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January 1987

Cognitive and Neurologic Findings in Demented Patients With Diffuse White Matter Lucencies on Computed Tomographic Scan (Leuko-Araiosis)

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).

Arch Neurol. 1987;44(1):36-39. doi:10.1001/archneur.1987.00520130028013

• 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.

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