White matter disease

[nomo]

<br>White matter disease takes away ability to make decisions; can be prevented<br><br>Provided by: Canadian Press<br>Written by: SHERYL UBELACKER<br>Mar. 6, 2006<br><br><!--EZCODE AUTOLINK START--><a href="http://bodyandhealth.canada.com/channel_health_news_details.asp?news_id=9443&news_channel_id=41&channel_id=41&rot=11">bodyandhealth.canada.com/...=41&rot=11</a><!--EZCODE AUTOLINK END--><br><br>TORONTO (CP) - Just when you might have thought there couldn't possibly be another chronic disease to worry about, doctors are raising alarm bells about a common affliction of the brain that can severely impair cognitive abilities later in life.<br><br>Unlike Alzheimer's, which progressively erodes memory, white matter disease gradually robs a person of the ability to make decisions, on everything from looking after finances and organizing one's day to choosing what to wear or what to eat for supper.<br><br>But what's important, doctors say, is that lesions affecting the white matter of the brain can be prevented with simple steps - and the earlier in life one starts, the better.<br><br>About 40 per cent of the brain is made up of white matter (the rest is called grey matter) and is the area where "all the wires" connect," said Dr. Sandra Black, head of neurology at Sunnybrook and Women's Health Sciences Centre in Toronto.<br><br>Lesions in the white matter can occur when blood supply is disrupted as a result of hardening of the tiny arteries that feed this portion of brain tissue; the damage mucks up the connecting pathways that allow for what's known as executive decision-making - the ability to plan and problem-solve.<br><br>These lesions "slowly strangle the brain," Black said in an interview Monday from the Rotman Research Institute Conference in Toronto, where she was presenting studies on the neurological disorder.<br><br>"It's a sort of covert operation. It's like sleeper cells that are waiting to sabotage little by little the quality of your mental life and your mood state, because they're associated with depression as well as cognitive decline."<br><br>Not only is the speed and agility of thinking compromised, but white matter disease can eventually throw off balance, affecting gait while walking, and lead to incontinence of bladder and bowels.<br><br>"This is something that is quietly happening in the brain and most people don't realize it's happening."<br><br>But the good news, said Black, is that white matter damage can be prevented by taking the same steps as those recommended for warding off heart attack and stroke.<br><br>Those include keeping blood pressure and cholesterol at healthy levels, not smoking, exercising regularly and eating right. People with diabetes need to keep a tight rein on blood-sugar, another risk factor for the cardiovascular disease that doctors now realize goes hand in hand with white matter disease.<br><br>"It's very much related to risk factors that are controllable," Black said. "It's important to know your blood pressure and have it under control when you're in your 30s and 40s (so) that you're going to have a better life when you're in your 60s and 70s."<br><br>Neurologists have known of white matter abnormalities since the advent of CT scans decades ago. But it wasn't until five or six years ago that a highly sensitive brain scan, called Diffusion Tensor Imaging (DTI), allowed doctors to see the extent and nature of the damage.<br><br>"This is an important disease that we're becoming more aware of with the imaging," said Black, adding that researchers are turning their attention to finding drugs that could slow the progression of the disease or even repair the damage. Currently, cognitive rehabilitation programs exist in some centres specifically aimed at helping people with white matter disease.<br><br>While adopting a healthy lifestyle at any age will lessen the risks of heart attack stroke, Alzheimer's and white matter disease, "the best investment is to do it young because you give yourself a better chance," she said.<br><br>"As we are surviving longer and longer, the quality of people's life and their mental life in older age is going to become absolutely crucial. Our bodies can survive, but if you can't think properly and you can't conduct your own life in the way you want to, will that be a life worth living?<br><br>"I think that's what we have to start bringing home to people."<br> <p></p><i></i>