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Published on: February 7, 2015
Biomarkers Related to Endothelial Dysfunction and Vascular Cognitive Impairment: A Systematic Review
Rui Kleber Martins-Filho1, Maria Clara Zotin2, Guilherme Rodrigues3
1Department of Neurosciences and Behavioural Sciences, Hospital das Clínicas - Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil, ruikleber@usp.br.
Insights
Biomarkers show a link between endothelial dysfunction and vascular cognitive impairment (VCI). More research is needed to find specific markers for better diagnosis and new treatments for VCI.
Area of Science:
- Neurology
- Biomarker Research
- Vascular Dementia
Background:
- Endothelial damage and neurovascular unit dysfunction are central to vascular cognitive impairment (VCI) pathogenesis.
- Despite advances, unanswered questions and diagnostic challenges hinder VCI comprehension and treatment development.
- Biomarker investigation is crucial for novel VCI models and therapeutic targets.
Purpose of the Study:
- To review current research on biomarkers for vascular cognitive impairment (VCI).
- To synthesize findings on various types of VCI biomarkers.
- To identify gaps in biomarker research for improved VCI diagnosis and treatment.
Main Methods:
- Conducted a systematic literature search of MEDLINE for VCI biomarker research over the past 20 years.
- Included original research adhering to prespecified selection criteria.
- Performed qualitative synthesis of extracted data.
Main Results:
- Reviewed 42 articles focusing on VCI biomarkers.
- Investigated plasma (16), neuropathological (17), CSF (4), and neuroimaging (4) markers.
- Included one study on peripheral Doppler perfusion imaging.
Conclusions:
- Biomarker studies indicate a strong association between endothelial dysfunction and VCI.
- A distinct set of biomarkers is needed to enhance VCI clinical approaches and diagnostic accuracy.
- Further biomarker identification is essential for developing alternative VCI therapies.
Introduction:
The damage in the endothelium and the neurovascular unit appears to play a key role in the pathogenesis of vascular cognitive impairment (VCI). Although there have been many advances in understanding the physiopathology of this disease, several questions remain unanswered. The association with other degenerative diseases and the heterogeneity of its clinical spectrum establish a diagnostic problem, compromising a better comprehension of the pathology and halting the development of effective treatments. The investigation of biomarkers is an important movement to the development of novel explicative models and treatment targets involved in VCI.
Methods:
We searched MEDLINE considering the original research based on VCI biomarkers in the past 20 years, following prespecified selection criteria, data extraction, and qualitative synthesis.
Results:
We reviewed 42 articles: 16 investigated plasma markers, 17 analyzed neuropathological markers, 4 studied CSF markers, 4 evaluated neuroimaging markers (ultrasound and MRI), and 1 used peripheral Doppler perfusion imaging.
Conclusions:
The biomarkers in these studies suggest an intrinsic relationship between endothelial dysfunction and VCI. Nonetheless, there is still a need for identification of a distinctive set of markers that can integrate the clinical approach of VCI, improve diagnostic accuracy, and support the discovery of alternative therapies.
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