SUBCORTICAL SYMPTOMS PREDOMINATE IN VASCULAR DEMENTIA

Thirty‐one patients with the clinical diagnosis of vascualar dementia were examined with regard to symptoms reflecting disturbances in various brain regions. Frontal, parietal, subcortical and non‐regional symptom complexes were used to characterize each patient. Frontal (77%) and subcortical (68%) symptoms were the most common clinical patterns. Using an overall evaluation, subcortical symptomatology was the most prominent clinical picture (45%) Extrapyramidal symptoms, an important aspect of the subcortical symptom complex, were associated with histories of hypertension (p<0.05) and low levels of 5‐hydroxyindoleacetic acid (p<0.05) in the spinal fluid. This study suggests that subcortical, and possibly also frontal, symptoms are typical and perhaps underestimated manifestations of vascular dementia and that they may reflect important pathogenetic pathways in this disorder. Copyright © 1991 John Wiley & Sons, Ltd.