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Brain White-Matter Lesions and Psychosis

Published online by Cambridge University Press:  02 January 2018

Bruce L. Miller*
Affiliation:
Department of Neurology
Ira M. Lesser
Affiliation:
Department of Psychiatry
Kyle Boone
Affiliation:
Department of Psychiatry
Mark Goldberg
Affiliation:
Department of Neurology
Elizabeth Hill
Affiliation:
Department of Psychiatry
Milton H. Miller
Affiliation:
Department of Psychiatry
D. Frank Benson
Affiliation:
Department of Radiology at Harbor-UCLA Medical Center
Mark Mehringer
Affiliation:
Department of Radiology at Harbor-UCLA Medical Center
*
Harbor-UCLA Medical Center, 1000 W. Carson, Torrance, CA 90509, USA.

Abstract

In a prospective study of late-life onset psychosis, five of the first 27 patients studied had extensive white-matter lesions demonstrated by MRI and/or CT. None of 60 age-matched psychiatrically healthy controls demonstrated such lesions. All five patients had a mild dementia and a frontal behavioural syndrome. In addition, every patient performed poorly on neuropsychological tests of frontal function. Dysfunction of the frontal cortex associated with white-matter lesions appears to contribute to the clinical picture of some cases of late-life psychosis.

Type
Papers
Copyright
Copyright © The Royal College of Psychiatrists 

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References

Adams, R. L., Smigielski, J. & Jenkins, R. L. (1984) Development of a Satz-Mogel short form of the WAIS-R. Journal of Consulting and Clinical Psychology, 52, 908.CrossRefGoogle Scholar
Alexander, M. P., Stuss, D. T. & Benson, D. F. (1979) Capgras syndrome: a reduplicative phenomenon. Neurology, 29, 334339.Google Scholar
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Benson, D. F., Gardner, H. & Meadows, J. C. (1976) Reduplicative paramnesia. Neurology, 26, 147151.Google Scholar
Benton, A. L. & Hamsher, K. de S. (1976) Multilingual Aphasia Examination. Iowa City: University of Iowa.Google Scholar
Berg, E. A. (1948) A simple objective test for measuring flexibility in thinking. Journal of General Psychology, 39, 1522.Google Scholar
Bradley, W. G., Waluch, V., Brant-Zawadzki, M., et al (1984) Patchy, periventricular white matter lesions in the elderly: a common observation during NMR imaging. Noninvasive Medical Imaging, 1, 3541.Google Scholar
Brant-Zawadzki, M., Fein, G., Van Dyke, C., et al (1985) MR imaging of the aging brain: patchy white-matter lesions and dementia. American Journal of Neuroradiology, 6, 675682.Google Scholar
Bridge, P. T. & Wyatt, R. J. (1980) Paraphrenia: paranoid states of late life. I. European research. Journal of the American Geriatric Society, 28, 193200.CrossRefGoogle ScholarPubMed
Cummings, J. L. & Miller, B. L. (1987) Visual hallucinations: an overview. Western Journal of Medicine, 146, 4651.Google Scholar
Cooper, A. F. & Curry, A. R. (1975) The pathology of deafness in the paranoid and affective psychoses of later life. Journal of Psychosomatic Research, 20, 97105.CrossRefGoogle Scholar
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975) “Mini-Mental State”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 185198.Google Scholar
Gold, D. (1984) Late age of onset schizophrenia: present but unaccounted for. Comprehensive Psychiatry, 25, 225237.CrossRefGoogle ScholarPubMed
Goto, K., Ishii, N., & Fukasawa, H. (1981) Diffuse white-matter disease in the geriatric population. Radiology, 141, 687695.Google Scholar
Hachinski, V. C., Lassen, N. A. & Marshall, J. (1974) Multi-infarct dementia. A cause of mental deterioration in the elderly. Lancet, ii, 207210.Google Scholar
