NEUROPSYCHOLOGICAL, PSYCHIATRIC, AND CEREBRAL PERFUSION CORRELATES OFLEUKOARAIOSIS IN ALZHEIMERS-DISEASE

Objective-To examine neurological, neuropsychological, psychiatric, an d cerebral perfusion correlates of leukoaraiosis in Alzheimer's diseas e. Methods-A consecutive series of patients with probable Alzheimer's disease was assessed with a comprehensive neuropsychological battery, a structured psychiatric evaluation, the unified Parkinson's disease r ating scale, MRI, and single photon emission computed tomography with technetium 99m hexamethylpropyleneamine oxime (HMPAO) and regional cer ebral perfusion measurements. Results-Patients with Alzheimer's diseas e and leukoaraiosis were significantly more apathetic and had signific antly more extrapyramidal signs than patients with Alzheimer's disease without leukoaraiosis. Patients with Alzheimer's disease with leukoar aiosis also had significantly lower bilateral perfusion in the basal g anglia, thalamus, and frontal lobes than patients with Alzheimer's dis ease without leukoaraiosis. On the other hand, there were no significa nt differences between groups in age, duration of illness, depression scores, severity of delusions, or deficits on specific neuropsychologi cal tasks. Conclusions-Leukoaraiosis in Alzheimer's disease may produc e significant basal ganglia, and thalamic and frontal lobe dysfunction , which may be associated with more severe apathy and extrapyramidal s igns.