BACKGROUND: Diagnostic criteria separating vascular dementia from other dementias, particularly Alzheimer's disease (AD) neglect the real world in which most AD cases present with at least some vascular brain lesions. Most importantly, vascular lesions, even if subtle, exert significant effects on the patients' cognitive functioning if they coexist with AD pathology. OBJECTIVES: To emphasize the need for an integrative dementia concept in which the vascular component represents an important end point in trial planning and a possibility for disease modification along the whole spectrum of combined vascular and primary degenerative pathology. METHODS: Review of the literature on possible surrogate markers to study the contribution of vascular brain damage in dementia. RESULTS: The longitudinal change in volume of white matter lesions is the best elaborated putative surrogate marker for the study of the vascular component in dementia. Validation of the role of lacunes and microbleeds as surrogate end points is poor. Loss of brain volume is an important adjunct outcome measure even though the vascular origin of atrophy remains uncertain. CONCLUSIONS: A focus on pure vascular dementia distracts from the importance of vascular factors in dementia. Consideration of the vascular component in future clinical trials will improve our pathophysiological understanding and provide options for treatment. Copyright 2010 S. Karger AG, Basel.
BACKGROUND: Diagnostic criteria separating vascular dementia from other dementias, particularly Alzheimer's disease (AD) neglect the real world in which most AD cases present with at least some vascular brain lesions. Most importantly, vascular lesions, even if subtle, exert significant effects on the patients' cognitive functioning if they coexist with AD pathology. OBJECTIVES: To emphasize the need for an integrative dementia concept in which the vascular component represents an important end point in trial planning and a possibility for disease modification along the whole spectrum of combined vascular and primary degenerative pathology. METHODS: Review of the literature on possible surrogate markers to study the contribution of vascular brain damage in dementia. RESULTS: The longitudinal change in volume of white matter lesions is the best elaborated putative surrogate marker for the study of the vascular component in dementia. Validation of the role of lacunes and microbleeds as surrogate end points is poor. Loss of brain volume is an important adjunct outcome measure even though the vascular origin of atrophy remains uncertain. CONCLUSIONS: A focus on pure vascular dementia distracts from the importance of vascular factors in dementia. Consideration of the vascular component in future clinical trials will improve our pathophysiological understanding and provide options for treatment. Copyright 2010 S. Karger AG, Basel.
Authors: Mitchel A Kling; John Q Trojanowski; David A Wolk; Virginia M Y Lee; Steven E Arnold Journal: Alzheimers Dement Date: 2012-11-22 Impact factor: 21.566
Authors: Sara Shams; Juha Martola; Andreas Charidimou; Lena Cavallin; Tobias Granberg; Mana Shams; Yngve Forslin; Peter Aspelin; Maria Kristoffersen-Wiberg; Lars-Olof Wahlund Journal: Neurology Date: 2016-08-17 Impact factor: 9.910
Authors: Eloise H Kok; Teemu Luoto; Satu Haikonen; Sirkka Goebeler; Hannu Haapasalo; Pekka J Karhunen Journal: Alzheimers Res Ther Date: 2011-04-05 Impact factor: 6.982
Authors: Franc Llorens; Peter Hermann; Anna Villar-Piqué; Daniela Diaz-Lucena; Katarina Nägga; Oskar Hansson; Isabel Santana; Matthias Schmitz; Christian Schmidt; Daniela Varges; Stefan Goebel; Julien Dumurgier; Henrik Zetterberg; Kaj Blennow; Claire Paquet; Inês Baldeiras; Isidro Ferrer; Inga Zerr Journal: Nat Commun Date: 2020-01-30 Impact factor: 14.919