Skip to main content
PMC home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1991 Jan;54(1):46–50. doi: 10.1136/jnnp.54.1.46

Could Wallerian degeneration contribute to "leuko-araiosis" in subjects free of any vascular disorder?

D Leys 1, J P Pruvo 1, M Parent 1, P Vermersch 1, G Soetaert 1, M Steinling 1, A Delacourte 1, A Défossez 1, A Rapoport 1, J Clarisse 1, et al.
PMCID: PMC1014298  PMID: 2010759

Abstract

To determine the possible role of Wallerian degeneration secondary to the grey matter neuronal loss in the pathogenesis of "leuko-araiosis", computerised tomography (CT) of the brain was studied in 98 normotensive and non diabetic subjects free of cardiac diseases: 32 with Alzheimer's disease, 36 with Parkinson's disease, eight with progressive supranuclear palsy, and 22 controls. In Alzheimer's disease, leuko-araiosis scores were greater than in control subjects. Leuko-araiosis was more prominent in anterior periventricular areas in Parkinson's disease and progressive supranuclear palsy, and in posterior periventricular areas in Alzheimer's disease. In two patients with Alzheimer's disease and leuko-araiosis, necropsy revealed diffuse white matter pallor, mild fibrillary astrocytosis, and in one patient limited hyaline thickening of small white matter vessels, without any infarction or hypertensive change. Changes were more severe in white matter close to cortical areas with a great density of neurofibrillary tangles. Leuko-araiosis was more severe or more widespread in Alzheimer's disease than in Parkinson's disease, progressive supranuclear palsy and normal ageing. Differences in the location of leuko-araiosis between the four groups might be due to differences in the location of the grey matter disorder and Wallerian degeneration rather than amyloid in Alzheimer's disease, Parkinson's disease, progressive supranuclear palsy and normal ageing. Wallerian degeneration might be another cause of leuko-araiosis in neuro-degenerative disorders beside previously reported extra-cerebral predisposing factors and amyloid angiopathy.

