What are the symptoms of Subcortical Arteriosclerotic Leucoencephalopathy?

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Last updated: June 13, 2025View editorial policy

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From the Research

Subcortical Arteriosclerotic Leucoencephalopathy, also known as Binswanger's disease, presents with a range of neurological symptoms that develop gradually due to damage to the white matter of the brain, including progressive cognitive decline, memory problems, mood changes, and physical symptoms such as gait disturbances and pseudobulbar palsy, as reported in studies such as 1 and 2. The symptoms of Subcortical Arteriosclerotic Leucoencephalopathy can be categorized into several key areas, including:

  • Cognitive symptoms: progressive cognitive decline, particularly affecting executive function, attention, and processing speed, as well as memory problems, mood changes, depression, and apathy, as described in 3 and 4.
  • Physical symptoms: gait disturbances with small, shuffling steps (marche à petit pas), balance problems, urinary incontinence, and difficulty with coordination, as noted in 1 and 2.
  • Speech and emotional symptoms: speech may become slurred or slow, and patients might develop pseudobulbar palsy with emotional lability, as reported in 3 and 5. These symptoms result from small vessel disease causing inadequate blood flow to the subcortical white matter, leading to multiple small strokes and chronic ischemia, as discussed in 3, 4, and 2. The condition is often associated with poorly controlled hypertension, diabetes, or other vascular risk factors, as mentioned in 3, 4, and 2. Unlike Alzheimer's disease, the cognitive decline in Subcortical Arteriosclerotic Leucoencephalopathy may have a more stepwise progression with periods of stability followed by sudden worsening, as noted in 1 and 2. Early recognition of these symptoms is important as managing underlying vascular risk factors can potentially slow disease progression, though there is no specific treatment that reverses the white matter damage, as discussed in 3, 4, and 2.

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