Abstract
Background: Vascular cognitive impairment (VCI) is a major public health problem. The current diagnosis of VCI is made based on the assessment of clinical symptoms and neuropsychological measurements, and is supported by neuroimaging. These methods are both time-consuming and expensive, which leads to needs for alternative biomarkers for VCI. Metabolomics is an emerging and powerful tool to discover of new biomarkers of disease, which can investigate variations in different metabolic processes such as lipid, since the brain is highly enriched in lipids and that lipid changes may lead to pathology in the brain. Vascular cognitive impairment is vulnerable to the disturbance of lipid metabolism. Furthermore, blood samples, which could be identified as reliable clinical biomarkers are relatively convenient to obtain and provide a non-invasive assessment. Therefore, our study aims to understand whether peripheral lipid biomarkers can be used as diagnostic biomarkers and monitor the progression of VCI.Methods: We systematically searched the PubMed, Embase, CNKI, and VIP databases to find VCI and lipid metabolism in reports from inception through February 2021. Studies meeting the following criteria were eligible: (1) original studies in humans; (2) lipid metabolites in blood; (3) reports of VCI.Results: Through our review, nine original articles were eligible. Blood-based metabolites that might be potential biomarkers were identified. Most of them including PC, PE, Cers, and ChEs were significantly lower, while elevation of FAs and DGs were associated with VCI. Most importantly, these blood-based metabolites might be proposed as potential biomarkers for VCI, which provides direction for further validation.Discussion and Conclusion: To the best of our knowledge, this is the first systemic review concerning the relationship of lipid metabolism and VCI. It identifies potential biomarkers and provides insights into the disease pathobiology. However, more advanced studies and researches on a lipidomic platform must be done to understand the exact pathology behind and identify potential lipid biomarkers, which might help achieve the goal of discovering novel therapeutics.
Highlights
Vascular cognitive impairment (VCI) was first put forward by Bowler in 1995 and has been considered an “umbrella term” in describing the cognitive and behavioral changes that occurs as a result of many different vascular pathologies
We identified nine original articles that identified the roles of lipids associated with VCI
We have identified potential lipid metabolism pathways that might be involved in the process
Summary
Vascular cognitive impairment (VCI) was first put forward by Bowler in 1995 and has been considered an “umbrella term” in describing the cognitive and behavioral changes that occurs as a result of many different vascular pathologies It is a wide spectrum of cognitive and behavioral changes ranging from subjective cognitive decline to dementia in recent years [1]. Vascular dementia is the second most common cause of cognitive decline, accounting for 15–30% of cases [3, 4], creating challenges for policy makers, healthcare professionals, and family members It can be caused by cerebrovascular disease of different etiologies, including stroke, subcortical ischaemic vascular disease (SIVD), multi-infarct strokes, border-zone ischaemia, and intracerebral hemorrhages [4].
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