Abstract
Subcortical Ischemic Vascular Disease (SIVD) is underdiagnosed. This review investigates the relationship among SIVD severity, cognitive status and neuroimaging markers.MethodsCohort, cross-sectional and case control studies were searched on ISI, Medline, Scielo, PsychoInfo and LILACS databases published between 1995 and 2006.ResultsThe most impaired cognitive domains were executive, attentional and memory retrieval mechanisms. These cognitive features were frequently associated to White Matter Lesions (WML).ConclusionsWML is an independent factor in cognitive decline. However, the threshold for this impact is not yet clearly established.
Highlights
Subcortical Ischemic Vascular Disease (SIVD) is underdiagnosed
This review aimed to investigate the relationship between SIVD severity and cognitive status with possible neuroimaging markers, addressing two main questions: (1) how the clinical stage of subcortical disease is related to impairment in specific cognitive domains and how it affects prognosis and functional status; (2) the impact of the presence, localization and extent of White Matter Lesions (WML) on cognition
To the best of our knowledge, only one other systematic review on the subject has sought to study the relationship between WML and cognition.[16]. This search retrieved a total of 159 articles, only 32 of which remained eligible according to the inclusion and exclusion criteria
Summary
Abstract – Subcortical Ischemic Vascular Disease (SIVD) is underdiagnosed. This review investigates the relationship among SIVD severity, cognitive status and neuroimaging markers. The diagnosis of SIVD allows better knowledge of the clinical picture as well as of the natural history, outcome and clinical response to treatment strategies.[5,6,7,8] Regardless of the causal pathological factor of brain vascular lesions, a wide variety of complex mechanisms can be singled out as risk and intervening factors for SIVD These factors include interactions between vascular etiologies (hypoperfusion caused by arterial stiffness and its relationship to risk factors such as arterial hypertension), microvascular changes in the brain (infarcts, WML, atrophy), host factors (age, education), hypotension, genetic inheritance (CADASIL), and cognitive characteristics.[5,9]. The main clinical manifestations of SIVD may be summarized as a “dysexecutive syndrome” due to the interruption of prefrontal-subcortical loops[10,11] affecting control, volition, planning, programming, anticipation, inhibition of inappropriate behaviors, and monitoring of complex
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