Neuropsychiatric symptoms and behavioral disturbances in vascular dementia : the impact of the location and the amount of lesions

Yoshiyuki Nishio, Etsuro Mori

Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine

Neuropsychiatric symptoms and behavioral disturbances of vascular dementia vary depending on the location and the amount of lesions. Lesions located in the strategic sites, including the caudate nucleus, the anterior and medial thalami and the anterior limb and the genu of the internal capsule, disrupt the frontal-subcortical circuits and, even if the lesions are small in size, result in prominent behavioral alteration. Regardless of brain regions, right hemisphere lesions tend to be associated with mania/hypomania, disinhibition and delusions. The laterality of lesions has less impact on apathy and depression, whereas the amount of lesions significantly contributes to the occurrence and the severity of those symptoms. Apathy and depression are dominant symptoms in vascular dementia probably because the impact of the amount of lesions is dominant over the impact of the location of lesions in conditions associated with diffuse and multiple lesions.

Address correspondence to Yoshiyuki Nishio, MD, PhD, Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine(2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan)