Abstract
Dementia is one of the most disabling conditions. Alzheimer's disease and vascular dementia (VaD) are the most frequent causes. Subcortical VaD is consequent to deep-brain small vessel disease (SVD) and is the most frequent form of VaD. Its pathological hallmarks are ischemic white matter changes and lacunar infarcts. Degenerative and vascular changes often coexist, but mechanisms of interaction are incompletely understood. The term mild cognitive impairment defines a transitional state between normal ageing and dementia. Pre-dementia stages of VaD are also acknowledged (vascular mild cognitive impairment, VMCI). Progression relates mostly to the subcortical VaD type, but determinants of such transition are unknown. Variability of phenotypic expression is not fully explained by severity grade of lesions, as depicted by conventional MRI that is not sensitive to microstructural and metabolic alterations. Advanced neuroimaging techniques seem able to achieve this. Beside hypoperfusion, blood-brain-barrier dysfunction has been also demonstrated in subcortical VaD. The aim of the Vascular Mild Cognitive Impairment Tuscany Study is to expand knowledge about determinants of transition from mild cognitive impairment to dementia in patients with cerebral SVD. This paper summarizes the main aims and methodological aspects of this multicenter, ongoing, observational study enrolling patients affected by VMCI with SVD.
Highlights
Dementia is one of the most disabling conditions affecting older people
This paper summarizes the main aims and methodological aspects of this multicenter, ongoing, observational study enrolling patients affected by vascular mild cognitive impairment (VMCI) with small vessel disease (SVD)
In Italy one-third of dementia cases are due to vascular dementia (VaD), a term that encompasses a few subtypes, among which subcortical VaD consequent to deep brain small vessel disease (SVD) is the most frequent [1]
Summary
Dementia is one of the most disabling conditions affecting older people. The most frequent cause is Alzheimer’s disease (AD) which is attributed to brain cortex degeneration. In Italy one-third of dementia cases are due to vascular dementia (VaD), a term that encompasses a few subtypes, among which subcortical VaD consequent to deep brain small vessel disease (SVD) is the most frequent [1]. Its pathological hallmarks are ischemic white matter changes, caused by hypoperfusion and lacunar infarcts [2]. These changes can progress over time silently, a profile similar to that occurring in AD. In the old brain degenerative and vascular changes may often coexist and possibly interact
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