The General about Cerebral Atrophy and Dementia

What is Cerebral Atrophy?

Cerebral atrophy is a common feature of many of the diseases that affect the brain. Atrophy of any tissue means loss of cells. In brain tissue, atrophy describes a loss of neurons and the connections between them. Atrophy can be generalized, which means that all of the brain has shrunk; or it can be focal, affecting only a limited area of the brain and resulting in a decrease of the functions that area of the brain controls. If the cerebral hemispheres (the two lobes of the brain that ancient Chinese figureform the cerebrum) are affected, conscious thought and voluntary processes may be impaired.

Neuroimaging techniques such as magnetic resonance imaging (MRI), computer tomography (CT), positron emission tomography (PET), and single-photon emission computed tomography (SPECT), are used to diagnose the disorder. Cerebral atrophy is a feature of numerous disorders, and may affect only part of the brain.

A number of conditions involving the brain can lead to brain atrophy, including epilepsy, traumatic brain injuries, strokes, Alzheimer’s disease, multiple sclerosis, cerebral palsy, and Huntington’s disease. Brain atrophy has also been observed in patients with chronic wasting, also known as cachexia, with brain atrophy being particularly common in AIDS patients who develop cachexia.

Like other atrophies, brain atrophy involves loss of tissue. In the brain, losing neurons is highly undesirable, as loss of brain tissue can cause a variety of neurological and cognitive problems. Patients with brain atrophy may develop seizures, dementia, and aphasias. In focal cerebral atrophy, the damage is concentrated on a particular area of the brain, which means that the functions of that area of the brain can become impaired. Generalized brain atrophy involves the whole brain, and may be associated with a range of problems.

This condition can usually be identified in a medical imaging study of the brain such as an MRI, which can reveal structural changes in the brain. Functional scans of the brain may reveal decreased brain activity caused by brain atrophy. Patients at risk for this condition may have such scans recommended on a periodic basis for their physicians to monitor for changes in brain structure or function. People who experience symptoms associated with cerebral atrophy may also undergo such scans to assist with diagnosis.

Associated Diseases/Disorders

The pattern and rate of progression of cerebral atrophy depends on the disease involved. Diseases that cause cerebral atrophy include:

• leukodystrophies, such as Krabbe disease, which destroy the myelin sheath that protects axons
• mitochondrial encephalomyopathies, such as Kearns-Sayre syndrome, which interfere with the basic functions of neurons
• multiple sclerosis, which causes inflammation, myelin damage, and lesions in cerebral tissue
• stroke and traumatic brain injury
• Alzheimer’s disease, Pick’s disease, senile dementia, fronto-temporal dementia, and vascular dementia
• cerebral palsy, in which lesions (damaged areas) may impair motor coordination
• Huntington’s disease, and other gene-linked, hereditary diseases that cause build-up of toxic levels of proteins in neurons
• infectious diseases, such as encephalitis, neurosyphilis, and AIDS, in which an infectious agent or the inflammatory reaction to it destroys neurons and their axons
• epilepsy, in which lesions cause abnormal electrochemical discharges that result in seizures

Symptoms

Many diseases that cause cerebral atrophy are associated with dementia, seizures, and a group of language disorders called the aphasias. Dementia is characterized by a progressive impairment of memory and intellectual function that is severe enough to interfere with social and work skills. Memory, orientation, abstraction, ability to learn, visual-spatial perception, and higher executive functions such as planning, organizing and sequencing may also be impaired. Seizures can take different forms, appearing as disorientation, strange repetitive movements, loss of consciousness, or convulsions. Aphasias are a group of disorders characterized by disturbances in speaking and understanding language. Receptive aphasia causes impaired comprehension. Expressive aphasia is reflected in odd choices of words, the use of partial phrases, disjointed clauses, and incomplete sentences.

What Treatment is adopted?

Generally, treatment-which is symptomatic and supportive-depends upon the specific disorder of which cerebral atrophy is a component. In some cases, drug therapy may relieve some symptoms. Care that maintains and stimulates individuals with the disorder improves their quality of life.

Diagnostic Test list for Cerebral Atrophy

The list of diagnostic tests mentioned in various sources as used in the diagnosis of Cerebral Atrophy includes:

• CT scan
• MRI scan
• PET scan
• Single-photon emission computed tomography (SPECT)

Neuroimaging techniques such as magnetic resonance imaging (MRI), computer tomography (CT), positron emission tomography (PET), and single-photon emission computed tomography (SPECT), are used to diagnose the disorder.

What is the prognosis?

The prognosis for individuals with the disorder varies. Progressive cerebral atrophy is fatal because the atrophy spreads to all parts of the brain. Cerebral atrophy that is limited to a specific area of the brain affects normal functioning, however, it is not necessarily fatal.