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Neuropathologic substrates of ischemic vascular dementia
H V Vinters1, W G Ellis, C Zarow
1Department of Pathology and Laboratory Medicine, UCLA Medical Center, Los Angeles, California 90095-1732, USA.
Journal of Neuropathology and Experimental Neurology
|November 23, 2000
Summary
Ischemic vascular dementia (IVD) involves multiple brain lesions causing cognitive decline. Autopsy findings reveal lacunar infarcts and microinfarcts are common in IVD patients.
Area of Science:
- Neurology
- Pathology
- Gerontology
Background:
- Ischemic vascular dementia (IVD) is characterized by progressive cognitive and memory impairment due to multiple ischemic brain lesions.
- These lesions can exacerbate neuropsychological deficits in Alzheimer disease (AD).
- Cerebral microvascular disease is a key factor in many dementia cases.
Purpose of the Study:
- To review neuropathological findings in 20 patients with diagnosed IVD.
- To correlate vascular pathologies with cognitive impairment.
- To propose a method for quantifying ischemic burden in dementia.
Main Methods:
- Autopsy examination of the central nervous system from 20 patients (aged 68-92).
- Longitudinal investigation including structural, neurochemical, neuroimaging, and neuropsychological assessments.
- Analysis of neuropathological abnormalities such as infarcts and vascular changes.
Main Results:
- Lacunar infarcts and microinfarcts were the most common abnormalities, found in over half of the patients.
- Evidence of hippocampal injury was present in 11/20 patients.
- Severe atherosclerosis and arterio/arteriolosclerosis correlated with multiple lacunar infarcts.
Conclusions:
- IVD is associated with widespread small ischemic lesions throughout the CNS.
- Quantifying ischemic and parenchymal disease burden may aid in understanding dementia syndromes.
- Neuropathological features of both familial and sporadic vascular dementia are relevant.