Post-mortem assessment in vascular dementia: advances and aspirations.
- McAleese KE Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
- Alafuzoff I Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.
- Charidimou A Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, Boston, MA, USA.
- De Reuck J Stroke Research Team, University Hospital Lille, Lille, France.
- Grinberg LT Departments of neurology and Pathology, University of California, San Francisco, USA.
- Hainsworth AH Institute of Cardiovascular and Cell Sciences, St George's University of London, London, UK.
- Hortobagyi T Department of Neuropathology, University of Debrecen, Debrecen, Hungary.
- Ince P Sheffield Institute for Translational Neuroscience, Sheffield, UK.
- Jellinger K Institute of Clinical Neurobiology, Vienna, Austria.
- Gao J Neurological Department, Peking Union Medical College Hospital, Beijing, China.
- Kalaria RN Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
- Kovacs GG Institute of Neurology, Medical University of Vienna, Vienna, Austria.
- Kövari E Department of Mental Health and Psychiatry, University of Geneva, Geneva, Switzerland.
- Love S Clincial Neurosciences, University of Bristol, Bristol, UK.
- Popovic M Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
- Skrobot O Clincial Neurosciences, University of Bristol, Bristol, UK.
- Taipa R Unit of Neuropathology, Centro Hospitalar do Porto, University of Porto, Porto, Portugal.
- Thal DR Department of Neuroscience, KU-Leuven and Department of Pathology, UZ-Leuven, Leuven, Belgium.
- Werring D Institute of Neurology, University College London, London, UK.
- Wharton SB Sheffield Institute for Translational Neuroscience, Sheffield, UK.
- Attems J Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK. Johannes.Attems@ncl.ac.uk.
- 2016-09-08
Published in:
- BMC medicine. - 2016
Cerebrovascular disease
Cerebrovascular lesions
Magnetic resonance imaging
Mixed dementia
Neuropathology
Post-mortem MRI
Vascular cognitive impairment
Vascular dementia
Aged
Alzheimer Disease
Autopsy
Brain
Cerebrovascular Disorders
Comorbidity
Dementia
Dementia, Vascular
Humans
Prevalence
English
BACKGROUND
Cerebrovascular lesions are a frequent finding in the elderly population. However, the impact of these lesions on cognitive performance, the prevalence of vascular dementia, and the pathophysiology behind characteristic in vivo imaging findings are subject to controversy. Moreover, there are no standardised criteria for the neuropathological assessment of cerebrovascular disease or its related lesions in human post-mortem brains, and conventional histological techniques may indeed be insufficient to fully reflect the consequences of cerebrovascular disease.
DISCUSSION
Here, we review and discuss both the neuropathological and in vivo imaging characteristics of cerebrovascular disease, prevalence rates of vascular dementia, and clinico-pathological correlations. We also discuss the frequent comorbidity of cerebrovascular pathology and Alzheimer's disease pathology, as well as the difficult and controversial issue of clinically differentiating between Alzheimer's disease, vascular dementia and mixed Alzheimer's disease/vascular dementia. Finally, we consider additional novel approaches to complement and enhance current post-mortem assessment of cerebral human tissue.
CONCLUSION
Elucidation of the pathophysiology of cerebrovascular disease, clarification of characteristic findings of in vivo imaging and knowledge about the impact of combined pathologies are needed to improve the diagnostic accuracy of clinical diagnoses.
Cerebrovascular lesions are a frequent finding in the elderly population. However, the impact of these lesions on cognitive performance, the prevalence of vascular dementia, and the pathophysiology behind characteristic in vivo imaging findings are subject to controversy. Moreover, there are no standardised criteria for the neuropathological assessment of cerebrovascular disease or its related lesions in human post-mortem brains, and conventional histological techniques may indeed be insufficient to fully reflect the consequences of cerebrovascular disease.
DISCUSSION
Here, we review and discuss both the neuropathological and in vivo imaging characteristics of cerebrovascular disease, prevalence rates of vascular dementia, and clinico-pathological correlations. We also discuss the frequent comorbidity of cerebrovascular pathology and Alzheimer's disease pathology, as well as the difficult and controversial issue of clinically differentiating between Alzheimer's disease, vascular dementia and mixed Alzheimer's disease/vascular dementia. Finally, we consider additional novel approaches to complement and enhance current post-mortem assessment of cerebral human tissue.
CONCLUSION
Elucidation of the pathophysiology of cerebrovascular disease, clarification of characteristic findings of in vivo imaging and knowledge about the impact of combined pathologies are needed to improve the diagnostic accuracy of clinical diagnoses.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.1186/s12916-016-0676-5
- PMID 27600683
- Persistent URL
- https://sonar.ch/global/documents/46542
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