Binswanger's Disease (BD) | HealthInfi

About Binswanger’s Disease (BD)

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 BD-damaged brain tissue can be seen with modern brain imaging techniques such as CT scans or magnetic resonance imaging (MRI). The symptoms associated with BD are related to the disruption of subcortical neural circuits that control what neuroscientists callexecutive cognitive functioning: short-term memory, organization, mood, the regulation of attention, the ability to act or make decisions, and appropriate behavior.

Binswanger’s disease (BD) is a progressive form of cerebral small vessel disease (SVD) affecting the white matter (WM) and other subcortical structures. Advances in imaging have increased interest in understanding has arisen in the definitions, clinical presentations, differential diagnoses, risk factors and complications of BD.

Clinical and imaging features, neurophyschological profile and cerebrospinal fluid analysis aid in making the diagnosis. With recent developments in MRI methods and analysis of CSF and blood biomarkers, we have gained a greater understanding of the complex pathophysiology of the disease, which has helped with the diagnosis and prognosis of BD.

There is growing evidence that the WM injury in BD is related to endothelial dysfunction with secondary inflammatory response leading to breakdown of the neurovascular unit (NVU). This review summarizes current and future research directions, including pathophysiological mechanisms and potential therapeutic approaches.Read More