Full text

PDF
48

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aharon-Peretz J., Cummings J. L., Hill M. A. Vascular dementia and dementia of the Alzheimer type. Cognition, ventricular size, and leuko-araiosis. Arch Neurol. 1988 Jul;45(7):719–721. doi: 10.1001/archneur.1988.00520310025011. [DOI] [PubMed] [Google Scholar]
  2. Brun A., Englund E. A white matter disorder in dementia of the Alzheimer type: a pathoanatomical study. Ann Neurol. 1986 Mar;19(3):253–262. doi: 10.1002/ana.410190306. [DOI] [PubMed] [Google Scholar]
  3. Cambier J., Masson M., Viader F., Limodin J., Strube A. Le syndrome frontal de la paralysie supranucléaire progressive. Rev Neurol (Paris) 1985;141(8-9):528–536. [PubMed] [Google Scholar]
  4. D'Antona R., Baron J. C., Samson Y., Serdaru M., Viader F., Agid Y., Cambier J. Subcortical dementia. Frontal cortex hypometabolism detected by positron tomography in patients with progressive supranuclear palsy. Brain. 1985 Sep;108(Pt 3):785–799. doi: 10.1093/brain/108.3.785. [DOI] [PubMed] [Google Scholar]
  5. De Reuck J., Crevits L., De Coster W., Sieben G., vander Eecken H. Pathogenesis of Binswanger chronic progressive subcortical encephalopathy. Neurology. 1980 Sep;30(9):920–928. doi: 10.1212/wnl.30.9.920. [DOI] [PubMed] [Google Scholar]
  6. Englund E., Brun A., Alling C. White matter changes in dementia of Alzheimer's type. Biochemical and neuropathological correlates. Brain. 1988 Dec;111(Pt 6):1425–1439. doi: 10.1093/brain/111.6.1425. [DOI] [PubMed] [Google Scholar]
  7. Folstein M. F., Folstein S. E., McHugh P. R. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov;12(3):189–198. doi: 10.1016/0022-3956(75)90026-6. [DOI] [PubMed] [Google Scholar]
  8. Goffinet A. M., De Volder A. G., Gillain C., Rectem D., Bol A., Michel C., Cogneau M., Labar D., Laterre C. Positron tomography demonstrates frontal lobe hypometabolism in progressive supranuclear palsy. Ann Neurol. 1989 Feb;25(2):131–139. doi: 10.1002/ana.410250205. [DOI] [PubMed] [Google Scholar]
  9. Gupta S. R., Naheedy M. H., Young J. C., Ghobrial M., Rubino F. A., Hindo W. Periventricular white matter changes and dementia. Clinical, neuropsychological, radiological, and pathological correlation. Arch Neurol. 1988 Jun;45(6):637–641. doi: 10.1001/archneur.1988.00520300057019. [DOI] [PubMed] [Google Scholar]
  10. Hachinski V. C., Potter P., Merskey H. Leuko-araiosis. Arch Neurol. 1987 Jan;44(1):21–23. doi: 10.1001/archneur.1987.00520130013009. [DOI] [PubMed] [Google Scholar]
  11. Huang K., Wu L., Luo Y. Binswanger's disease: progressive subcortical encephalopathy or multi-infarct dementia? Can J Neurol Sci. 1985 May;12(2):88–94. doi: 10.1017/s031716710004676x. [DOI] [PubMed] [Google Scholar]
  12. Inzitari D., Diaz F., Fox A., Hachinski V. C., Steingart A., Lau C., Donald A., Wade J., Mulic H., Merskey H. Vascular risk factors and leuko-araiosis. Arch Neurol. 1987 Jan;44(1):42–47. doi: 10.1001/archneur.1987.00520130034014. [DOI] [PubMed] [Google Scholar]
  13. Iseki E., Matsushita M., Kosaka K., Kondo H., Ishii T., Amano N. Distribution and morphology of brain stem plaques in Alzheimer's disease. Acta Neuropathol. 1989;78(2):131–136. doi: 10.1007/BF00688200. [DOI] [PubMed] [Google Scholar]
  14. Janota I., Mirsen T. R., Hachinski V. C., Lee D. H., Merskey H. Neuropathologic correlates of leuko-araiosis. Arch Neurol. 1989 Oct;46(10):1124–1128. doi: 10.1001/archneur.1989.00520460118023. [DOI] [PubMed] [Google Scholar]
  15. Kinkel W. R., Jacobs L., Polachini I., Bates V., Heffner R. R., Jr Subcortical arteriosclerotic encephalopathy (Binswanger's disease). Computed tomographic, nuclear magnetic resonance, and clinical correlations. Arch Neurol. 1985 Oct;42(10):951–959. doi: 10.1001/archneur.1985.04060090033010. [DOI] [PubMed] [Google Scholar]
  16. Loeb C., Gandolfo C. Diagnostic evaluation of degenerative and vascular dementia. Stroke. 1983 May-Jun;14(3):399–401. doi: 10.1161/01.str.14.3.399. [DOI] [PubMed] [Google Scholar]
  17. Loizou L. A., Kendall B. E., Marshall J. Subcortical arteriosclerotic encephalopathy: a clinical and radiological investigation. J Neurol Neurosurg Psychiatry. 1981 Apr;44(4):294–304. doi: 10.1136/jnnp.44.4.294. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. McKhann G., Drachman D., Folstein M., Katzman R., Price D., Stadlan E. M. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology. 1984 Jul;34(7):939–944. doi: 10.1212/wnl.34.7.939. [DOI] [PubMed] [Google Scholar]
  19. Rezek D. L., Morris J. C., Fulling K. H., Gado M. H. Periventricular white matter lucencies in senile dementia of the Alzheimer type and in normal aging. Neurology. 1987 Aug;37(8):1365–1368. doi: 10.1212/wnl.37.8.1365. [DOI] [PubMed] [Google Scholar]
  20. Steingart A., Hachinski V. C., Lau C., Fox A. J., Diaz F., Cape R., Lee D., Inzitari D., Merskey H. Cognitive and neurologic findings in subjects with diffuse white matter lucencies on computed tomographic scan (leuko-araiosis). Arch Neurol. 1987 Jan;44(1):32–35. doi: 10.1001/archneur.1987.00520130024012. [DOI] [PubMed] [Google Scholar]
  21. Steingart A., Hachinski V. C., Lau C., Fox A. J., Fox H., Lee D., Inzitari D., Merskey H. Cognitive and neurologic findings in demented patients with diffuse white matter lucencies on computed tomographic scan (leuko-araiosis). Arch Neurol. 1987 Jan;44(1):36–39. doi: 10.1001/archneur.1987.00520130028013. [DOI] [PubMed] [Google Scholar]
  22. Taylor A. E., Saint-Cyr J. A., Lang A. E. Frontal lobe dysfunction in Parkinson's disease. The cortical focus of neostriatal outflow. Brain. 1986 Oct;109(Pt 5):845–883. doi: 10.1093/brain/109.5.845. [DOI] [PubMed] [Google Scholar]
  23. Theodossi A., Skene A. M., Portmann B., Knill-Jones R. P., Patrick R. S., Tate R. A., Kealey W., Jarvis K. J., O'Brian D. J., Williams R. Observer variation in assessment of liver biopsies including analysis by kappa statistics. Gastroenterology. 1980 Aug;79(2):232–241. [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES