Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
BMC Medicine
Published in: BMC Medicine 1/2016

Open Access 01-12-2016 | Opinion

Is the time ripe for new diagnostic criteria of cognitive impairment due to cerebrovascular disease? Consensus report of the International Congress on Vascular Dementia working group

Authors: Robert Perneczky, Oren Tene, Johannes Attems, Panteleimon Giannakopoulos, M. Arfan Ikram, Antonio Federico, Marie Sarazin, Lefkos T. Middleton

Published in: BMC Medicine | Issue 1/2016

Login to get access

Abstract

Background

Long before Alzheimer’s disease was established as the leading cause of dementia in old age, cerebrovascular lesions were known to cause cognitive deterioration and associated disability. Since the middle of the last century, different diagnostic concepts for vascular dementia and related syndromes were put forward, yet no widely accepted diagnostic consensus exists to date.

Discussion

Several international efforts, reviewed herein, are ongoing to define cognitive impairment due to cerebrovascular disease in its different stages and subtypes. The role of biomarkers is also being discussed, including cerebrospinal fluid proteins, structural and functional brain imaging, and genetic markers. The influence of risk factors, such as diet, exercise and different comorbidities, is emphasised by population-based research, and lifestyle changes are considered for the treatment and prevention of dementia.

Conclusion

To improve the diagnosis and management of vascular cognitive impairment, further progress has to be made in understanding the relevant pathomechanisms, including shared mechanisms with Alzheimer’s disease; bringing together fragmented research initiatives in coordinated international programs; testing if known risk factors are modifiable in prospective interventional studies; and defining the pre-dementia and pre-clinical stages in line with the concept of mild cognitive impairment due to Alzheimer’s disease.
Literature
1.
2.
3.
Blessed G, Tomlinson BE, Roth M. The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. Br J Psychiatry. 1968;114(512):797–811.CrossRefPubMed
4.
Chui HC, Victoroff JI, Margolin D, Jagust W, Shankle R, Katzman R. Criteria for the diagnosis of ischemic vascular dementia proposed by the State of California Alzheimer’s Disease Diagnostic and Treatment Centers. Neurology. 1992;42(3 Pt 1):473–80.CrossRefPubMed
5.
Erkinjuntti T, Inzitari D, Pantoni L, Wallin A, Scheltens P, Rockwood K, Roman GC, Chui H, Desmond DW. Research criteria for subcortical vascular dementia in clinical trials. J Neural Transm Suppl. 2000;59:23–30.PubMed
6.
Sachdev PS, Chen X, Brodaty H, Thompson C, Altendorf A, Wen W. The determinants and longitudinal course of post-stroke mild cognitive impairment. J Int Neuropsychol Soc. 2009;15(6):915–23.CrossRefPubMed
7.
Stephan BC, Matthews FE, Khaw KT, Dufouil C, Brayne C. Beyond mild cognitive impairment: vascular cognitive impairment, no dementia (VCIND). Alzheimers Res Ther. 2009;1(1):4.CrossRefPubMedPubMedCentral
8.
Matz K, Teuschl Y, Firlinger B, Dachenhausen A, Keindl M, Seyfang L, Tuomilehto J, Brainin M, ASPIS Study Group. Multidomain lifestyle interventions for the prevention of cognitive decline after ischemic stroke: randomized trial. Stroke. 2015;46(10):2874–80.CrossRefPubMed
9.
O’Brien JT, Erkinjuntti T, Reisberg B, Roman G, Sawada T, Pantoni L, Bowler JV, Ballard C, DeCarli C, Gorelick PB, et al. Vascular cognitive impairment. Lancet Neurol. 2003;2(2):89–98.CrossRefPubMed
10.
Wardlaw JM, Smith EE, Biessels GJ, Cordonnier C, Fazekas F, Frayne R, Lindley RI, O’Brien JT, Barkhof F, Benavente OR, et al. Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration. Lancet Neurol. 2013;12(8):822–38.CrossRefPubMedPubMedCentral
11.
12.
de Bruijn RF, Heeringa J, Wolters FJ, Franco OH, Stricker BH, Hofman A, Koudstaal PJ, Ikram MA. Association between atrial fibrillation and dementia in the general population. JAMA Neurol. 2015;72(11):1288–94.CrossRefPubMed
13.
Ikram MA, van Oijen M, de Jong FJ, Kors JA, Koudstaal PJ, Hofman A, Witteman JC, Breteler MM. Unrecognized myocardial infarction in relation to risk of dementia and cerebral small vessel disease. Stroke. 2008;39(5):1421–6.CrossRefPubMed
14.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th Edition. Arlington: American Psychiatric Association; 2013.CrossRef
15.
Rusanen M, Kivipelto M, Levalahti E, Laatikainen T, Tuomilehto J, Soininen H, Ngandu T. Heart diseases and long-term risk of dementia and Alzheimer’s disease: a population-based CAIDE study. J Alzheimers Dis. 2014;42(1):183–91.PubMed
16.
de Bruijn RF, Portegies ML, Leening MJ, Bos MJ, Hofman A, van der Lugt A, Niessen WJ, Vernooij MW, Franco OH, Koudstaal PJ, et al. Subclinical cardiac dysfunction increases the risk of stroke and dementia: the Rotterdam Study. Neurology. 2015;84(8):833–40.CrossRefPubMed
17.
de Bruijn RF, Bos MJ, Portegies ML, Hofman A, Franco OH, Koudstaal PJ, Ikram MA. The potential for prevention of dementia across two decades: the prospective, population-based Rotterdam Study. BMC Med. 2015;13:132.CrossRefPubMedPubMedCentral
18.
19.
Norton S, Matthews FE, Barnes DE, Yaffe K, Brayne C. Potential for primary prevention of Alzheimer’s disease: an analysis of population-based data. Lancet Neurol. 2014;13(8):788–94.CrossRefPubMed
20.
Attems J, Jellinger K. Neuropathological correlates of cerebral multimorbidity. Curr Alzheimer Res. 2013;10(6):569–77.CrossRefPubMed
21.
Schrijvers EM, Verhaaren BF, Koudstaal PJ, Hofman A, Ikram MA, Breteler MM. Is dementia incidence declining? Trends in dementia incidence since 1990 in the Rotterdam Study. Neurology. 2012;78(19):1456–63.CrossRefPubMed
22.
Qiu C, von Strauss E, Backman L, Winblad B, Fratiglioni L. Twenty-year changes in dementia occurrence suggest decreasing incidence in central Stockholm, Sweden. Neurology. 2013;80(20):1888–94.CrossRefPubMed
23.
Lobo A, Saz P, Marcos G, Dia JL, De-la-Camara C, Ventura T, Montanes JA, Lobo-Escolar A, Aznar S, ZARADEMP Workgroup. Prevalence of dementia in a southern European population in two different time periods: the ZARADEMP Project. Acta Psychiatr Scand. 2007;116(4):299–307.CrossRefPubMed
24.
Matthews FE, Arthur A, Barnes LE, Bond J, Jagger C, Robinson L, Brayne C. Medical Research Council Cognitive Function and Ageing Collaboration. A two-decade comparison of prevalence of dementia in individuals aged 65 years and older from three geographical areas of England: results of the Cognitive Function and Ageing Study I and II. Lancet. 2013;382(9902):1405–12.CrossRefPubMedPubMedCentral
25.
Ngandu T, Lehtisalo J, Solomon A, Levalahti E, Ahtiluoto S, Antikainen R, Backman L, Hanninen T, Jula A, Laatikainen T, et al. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet. 2015;385(9984):2255–63.CrossRefPubMed
26.
Bjerke M, Zetterberg H, Edman A, Blennow K, Wallin A, Andreasson U. Cerebrospinal fluid matrix metalloproteinases and tissue inhibitor of metalloproteinases in combination with subcortical and cortical biomarkers in vascular dementia and Alzheimer’s disease. J Alzheimers Dis. 2011;27(3):665–76.PubMed
27.
Sinka L, Kovari E, Gold G, Hof PR, Herrmann FR, Bouras C, Giannakopoulos P. Small vascular and Alzheimer disease-related pathologic determinants of dementia in the oldest-old. J Neuropathol Exp Neurol. 2010;69(12):1247–55.CrossRefPubMed
28.
Vickrey BG, Brott TG, Koroshetz WJ, Stroke Research Priorities Meeting Steering Committee and the National Advisory Neurological Disorders and Stroke Council; National Institute of Neurological Disorders and Stroke. Research priority setting: a summary of the 2012 NINDS Stroke Planning Meeting Report. Stroke. 2013;44(8):2338–42.CrossRefPubMed
29.
Zlokovic BV. Neurovascular pathways to neurodegeneration in Alzheimer’s disease and other disorders. Nat Rev Neurosci. 2011;12(12):723–38.PubMedPubMedCentral
30.
Chabriat H, Mrissa R, Levy C, Vahedi K, Taillia H, Iba-Zizen MT, Joutel A, Tournier-Lasserve E, Bousser MG. Brain stem MRI signal abnormalities in CADASIL. Stroke. 1999;30(2):457–9.CrossRefPubMed
31.
Pantoni L. Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges. Lancet Neurol. 2010;9(7):689–701.CrossRefPubMed
32.
Rost NS, Rahman RM, Biffi A, Smith EE, Kanakis A, Fitzpatrick K, Lima F, Worrall BB, Meschia JF, Brown Jr RD, et al. White matter hyperintensity volume is increased in small vessel stroke subtypes. Neurology. 2010;75(19):1670–7.CrossRefPubMedPubMedCentral
33.
O’Sullivan M. Imaging small vessel disease: lesion topography, networks, and cognitive deficits investigated with MRI. Stroke. 2010;41(10 Suppl):S154–8.CrossRefPubMed
34.
35.
Yan T, Yu JR, Zhang YP, Li T. Analysis on correlation of white matter lesion and lacunar infarction with vascular cognitive impairment. Int J Clin Exp Med. 2015;8(8):14119–22.PubMedPubMedCentral
36.
Kim S, Choi SH, Lee YM, Kim MJ, Kim YD, Kim JY, Park JH, Myung W, Na HR, Han HJ, et al. Periventricular white matter hyperintensities and the risk of dementia: a CREDOS study. Int Psychogeriatr. 2015;27(12):2069–77.CrossRefPubMed
37.
Hansen TP, Cain J, Thomas O, Jackson A. Dilated perivascular spaces in the Basal Ganglia are a biomarker of small-vessel disease in a very elderly population with dementia. AJNR Am J Neuroradiol. 2015;36(5):893–8.CrossRefPubMed
38.
Miwa K, Tanaka M, Okazaki S, Yagita Y, Sakaguchi M, Mochizuki H, Kitagawa K. Multiple or mixed cerebral microbleeds and dementia in patients with vascular risk factors. Neurology. 2014;83(7):646–53.CrossRefPubMed
39.
De Reuck JL, Deramecourt V, Auger F, Durieux N, Cordonnier C, Devos D, Defebvre L, Moreau C, Capparos-Lefebvre D, Pasquier F, et al. The significance of cortical cerebellar microbleeds and microinfarcts in neurodegenerative and cerebrovascular diseases. A post-mortem 7.0-tesla magnetic resonance study with neuropathological correlates. Cerebrovasc Dis. 2015;39(2):138–43.CrossRefPubMed
40.
Ye BS, Seo SW, Kim JH, Kim GH, Cho H, Noh Y, Kim HJ, Yoon CW, Woo SY, Kim SH, et al. Effects of amyloid and vascular markers on cognitive decline in subcortical vascular dementia. Neurology. 2015;85(19):1687–93.CrossRefPubMedPubMedCentral
41.
Zhang B, Xu Y, Zhu B, Kantarci K. The role of diffusion tensor imaging in detecting microstructural changes in prodromal Alzheimer’s disease. CNS Neurosci Ther. 2014;20(1):3–9.CrossRefPubMed
42.
Otsuka Y, Yamauchi H, Sawamoto N, Iseki K, Tomimoto H, Fukuyama H. Diffuse tract damage in the hemispheric deep white matter may correlate with global cognitive impairment and callosal atrophy in patients with extensive leukoaraiosis. AJNR Am J Neuroradiol. 2012;33(4):726–32.CrossRefPubMed
43.
Lambert JC, Ibrahim-Verbaas CA, Harold D, Naj AC, Sims R, Bellenguez C, DeStafano AL, Bis JC, Beecham GW, Grenier-Boley B, et al. Meta-analysis of 74,046 individuals identifies 11 new susceptibility loci for Alzheimer’s disease. Nat Genet. 2013;45(12):1452–8.CrossRefPubMedPubMedCentral
44.
Federico A, Di Donato I, Bianchi S, Di Palma C, Taglia I, Dotti MT. Hereditary cerebral small vessel diseases: a review. J Neurol Sci. 2012;322(1–2):25–30.CrossRefPubMed
45.
Tan RY, Markus HS. Monogenic causes of stroke: now and the future. J Neurol. 2015;262(12):2601–16.CrossRefPubMed
46.
Rombach SM, Smid BE, Linthorst GE, Dijkgraaf MG, Hollak CE. Natural course of Fabry disease and the effectiveness of enzyme replacement therapy: a systematic review and meta-analysis: effectiveness of ERT in different disease stages. J Inherit Metab Dis. 2014;37(3):341–52.CrossRefPubMed
Metadata
Title
Is the time ripe for new diagnostic criteria of cognitive impairment due to cerebrovascular disease? Consensus report of the International Congress on Vascular Dementia working group
Authors
Robert Perneczky
Oren Tene
Johannes Attems
Panteleimon Giannakopoulos
M. Arfan Ikram
Antonio Federico
Marie Sarazin
Lefkos T. Middleton
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2016
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-016-0719-y

Other articles of this Issue 1/2016

BMC Medicine 1/2016 Go to the issue

Erratum

Erratum to: Diagnostic work-up of patients presenting in primary care with lower abdominal symptoms: which faecal test and triage strategy should be used?

Editorial

Gout: will the “King of Diseases” be the first rheumatic disease to be cured?

Review

Clinical use of whole genome sequencing for Mycobacterium tuberculosis

Research article

Quantifying the economic impact of government and charity funding of medical research on private research and development funding in the United Kingdom

Research article

Quantification of the smoking-associated cancer risk with rate advancement periods: meta-analysis of individual participant data from cohorts of the CHANCES consortium

Correspondence

What is a clinical pathway? Refinement of an operational definition to identify clinical pathway studies for a Cochrane systematic review