Binswanger's disease (BD)
- Article
- 2021-03-05
Binswanger's disease (BD), also called subcortical vascular dementia , is a form of dementia caused by widespread, microscopic damage to the deep layers of white matter in the brain. The damage results from the thickening and narrowing (atherosclerosis) of arteries supplying the subcortical regions of the brain. Atherosclerosis (commonly known as "hardening of the arteries") is a systemic process that affects blood vessels throughout the body. It starts late in the fourth decade of life and increases with age. As the arteries continue to narrow, the blood supplied by those arteries decreases and brain tissue dies. A characteristic pattern of brain tissue damaged by BD can be seen with modern brain imaging techniques such as CT scans or magnetic resonance imaging (MRI). executive cognitive functioning : short-term memory, organization, mood, regulation of attention, ability to act or make decisions, and appropriate behavior. The most characteristic feature of BD is psychomotor inertia - an increase in the time it takes the fingers, for example, to convert the thought of a letter into the form of a letter on a piece of paper. Other symptoms include forgetfulness (but not as severe as Alzheimer's disease forgetfulness), changes in speech, an unstable gait, clumsiness or frequent falls, changes in personality or mood (most likely in the form of apathy, irritability and depression ), and urinary symptoms not caused by urological conditions. Brain imaging, which reveals BD's characteristic brain lesions, is essential for a positive diagnosis.
Therapy
There is no specific treatment for BD. Treatment is symptomatic. People with depression or anxiety may need antidepressants, such as the serotonin-specific reuptake inhibitors (SSRI) sertraline or citalopram. Atypical antipsychotics, such as risperidone and olanzapine, may be useful in individuals with agitation and disruptive behavior. Recent drug studies with the drug memantine have shown improved cognition and stabilization of global functioning and behavior. The successful treatment of hypertension and diabetes can slow the progression of atherosclerosis and subsequently slow the progression of BD. Since there is no cure, the best treatment is preventative, early in the adult years, by controlling risk factors such as hypertension, diabetes and smoking.
Prognosis
BD is a progressive disease; there is no cure. Changes can be sudden or gradual and then incremental. BD can often coexist with Alzheimer's disease. Behaviors that slow the progression of high blood pressure, diabetes, and atherosclerosis - such as eating healthy and maintaining healthy wake / sleep schedules, exercising, and not smoking or drinking too much alcohol - can also slow the progression of BD.
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