Binswanger's Disease

What is Binswanger's Disease?

Binswanger's disease (BD), also called subcortical vascular dementia, is a type of dementia caused by widespread, microscopic areas of damage to the deep layers of white matter in the brain. The damage is the result of the thickening and narrowing (atherosclerosis) of arteries that feed the subcortical areas of the brain. Atherosclerosis (commonly known as "hardening of the arteries") is a systemic process that affects blood vessels throughout the body. It begins late in the fourth decade of life and increases in severity with age. As the arteries become more and more narrowed, the blood supplied by those arteries decreases and brain tissue dies. A characteristic pattern of Binswanger's disease-damaged brain tissue can be seen with modern brain imaging techniques such as CT scans or magnetic resonance imaging (MRI).

What are the symptoms of Binswanger's disease?

The symptoms associated with Binswanger's disease are related to the disruption of subcortical neural circuits that control what neuroscientists call executive cognitive functioning:

  • short-term memory,

  • organization,

  • mood,

  • the regulation of attention,

  • the ability to act or make decisions, and

  • appropriate behavior.

The most characteristic feature of Binswanger's disease is psychomotor slowness - an increase in the length of time it takes, for example, for the fingers to turn the thought of a letter into the shape of a letter on a piece of paper.

Other symptoms include:

  • forgetfulness (but not as severe as the forgetfulness of Alzheimer's disease),

  • changes in speech,

  • an unsteady gait,

  • clumsiness or frequent falls,

  • changes in personality or mood (most likely in the form of apathy, irritability, and depression), and

  • urinary symptoms that aren't caused by urological disease.

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