People become more confused as they age, it turns out it's white matter disease

——Report on plain brain MRA examination and etiology analysis

Chief Physician of Shimashan Health Center, Lianyuan City, Hunan Province: Huang Yanhong

Member of China Science Writers Association: Duan Yuechu

White matter lesions are a common neurological disease in the elderly, and their impact on human health cannot be ignored. This article will combine relevant examination results and professional knowledge to comprehensively introduce the causes of white matter lesions, possible diseases and symptoms, treatment methods, and preventive measures.

1. Analysis of inspection results

Through the plain scan of the brain MRI, we can get the following examination findings:

1. Point-like and spot-like long T1 and long T2 signal foci can be seen in the deep supratentorial white matter on both sides, T2FLAIR shows high signal, and DWI shows no obvious diffusion restriction. This suggests that there may be mild lesions in the white matter, which may be caused by cerebral small vessel lesions caused by various factors, such as microvascular damage caused by hypertension, diabetes, hyperlipidemia, etc., and may also be related to age-related degenerative changes.

2. There are cap-shaped long T1 and long T2 signal foci beside the anterior and posterior horns of the bilateral lateral ventricles and pencil-thin lines beside the body of the lateral ventricles. T2FLAIR shows high signal, which is considered to be a manifestation of leukoaraiosis. Its pathogenesis may be related to cerebral ischemia, chronic cerebral hypoperfusion, etc.

According to these examination results, plain scan brain MRI showed high signals in the deep supratentorial white matter and periventricular white matter on both sides, with a Fazckas score of 1, which may be of vascular origin.

2. Possible diseases and symptoms

In the case of the above-mentioned plain brain MRA examination results, some neurological diseases may be caused:

1. Cerebrovascular disease: Cerebral small vessel disease may increase the risk of stroke (including ischemic stroke and hemorrhagic stroke).

2. Cognitive dysfunction: White matter lesions and leukoaraiosis may affect the brain's ability to transmit and process information, leading to decreased cognitive function, such as memory loss, inattention, and decreased thinking ability.

3. Emotional disorders: Some patients may experience emotional problems such as emotional instability, anxiety, and depression.

Possible symptoms include:

1. Neurological symptoms: may include headache, dizziness, limb numbness, fatigue, unsteady gait, etc.

2. Cognitive symptoms: such as memory loss, slow thinking, decreased judgment, etc.

3. Mental and emotional symptoms: mood swings, anxiety, depression, irritability, etc.

It should be noted that specific symptoms and disease manifestations vary from person to person, and these test results do not necessarily mean that the patient will develop the above diseases and symptoms. The doctor will conduct a comprehensive assessment and diagnosis based on the patient's specific situation, combined with other test results and clinical manifestations.

3. Treatment Methods

At present, the choice of drugs for treating white matter lesions needs to be determined according to the specific conditions of the patient. There is no "best drug" that is suitable for all patients. The following are some commonly used types of drugs, but specific medications must be used under the guidance of a doctor:

1. Drugs to control risk factors:

- Antihypertensive drugs: such as nifedipine, amlodipine, valsartan, etc., used to control high blood pressure.

- Hypoglycemic drugs: including metformin, insulin, etc., used to control diabetes.

- Lipid-lowering drugs: Common ones include atorvastatin, rosuvastatin, etc., which are used to lower blood lipids.

2. Drugs to improve cerebral circulation:

- Ginkgo biloba extract: can improve blood circulation in the brain.

- Butylphthalide: It improves the damage of central nervous system function in patients with acute ischemic stroke.

3. Neuroprotective drugs:

- Edaravone: can scavenge free radicals and reduce brain damage.

It should be noted that the efficacy and safety of drugs will vary from person to person. Doctors will consider the patient's age, condition, underlying diseases and other factors comprehensively to select the most appropriate drugs and treatment plans. At the same time, the treatment of white matter lesions does not only rely on drugs, but also includes comprehensive measures such as lifestyle adjustments and rehabilitation treatment. In recent reports, although there may be some new research results and drugs, the application of these drugs still needs to undergo rigorous clinical trials and approval procedures before they can be widely used in clinical treatment. Therefore, patients should follow the doctor's advice during treatment and not take medication on their own or pursue the so-called "best medicine."

Although there is no complete cure for cerebral small vessel disease and leukoaraiosis, active treatment and management can control the progression of the disease, relieve symptoms, and improve the quality of life. Treatment measures include:

1. Control risk factors: Actively treat underlying diseases such as hypertension, diabetes, and hyperlipidemia, and control blood pressure, blood sugar, blood lipids and other indicators within the ideal range through diet control, exercise, and drug therapy to reduce microvascular damage.

2. Improve cerebral circulation: Use some drugs to improve blood circulation in the brain, increase cerebral perfusion, and relieve cerebral ischemia.

3. Neuroprotective treatment: Use some drugs to protect nerve cells and reduce nerve damage.

4. Rehabilitation therapy: For patients who have already developed neurological symptoms, rehabilitation training, such as physical therapy, cognitive training, language training, etc., can help restore function.

