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Decrease in nerve fibres in cerebral white matter in progressive subcortical vascular encephalopathy of Binswanger
H Yamanouchi1, S Sugiura, M Tomonaga
1Department of Neurology, Tokyo Metropolitan Geriatric Hospital, Japan.
Journal of Neurology
|October 1, 1989
Summary
Progressive subcortical vascular encephalopathy (PSVE) causes dementia due to significant loss of nerve fibers in frontal white matter. This nerve fiber loss, not myelin thinning, underlies the observed cognitive decline in PSVE patients.
Area of Science:
- Neuropathology
- Neurodegenerative Diseases
- Vascular Dementia
Background:
- Progressive subcortical vascular encephalopathy (PSVE) is characterized by dementia.
- The histopathological basis of dementia in PSVE, particularly white matter changes, requires detailed investigation.
Purpose of the Study:
- To examine white matter alterations in the frontal lobes of PSVE cases.
- To elucidate the histopathological underpinnings of dementia in PSVE.
- To compare these changes with control groups and Alzheimer's disease.
Main Methods:
- Electron microscopy was employed to analyze frontal white matter.
- Seven cases of PSVE were compared with control subjects and cases of senile dementia of Alzheimer's type (SDAT).
Main Results:
- A significant reduction in nerve fiber density was observed in the white matter of PSVE patients compared to controls and SDAT.
- While a trend towards thinner myelin sheaths was noted in PSVE, this difference was not statistically significant.
- Frontal white matter pallor in PSVE is primarily attributed to nerve fiber loss, potentially exacerbated by thinner myelin.
Conclusions:
- The dementia observed in PSVE is likely associated with the loss of nerve fibers within the cerebral white matter.
- Frontal white matter changes, specifically axonal loss, are a key feature of PSVE.
- These findings differentiate PSVE from SDAT in terms of white matter pathology.