Format

Send to

Choose Destination
Circ Res. 2017 Feb 3;120(3):573-591. doi: 10.1161/CIRCRESAHA.116.308426.

Vascular Cognitive Impairment.

Author information

1
From the Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany (M.D.); German Center for Neurodegenerative Diseases (DZNE), Munich, Germany (M.D.); Munich Cluster for Systems Neurology (SyNergy), Germany (M.D.); and University of Lille, INSERM, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, F-59000 Lille, France (D.L.). martin.dichgans@med.uni-muenchen.de.
2
From the Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany (M.D.); German Center for Neurodegenerative Diseases (DZNE), Munich, Germany (M.D.); Munich Cluster for Systems Neurology (SyNergy), Germany (M.D.); and University of Lille, INSERM, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, F-59000 Lille, France (D.L.).

Abstract

Cerebrovascular disease typically manifests with stroke, cognitive impairment, or both. Vascular cognitive impairment refers to all forms of cognitive disorder associated with cerebrovascular disease, regardless of the specific mechanisms involved. It encompasses the full range of cognitive deficits from mild cognitive impairment to dementia. In principle, any of the multiple causes of clinical stroke can cause vascular cognitive impairment. Recent work further highlights a role of microinfarcts, microhemorrhages, strategic white matter tracts, loss of microstructural tissue integrity, and secondary neurodegeneration. Vascular brain injury results in loss of structural and functional connectivity and, hence, compromise of functional networks within the brain. Vascular cognitive impairment is common both after stroke and in stroke-free individuals presenting to dementia clinics, and vascular pathology frequently coexists with neurodegenerative pathology, resulting in mixed forms of mild cognitive impairment or dementia. Vascular dementia is now recognized as the second most common form of dementia after Alzheimer's disease, and there is increasing awareness that targeting vascular risk may help to prevent dementia, even of the Alzheimer type. Recent advances in neuroimaging, neuropathology, epidemiology, and genetics have led to a deeper understanding of how vascular disease affects cognition. These new findings provide an opportunity for the present reappraisal of vascular cognitive impairment. We further briefly address current therapeutic concepts.

KEYWORDS:

cognitive impairment; intracranial hemorrhage; ischemic stroke; magnetic resonance imaging; vascular disease

PMID:
28154105
DOI:
10.1161/CIRCRESAHA.116.308426
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Atypon
Loading ...
Support Center