Home > Diagnosis, Types of dementia > What Is Binswanger’s Disease?

What Is Binswanger’s Disease?

Binswanger’s disease (also called “subcortical vascular dementia”) is a particular form of vascular dementia which was first described in 1894.  Dr. Otto Binswanger wrote about a patient who exhibited a dementia with slow progression, as well as subcortical white matter atrophy, ventricle enlargement, aphasia, hemianopsia, and hemiparesis.  He called the disease “encephalitis subcorticalis chronica progressive.”  But it was actually Dr. Alois Alzheimer, in 1902, who studied the disease further and gave it the name Binswanger’s disease.

The disease is characterized by a thickening and narrowing, or atherosclerosis, of the arteries that feed the subcortical areas of the brain (including the basal ganglia and thalamus).  This is a process that typically begins when a person is in his 40s, and continues through the 70s.  As the arteries become narrower and harder, the brain supply to the brain gradually diminishes and brain cells begin to die.  Most modern brain imaging techniques are able to allow doctors to see the brain damage that has occurred.

The symptoms associated with Binswanger’s disease most typically affect what is termed executive cognitive functioning.  This includes short-term memory, organization, mood, attention, decision-making, and appropriate behaviors.  The most pronounced characteristic of the disease is psychomotor slowness, or a marked increase in the amount of time that it takes the brain to process an action and to tell the body to carry it out.  Individuals with BD may also show forgetfulness (but not as severe as that seen in Alzheimer’s disease), changes in speech, gait problems, frequent falls, personality changes, and urinary symptoms.

BD is ultimately progressive in nature, as the blood vessels in the brain become increasingly blocked.  Because the disease affects the brain’s circulatory system, the individual with BD is at risk for stroke and other vascular incidents, which may produce a sudden worsening of symptoms.

There is no specific treatment that will provide a cure for Binswanger’s disease.  Most treatment is focused on relieving the symptoms associated with it.  Antidepressant and antipsychotic medications may be of help for some persons, and recent trials with drugs to improve cognitive functioning have yielded promising results.  Controlling the risk factors that contribute to atherosclerosis (for example, hypertension and diabetes) can also slow the progression of BD.  The best treatment at this time is actually prevention, in early adulthood, through lifestyle changes.

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