with high signal on the Diffusion Weighted Images (DWI) and Fluid Attenuated Inversion Recovery (FLAIR) images. The patient was managed with supportive care and sustained a clinically significant recovery (MOCA 26/30), despite ongoing cognitive impairments including working memory and deficits in social cognition including mood instability and disinhibition. Repeat neuroimaging 3 months after initial presentation revealed partial resolution of the white matter changes.ConclusionA diagnosis of DPHL should be considered in patients with variable mood and cognition following initial improvement after a hypoxic event.

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