5. Lifestyle adjustment: Maintaining a healthy lifestyle, such as a balanced diet, moderate exercise, smoking cessation and alcohol restriction, and maintaining a good attitude, is also very important for controlling the disease.

It should be noted that the treatment effect varies from person to person. Some patients may see significant improvement in symptoms, while others may only see a delay in the progression of the disease. Patients should actively cooperate with the doctor's treatment and undergo regular follow-up examinations so that the treatment plan can be adjusted in a timely manner.

4. The relationship between white matter lesions and dementia

Patients with white matter lesions are at risk of developing dementia, but not all patients with white matter lesions will develop dementia. White matter lesions may affect the brain's ability to transmit and process information. When the lesions are more severe or continue to progress, they may lead to cognitive decline and increase the risk of dementia. However, factors such as the extent of the lesions, individual differences, and whether active treatment and management measures are taken will affect the development of the disease.

If patients with white matter lesions can promptly detect and control related risk factors, such as high blood pressure, diabetes, and hyperlipidemia, actively undergo treatment and rehabilitation training, and improve their lifestyle, it is possible to slow the progression of the disease and reduce the risk of developing dementia. However, if the condition is not effectively controlled, cognitive dysfunction may gradually worsen and may develop into dementia. Therefore, patients with white matter lesions need to pay close attention to their condition, undergo regular checkups, and follow the doctor's advice for treatment and management to reduce the risk of dementia.

5. Measures to prevent white matter lesions

To prevent the occurrence of white matter lesions, you can start from the following aspects:

1. Control underlying diseases: Actively treat chronic diseases such as hypertension, diabetes, and hyperlipidemia, and control blood pressure, blood sugar, blood lipids and other indicators within normal ranges to reduce damage to cerebrovascular vessels.

2. Healthy Lifestyle:

- Balanced diet: Increase the intake of vegetables, fruits, whole grains, and low-fat proteins, and reduce the intake of high-salt, high-sugar, and high-fat foods.

- Moderate exercise: Maintaining at least 150 minutes of moderate-intensity aerobic exercise per week, such as brisk walking, jogging, swimming, etc., can help improve cardiopulmonary function and promote blood circulation.

- Quit smoking and limit alcohol consumption: Both smoking and excessive drinking can have adverse effects on vascular health and should be avoided as much as possible.

3. Manage weight: Maintaining a proper weight and avoiding obesity can reduce the risk of cardiovascular disease.

4. Reduce mental stress: learn to relax and reduce stress, avoid being in a state of tension and anxiety for a long time, and relieve stress through meditation, yoga, listening to music, etc.

5. Regular physical examinations: Get regular physical examinations, including brain imaging, to detect potential problems early and provide prompt treatment.

In short, by taking the above measures in combination, the occurrence of white matter lesions can be prevented to a certain extent. In addition to drug treatment, the following methods may also help relieve the symptoms of mild white matter lesions:

1. Healthy diet: Maintain a balanced diet, increase the intake of vegetables, fruits, whole grains, and low-fat proteins, and reduce the intake of saturated fats, trans fats, and high-sugar foods. Such a diet helps control blood pressure, blood sugar, and blood lipids, and is beneficial to improving cerebral blood circulation.

2. Moderate exercise: moderate aerobic exercise, such as walking, jogging, swimming, etc., can improve cardiopulmonary function, promote blood circulation, and help improve the brain's oxygen and nutrient supply. At the same time, exercise can also enhance the body's immunity and metabolic capacity.

3. Quit smoking and limit alcohol consumption: Smoking can damage vascular endothelial cells and aggravate vascular lesions; excessive drinking can also have adverse effects on the nervous system. Quitting smoking and limiting alcohol consumption can help reduce damage to cerebral blood vessels.

4. Psychological adjustment: Maintain a good attitude and avoid excessive tension, anxiety and depression. You can relieve psychological stress through meditation, relaxation training, psychological counseling, etc., which is also important for the health of the nervous system.

5. Intellectual training: Carrying out some cognitive training and intellectual activities, such as reading, playing chess, learning new skills, etc., can help maintain and improve the cognitive function of the brain.

6. Get enough sleep: Good sleep helps the brain repair and restore its functions. Maintain a regular schedule, create a good sleeping environment, and ensure you get enough sleep every day.

It should be noted that although these methods may help relieve symptoms to a certain extent, they cannot replace drug treatment. Patients should take a variety of treatment measures under the guidance of a doctor to achieve better treatment results.

In summary, white matter lesions are a neurological disease that needs to be taken seriously. By understanding its examination results, possible diseases and symptoms, treatment methods, and preventive measures, we can better understand and deal with this disease. In daily life, we should actively take preventive measures, maintain a healthy lifestyle, control underlying diseases, and have regular physical examinations to reduce the risk of white matter lesions. For patients who already have white matter lesions, they should seek medical attention in time and follow the doctor's advice for treatment and management to delay the progression of the disease and improve the quality of life.