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Post-mortem assessment in vascular dementia: advances and aspirations
Newcastle Univ, Inst Neurosci, Newcastle Upon Tyne, Tyne & Wear, England..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology.
Harvard Med Sch, Massachusetts Gen Hosp Stroke Res Ctr, Dept Neurol, Hemorrhag Stroke Res Program, Boston, MA USA..
Univ Hosp Lille, Stroke Res Team, Lille, France..
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2016 (English)In: BMC Medicine, ISSN 1741-7015, E-ISSN 1741-7015, Vol. 14, 129Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2016. Vol. 14, 129
Keyword [en]
Vascular dementia, Vascular cognitive impairment, Cerebrovascular disease, Cerebrovascular lesions, Neuropathology, Magnetic resonance imaging, Post-mortem MRI, Mixed dementia
National Category
Neurology Geriatrics
Identifiers
URN: urn:nbn:se:uu:diva-307880DOI: 10.1186/s12916-016-0676-5ISI: 000382735900001PubMedID: 27600683OAI: oai:DiVA.org:uu-307880DiVA: diva2:1048833
Funder
NIH (National Institute of Health), P50AG023501 P01AG019724 R01 AG040311
Available from: 2016-11-22 Created: 2016-11-22 Last updated: 2016-11-22Bibliographically approved

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Alafuzoff, Irina
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