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Diagnostic criteria of vascular dementia in CADASIL

Sarah Benisty1, Karen Hernandez, Anand Viswanathan

  • 1Department of Geriatric Medicine, University Paris 7, 2 rue Ambroise Paré, 75010 Paris, France.

Stroke
|February 9, 2008
PubMed

Insights

Modified NINDS-AIREN criteria best detect subcortical ischemic vascular dementia (SIVD) in CADASIL patients. Neuroimaging criteria show high sensitivity for SIVD diagnosis in this genetic model.

Area of Science:

  • Neurology
  • Genetics
  • Neuroimaging

Background:

  • Subcortical ischemic vascular dementia (SIVD) is a key subtype of vascular dementia (VaD).
  • Recent modifications to VaD diagnostic criteria aim to include SIVD.
  • CADASIL serves as a genetic model for SIVD, valuable for assessing diagnostic criteria.

Purpose of the Study:

  • To compare the effectiveness of various vascular dementia diagnostic criteria in CADASIL patients.
  • To evaluate the significance of modified VaD criteria in a specific genetic population.

Main Methods:

  • Applied DSM-IV, ICD-10, standard NINDS-AIREN, and modified NINDS-AIREN for SIVD criteria to 115 CADASIL patients.
  • Diagnosed dementia and its association with vascular lesions in two steps.
  • Analyzed the percentage of patients meeting each criterion and the concordance between them.

Main Results:

  • Twenty-nine patients met at least one VaD criterion.
  • Sensitivity for VaD diagnosis: DSM-IV (79%), ICD-10 (72%), standard NINDS-AIREN (45%).
  • Modified NINDS-AIREN criteria for SIVD showed 90% sensitivity; neuroimaging criteria were met by all dementia patients.

Conclusions:

  • Modified NINDS-AIREN criteria demonstrate the highest sensitivity for diagnosing SIVD in CADASIL.
  • Neuroimaging criteria are highly sensitive for SIVD but lack specificity.
  • Focal neurological signs were inconsistently present in CADASIL patients with dementia.
Abstract

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