The neuropsychiatry of subcortical ischemic brain disease

The subcortical regions of the brain, by virtue of their extensive connections to neocortical and limbic structures, play an important role in the regulation of neurobehavioral functions such as mood, memory, and affect. Compromise of the blood supply to the subcortex and its connections result in behavioral syndromes that often include disturbances in cognition and mood. The extent of the underlying vascular pathology and the precise circuits compromised, in general, determine the nature of the behavioral problems. The neurobiologic mechanisms responsible for these behaviors are complex and clinical management is symptomatic and largely aimed at treating the primary clinical features with appropriate pharmacologic and behavioral approaches.