[Diffusional anisotropy in cerebral white matter in patients with dementia]

We studied changes in water diffusion in cerebral white matter in 10 patients with Binswanger's disease (BD), 8 patients with Alzheimer's disease (AD) who had periventricular hyperintensity lesions on T2-weighted images, and 8 age-matched controls. The apparent diffusion coefficients measured in the anterior and posterior white matter were significantly higher in the patients than in the controls, but there was no significant difference between patients with BD and those with AD. The anisotropy ratios, difined as diffusion perpendicular to the nerve fiber direction, were higher in the patients than in the controls. The anisotropy ratio in the anterior white matter was significantly higher in patients with BD than in those with AD, while in the posterior white matter the ratio was significantly higher in patients with AD than in those with BD. These results suggest that in BD and AD cerebral white matter lesions such as periventricular hyperintensity lesions reflect a loss of myelin and axons, and that loss of myelin occurs preferentially in the anterior white matter in BD and in the posterior white matter in AD.