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Trichotillomania in a dementia case

Leonardo Caixeta1, Danielly Bandeira Lopes2

  • 1M.D, Ph.D. Associate Professor of Neuroscience, Federal University of Goiás (UFG), Goiânia GO, Brazil. Coordinator, Cognitive and Behavioral Neurology Unit, Hospital das Clínicas (UFG).

Dementia & Neuropsychologia
|December 8, 2017
PubMed

Insights

This case study explores trichotillomania in an elderly male with Binswanger's disease. The hair pulling disorder, linked to white matter changes, persisted despite standard treatments.

Area of Science:

  • Neurology
  • Psychiatry
  • Neuroscience

Background:

  • Binswanger's disease is a form of white-matter vascular dementia.
  • Trichotillomania is an impulse control disorder characterized by compulsive hair pulling.

Observation:

  • An 87-year-old male patient presented with trichotillomania.
  • The patient had a diagnosis of white-matter vascular dementia (Binswanger's disease).
  • Standard treatments including mirtazapine and anticholinesterasic medications were ineffective.

Findings:

  • Trichotillomania in this case appeared related to perseveration, a cognitive symptom of dementia.
  • The study suggests white matter abnormalities contribute to trichotillomania pathogenesis.
  • A potential defect in the right frontal-subcortical circuit connectivity is implicated.

Implications:

  • This case highlights a potential link between white matter integrity and trichotillomania.
  • Findings suggest novel therapeutic targets may exist within the frontal-subcortical circuits for dementia-related trichotillomania.
  • Further research into white matter connectivity may elucidate the pathophysiology of impulse control disorders in neurodegenerative diseases.
Keywords:
Binswanger’s diseaseTrichotillomaniadementiaimpulse-control disorderperseveration

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