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July 1990

Lower Body (Vascular) Parkinsonism

Author Affiliations

Department of Neurology Baylor College of Medicine 6550 Fannin, No. 1801 Houston, TX 77030

Arch Neurol. 1990;47(7):728. doi:10.1001/archneur.1990.00530070014003

To the Editor.  —I was very interested in the recent article in the Archives by Masdeu et al1 on the correlation between white matter hypodensity on computed tomography (CT) and impaired gait and balance in the elderly. The investigators excluded orthopedic, cognitive, sensory, and other neurologic reasons for the ambulatory problems and falls. While the fallers (66.7% of 20) were more likely to be demented than the controls (25.0% of 20), and the dementia could have contributed to the poor balance, I agree with their conclusion that the periventricular white matter disease, suggested by the abnormal CT scans, was primarily responsible for the abnormal gait and falls. Although CT may be less sensitive than magnetic resonance imaging (MRI) for detection of white matter changes, these MRI changes may be seen also in normal individuals.2 As noted by the authors, while the possible correlation between CT-MRI white matter changes

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