Subcortical ischemic vascular disease and dementia

Area of Science:

• Neurology
• Vascular Neurology
• Neuroimaging

Background:

• Subcortical ischemic vascular disease and dementia (SIVD) is characterized by small vessel disease, lacunar infarcts, and white-matter lesions in subcortical brain regions.
• It encompasses Binswanger's syndrome and the lacunar state, presenting with distinct neuroimaging findings.

Purpose of the Study:

• To define Subcortical ischemic vascular disease and dementia (SIVD) as a homogenous subtype of vascular cognitive impairment.
• To review and propose modified NINDS-AIREN research criteria for SIVD.
• To highlight the need for further research into SIVD's natural history and outcomes.

Main Methods:

• Literature review and synthesis of existing research on SIVD.
• Analysis of neuroimaging characteristics, including white-matter lesions and lacunae.
• Evaluation of proposed diagnostic criteria.

Main Results:

• SIVD is defined by specific vascular etiologies, lesion types (lacunar infarcts, white-matter lesions), subcortical locations, and clinical manifestations.
• Patients typically exhibit extensive white-matter lesions and multiple lacunae on neuroimaging.
• Modified NINDS-AIREN criteria have been proposed for SIVD.

Conclusions:

• SIVD represents a more homogenous subtype of vascular cognitive impairment and dementia.
• Refinement of diagnostic criteria, staging, and validation of imaging criteria are crucial.
• Further empirical research is required to elucidate the natural history and outcomes of SIVD.