ARE GAIT DISTURBANCES AND WHITE-MATTER DEGENERATION EARLY INDICATORS OF VASCULAR DEMENTIA

The objective of this study was to correlate clinical and brain imagin g findings with walking inabilities in patients with possible vascular dementia. For 24 patients with suspected initial vascular dementia ac cording to DSM-III-R, structured neurological, neuropsychological and neuroimaging (magnetic resonance tomography) examinations were evaluat ed alongside computerized gait analysis. Ah patients revealed an incre ased Variability of gait lines of various degrees: mild(11%), moderate (32%) and severe (57%). Lateralization of gait patterns was present i n 68% and bipedal instabilities of posture in 54%. These findings were significantly correlated with frontal periventricular white matter le sions (WMLs), which probably affect the thalamo-cortico-mediocapsular pathways. The association of gait abnormalities with WMLs of the front ocentral subcortical and periventricular territories in patients with possible vascular dementing illnesses maybe used as an early indicator of the disease for follow-up and treatment trials. However, since the degree of gait impairment varies considerably relative to the common mild intellectual limitations, these structural lesions are unlikely t o be directly related to the dementing process.