PERIVENTRICULAR WHITE-MATTER ALTERATIONS, DEMENTIA, AND BINSWANGERS-DISEASE

Although periventricular white matter alterations (PWMA) are commonly reported on magnetic resonance imaging (MRI) scans of elderly individu als, a consistent pattern of neuropsychological deficits has yet to be found. However, there are some findings suggesting that executive fun ctions (Luria, 1980) are more impaired than other areas of neuropsycho logical functioning. We undertook a prospective study of two groups of elderly demented patients with and without PWMA as measured by MRI. T he results demonstrated that subjects with greater white matter altera tions performed worse on some executive function tests (e.g., Trail Ma king Test-Part B and competing programs/go-no-go), whereas there were no differences in other areas of neuropsychological functioning. There were no between-group differences on the Modified Ischemic Scale (Ros en, Terry, Fuld, Katzman, & Peck, 1980) or on measures of depression. Other pertinent clinical and methodological issues related to the clin ical presentation of PWMA, as well as Binswanger's disease, are discus sed.