What matters in white matter dementia?

Area of Science:

• Neurology
• Neuroscience
• Geriatrics

Background:

• Dementia research has historically prioritized cerebral cortex and subcortical gray matter disorders.
• Cerebral white matter dementia subtypes remain under-explored, necessitating further investigation.

Purpose of the Study:

• To introduce and define the concept of "white matter dementia."
• To illustrate diverse white matter dementia subtypes through case studies.
• To review current literature on white matter dementia.

Main Methods:

• Presentation of five distinct case studies illustrating white matter dementia.
• Review of recent clinical and scientific literature on white matter dementia.

Main Results:

• Identified five illustrative cases: CADASIL, progressive subcortical gliosis, progressive multifocal leukoencephalopathy, normal-pressure hydrocephalus, and brain injury.
• Highlighted a characteristic symptom cluster including prominent psychiatric changes, neurological signs, and specific cognitive impairments.

Conclusions:

• The constellation of psychiatric, neurological, and cognitive symptoms strongly suggests white matter dementia.
• Differentiating white matter dementia from cortical or subcortical forms is essential for appropriate patient management.