Hachinski, V. C., Potter, P. & Merskey, H. (1987) Leuko-araiosis. Archives of Neurology, 44, 2123.CrossRefGoogle ScholarPubMed
Hamilton, M. (1967) Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6, 270296.Google Scholar
Hershey, L. A., Modic, M. T., Greenough, P. G., et al (1987) Magnetic resonance imaging in vascular dementia. Neurology, 37, 2936.CrossRefGoogle ScholarPubMed
Kay, D. W. K. & Roth, M. (1961) Environmental and hereditary factors in the schizophrenia of old age (“late paraphrenia”) and their bearing on the general problem of causation in schizophrenia. Journal of Mental Science, 17, 649686.Google Scholar
Leuchter, A. F., & Spar, J. E. (1985) The late-onset psychoses. Clinical and diagnostic features. Journal of Nervous and Mental Disease, 173, 488493.Google Scholar
Mercer, B., Wapner, W., Gardner, H., et al (1977) A study of confabulation. Archives of Neurology, 34, 429433.CrossRefGoogle ScholarPubMed
Miller, B. L., Benson, D. F., Cummings, J. L., et al (1986) Late-onset paraphrenia: an organic delusional system. Journal of Clinical Psychiatry, 47, 204207.Google Scholar
Miller, B. L. & Lesser, I. M. (1988) Late-life psychosis and modern neuroimaging. In Psychiatric Clinics of North America (ed. Jeste D.). Philadelphia: W. B. Saunders.Google Scholar
Osterrieth, P. A. (1944) Le test de copie d'une figure complexe. Archives de Psychologie 30, 206356.Google Scholar
Overall, J. W. & Gorham, D. R. (1962) The Brief Psychiatric Rating Scale. Psychological Research, 10, 795812.Google Scholar
Pick, A. (1903) Clinical studies: III. On reduplicative paramnesia. Brain, 26, 260267.CrossRefGoogle Scholar
Roth, M. (1955) The natural history of mental disorder in old age. Journal of Mental Science, 129, 281301.Google Scholar
Skomer, C., Stears, J. & Austin, J. (1983) Metachromatic leukodystrophy (MLD) adult MLD with focal lesions by computerized tomography. Archives of Neurology, 40, 354355.Google Scholar
Spitzer, R. L., Williams, J. B. & Gibbon, M. (1986) Structured Clinical Interview for DSM–III–R Patient Version (SCID 8/1/86). New York: New York State Psychiatric Institute.Google Scholar
Steingart, A., Hachinski, V., Lau, C., et al (1987) Cognitive and neurologic findings in subjects with diffuse white matter lucencies on computed tomographic scan (leuko-araiosis). Archives of Neurology, 44, 3235.CrossRefGoogle ScholarPubMed
Stroop, J. (1935) Studies of interference in serial verbal reactions. Journal of Experimental Psychology, 18, 643661.Google Scholar
Stuss, D. T., Alexander, M. P., Lieberman, A., et al (1978) An extraordinary form of fantastic confabulation. Neurology, 28, 11661172.Google Scholar
Stuss, D. T., Kaplan, E. F., Benson, D. F., et al (1982) Evidence for the involvement of orbitofrontal cortex in memory functions: an interference effect. Journal of Comparative Physiological Psychology, 96, 913925.CrossRefGoogle ScholarPubMed
Stuss, D. T. & Benson, D. F. (1984) Neuropsychological studies of the frontal lobes. Psychological Bulletin, 95, 328.Google Scholar
Tomonaga, M., Yamanouchi, H., Toghi, H., et al (1982) Clinicopathologic study of progressive subcortical vascular encephalopathy (Binswanger type) in the elderly. Journal of the American Geriatric Society, 30, 524529.Google Scholar
Wechsler, D. (1981) Wechsler Adult Intelligence Scale-Revised. New York: Psychological Corporation.Google Scholar
Wechsler, D. & Stone, C. (1945) Wechsler Memory Scale. New York: Psychological Corporation.Google Scholar
Weinstein, E. A. & Kahn, R. L. (1955) Denial of Illness: Symbolic and Physiological Aspects. Springfield: Charles C. Thomas.Google Scholar
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