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Published on: February 17, 2013
Blood and CSF biomarkers in brain subcortical ischemic vascular disease: Involved pathways and clinical applicability
Insights
Biomarkers in blood and cerebrospinal fluid show promise for detecting cerebral small-vessel disease (cSVD), a key factor in vascular dementia. Further research is needed to validate these markers for early diagnosis and monitoring.
Area of Science:
- Neurology
- Vascular Medicine
- Biomarker Research
Background:
- Vascular dementia is the second most common dementia type, often linked to cerebral small-vessel disease (cSVD).
- cSVD manifests as white matter hyperintensities and lacunar infarcts, detectable via neuroimaging.
- These findings, while related to aging and cognitive decline, can also be asymptomatic.
Purpose of the Study:
- To review existing studies on blood and cerebrospinal fluid (CSF) markers associated with WMHs and lacunar infarcts.
- To explore the potential of these markers in diagnosing and monitoring vascular cognitive impairment.
Main Methods:
- Literature review of population-based and high-risk patient studies.
- Analysis of blood and CSF markers related to inflammation, endothelial damage, and coagulation/fibrinolysis.
- Examination of marker associations with cSVD presence and progression.
Main Results:
- Blood markers associated with inflammation, endothelial damage, and coagulation/fibrinolysis show relevance to cSVD.
- Specific CSF marker combinations may aid in differentiating dementia etiologies.
- Candidate markers require validation in large-scale, prospective studies.
Conclusions:
- Blood and CSF biomarkers show potential for identifying and monitoring cSVD and vascular cognitive impairment.
- Replication in large-scale, multicenter, prospective studies is crucial for clinical translation.
- Biomarker development could significantly improve early diagnosis and management of vascular dementia.
Abstract:
Vascular dementia is the second most common type of dementia after Alzheimer’s disease (AD). Subcortical ischemic vascular disease refers to a form of vascular cognitive impairment characterized by the presence of diffuse white matter hyperintensities (WMHs) and multiple lacunar infarcts. These neuroimaging findings are mainly caused by cerebral small-vessel disease (cSVD) and relate to aging and cognitive impairment, but they can also be silent and highly prevalent in otherwise healthy individuals. We aimed to review studies on blood and cerebrospinal fluid (CSF) markers related to the presence of WMHs and lacunar infarcts that have been conducted in the past in large population-based studies and in high-risk selected patients (such as those with vascular risk factors, vascular cognitive impairment, or AD). Relevant associations with the presence and progression of cSVD have been described in the blood for markers related to inflammatory processes, endothelial damage and coagulation/fibrinolysis processes, etc. Also, different combinations of CSF markers might help to differentiate between etiologic types of dementia. In the future, to translate these findings into clinical practice and use biomarkers to early diagnosis and monitoring vascular cognitive impairment would require the replication of candidate markers in large-scale, multicenter, and prospectively designed studies.
