Comparison of imageology, electrophysiology and clinical characteristics between simple leukoaraiosis and Binswanger's disease

Linping LIANG; Lei WANG; Hongzhi GUO; Wenqing LIU

ABSTRACT

BACKGROUND:

Leukoaraiosis is a group of changes in image. Since the firm pathogenic mechanism on leukoaraiosis has been unknown, the evaluation at the earlier stage of the disease has not been emphasized commonly and there is rather less recognition of the alternations on its electrophysiological system.

OBJECTIVE:

To probe into the clinical characteristics and alternations on image and evoked potential in simple leukoaraiosis and subcortical arteriosclerotic encephalopathy(Binswanger' s disease) and carry on the comparison with healthy people.

DESIGN:

Retrospective comparative study based on patients and healthy people.

SETTING:

Department of neurological internal medicine of one university hospital and department of neurological internal medicine of one railway central hospital.

PARTICIPANTS:

Outpatients or inpatients with cerebral vascular disorders in Qilu Hospital Affiliated to Shandong University were collected from August 1995 to March 2000. Totally 114 cases were leukoaraiosis, of which, 79 cases were males and 35 cases females. And 41 cases were Binswanger' s disease,of which, 28 cases were males and 13 cases females. Fifty healthy aged people who received routine physical check were randomized from the clinic of the hospital as the control.

METHODS:

The analysis was carried on the risk factors, clinical characteristics and CT exam in 114 cases of leukoaraiosis and 41 cases of Binswanger' s disease, of which, 74 leukoaraiosis cases and 35 Binswanger' s disease cases had received cranial MRI exam. Of those, 43 cases of simple leukoaraiosis associated with hypertension, 30 cases of Binswanger' s disease and 50 cases in the normal control were selected to carry on the examinations of body-sensory evoked potential, brain stem auditory evoked potential and visual evoked potential.coronary heart disease, diabetes, hyperlipemia, smoke, cerebral apoplexy,evoked potential and visual evoked potential.

RESULTS:

According to practical management analysis, 114 cases of leukoaraiosis, 41 cases of Binswanger' s disease and 50 cases in the control were diversification, mainly characterized as slightly declining of memory and loss of gait stability. Hypertension is predominated anong risk factors in Binswanger' s disease group (95.1% ), mainly characterized as physical signs of local neural focus, obvious cognitive disturbance and cerebral in CT exam that 70.2% (80/114) of cases presented brain whiter-matter abnormity in type Ⅰ. It was indicated in MRI exam that 72% (53/74) of cases presented brain whiter-matter abnormity, type Ⅰ, 27% (20/74) presented type Ⅱ and 1% (1/74) presented type Ⅲ. For Binswanger's disease patients, it was indicated in MRI exam that 54% (19/35) of cases presented brain white-matter abnormity, type Ⅲ, and 46% (16/35) presented type Ⅳ.Symmetrical extension of bilateral ventricles presented in Binswanger' s disbody-sensory evoked potential was 84% (36/43), of which, the mild abnormity occupied 60% (26/43) and moderate abnormity 23% (10/43); The abnormity rate of brain stem auditory evoked potential was 63% (27/43) and that of visual evoked potential was 54% (23/43). In Binswanger' s disease group, the abnormity rate of body-sensory evoked potential was 97% (29/30),of which, mild abnormity was 7% (2/30), moderate abnormity was 47%(14/30) and severe abnormity was 43% (13/30); The abnormity rate of brain stem auditory evoked potential was 87% (26/30) and that of auditory evoked potential was 83% (25/30).

CONCLUSION:

The risk factors of simple leukoaraiosis are diversified,without obvious physical signs of local neural focus. The diagnosis of it is mainly depended on abnormity Ⅰ of brain white matter described in images,manifested as remarkable dysfunction of cerebral eletrophysiology. Binswanger' s disease patients are mainly characterized as hypertension, relevantly obvious cognitive disturbance and common seizure of cerebral apoplexy. Abnormity Ⅲ of brain white matter indicated in CT exam, abnormity Ⅲ or Ⅳ of that in MRI exam are the image evidence for diagnosis. Remarkable abnormity also presents in cerabral electrophysiology, in which, abnormal body-sensory evoked potential is especially significant.