White Matter Disease & Decision Making

White matter disease, leukodystrophy, gradually takes away the ability to form or make decisions. Lesions form when blood supply is disrupted, resulting in hardening of the arteries which feed the brain tissue. These block the connecting pathways which allow a person to think, plan and problem-solve. Disorders involving the cerebral white matter can be exclusive or in combination with gray matter changes. Gray matter is responsible for processing, while the white matter is responsible for passing the results of that processing to the other parts of the brain.

Diagnosing white matter diseases

• Laboratory tests and clinical examination, along with subjective complaints of the patient or family, are vital in determining if a white matter disease is the root of the problem. CT scans and MRI studies will show defects associated with this disease. Minimal damage is not detectable on tests. Strokes are one cause of white matter disease; causing limited blood flow to the brain will damage the white matter. Multiple sclerosis is the most common form of this disease.

Symptoms

• There are a multitude of symptoms including visual, motor, sensory and cognitive problems. Blurred vision as well as double vision has been reported with abnormal pupil response to stimuli. Some patients have difficulty controlling eye movements, such as having "jerky" eye movements. Weakness, paralysis, twitching and involuntary limb movements are common problems. Strange sensations and tingling of the limbs are also symptoms recognized with this disease.

Cognitive symptoms

• Decision-making is affected by white matter disease. Short-term and long-term memory problems, forgetfulness and slow word recall are common problems in patients with this disease. Impairment to speech comprehension (dysphasia) and production of speech (aphasia) are also difficulties with white matter diseases. However, performance accuracy of cognitive functioning is rarely affected; it is the speed of the performance which typically is altered. Cognitive dysfunction is most severe in the secondary progressive form of the disease. This phase is when disability begins for the patient.

Other symptoms

• There are other symptoms associated with white matter disease. They include fatigue, gastroesophageal reflux and sleeping disorders. The development of cold body parts has also been noted. Uhthoff's syndrome is when small increases in body temperature (hyperthermia) caused by exercise, hot baths or showers worsen the symptoms of white matter disease.

Prevention

• White matter disease can sometimes be prevented by following the same steps as those recommended for warding off heart attacks and stroke. They include maintaining a healthy blood pressure and cholesterol levels, regular exercise and making healthy food choices. White matter disease is not detectable by a person until the damage has already occurred. Healthy lifestyles are the key to preventing the likelihood of developing white matter disease.