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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
07:30

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

Published on: April 23, 2021

[Vascular dementia: big effects of small lesions]

G Gold1, E Kövari

  • 1Service de médecine interne et de réabilitation, Département de médecine interne, de réhabilitation et de gériatrie, Hôpital des Trois-Chêne, 1226 Thônex.

Revue Medicale Suisse
|December 15, 2011
PubMed

Insights

Small vessel disease and microscopic brain lesions, not large strokes, are the primary drivers of vascular dementia in aging brains. Identifying these small lesions improves diagnosis and potential treatments for dementia.

Area of Science:

  • Neurology
  • Neuroscience
  • Gerontology

Context:

  • Vascular dementia (VaD) is often attributed to multiple large strokes (multi-infarct dementia).
  • Emerging clinicopathologic and neuroimaging evidence indicates small vessel and microscopic vascular pathologies are prevalent in aging brains.
  • This suggests small lesion-induced VaD is likely the most common form.

Purpose:

  • To investigate the association between small vascular lesions and cognitive function in aging brains.
  • To determine the relative contribution of different small vascular pathologies to cognitive decline.
  • To highlight the significance of microscopic vascular changes in the diagnosis and treatment of dementia.

Summary:

  • Cortical microinfarcts show the strongest correlation with global cognitive function in cases of small lesion VaD.
  • Basal ganglia and thalamic lacunes are also significant correlates of cognitive impairment.
  • Demyelination has a weak association with cognition, which becomes insignificant when lacunes are considered.

Impact:

  • Increased awareness of small vascular lesions in brain aging can enhance diagnostic accuracy for dementia.
  • Identifying these microscopic pathologies may reveal novel therapeutic targets for age-related cognitive decline.
  • This research shifts focus towards microvascular changes in understanding and managing dementia.

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