White matter high intensity lesions on T2-weighted magnetic resonance imaging (MRI) are often detected in aged people. Arteriosclerosis appears to be the most important causative factor in the development of such high intensity signals, and the extent of white matter lesions is thought to reflect the extent of brain arteriosclerosis. We reported that elderly patients with dizziness, especially of central origin, showed significantly more severe white matter lesions. To investigate the relationship between these white matter lesions identified on magnetic resonance imaging and balance dysfunction in elderly patients, we evaluated findings on brain MRI and body sway examined by a stabilometer in patients with dizziness (n=79) aged over 60 years old. Deep white matter hyperintense signals (DWMH) and periventricular hyperintensity (PVH) on MRI was graded usig a qualitative rating scale (Fazekas et al.). Sway of the body's center of gravity was recorded with eyes open and closed for 60 seconds using a stabilometer. Sway area, locus length, and right-left (X position) and forward-backward (Y position) deviations of the center of sway were measured. The measurement values of these parameters were compared with standard values in healthy subjects. Patients with normal values in all 8 items were regarded as stable, and patients with values beyond the normal range were regarded as unstable. In patients with dizziness aged 60-79 years old, those with severe white matter lesions (grade 2-3) on MRI were signifi-cantly unstable. We suggested that elderly patients with severe white matter lesions tended to have postural abnormalities and show dysfunction of the central nervous system due to brain arteriolosclerosis.
