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Potential biomarkers for cerebral small vessel disease with cognitive impairment: a systematic review and

Libin Liao1, Weiquan Huang1, Rongchao Ma1

  • 1Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China.

Frontiers in Aging Neuroscience
|January 22, 2025
PubMed

Insights

Circulating homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) are potential biomarkers for diagnosing cognitive impairment in cerebral small vessel disease (CSVD). Elevated levels indicate a higher risk, aiding early detection and treatment strategies for this common age-related condition.

Area of Science:

  • Neurology
  • Biomarkers
  • Geriatrics

Background:

  • Cerebral small vessel disease (CSVD) is a primary cause of age-related cognitive impairment and dementia.
  • CSVD-related cognitive impairment (CSVD-CI) presents a growing global health challenge, impacting elderly populations and imposing significant socioeconomic burdens.
  • Circulating biomarkers are emerging as crucial tools for diagnosing, monitoring, and predicting outcomes in CSVD-CI.

Purpose of the Study:

  • To systematically review and meta-analyze the association between circulating factors and cognitive impairment in CSVD patients.
  • To evaluate the potential of identified circulating factors as diagnostic biomarkers for CSVD-CI.

Main Methods:

  • A systematic literature search was conducted across PubMed, Web of Science, Embase, and Cochrane Library for studies published before November 2023.
  • Twenty-nine relevant articles were selected from 2,911 initial records.
  • A meta-analysis was performed on studies reporting on four potential biomarkers: homocysteine (Hcy), high-sensitivity C-reactive protein (hs-CRP), lipoprotein-associated phospholipase A2 (Lp-PLA2), and neurofilament protein light chain (NfL).

Main Results:

  • Meta-analysis revealed significantly elevated levels of homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) in patients with CSVD-CI compared to those with CSVD but without cognitive impairment.
  • No statistically significant differences in Lp-PLA2 and NfL levels were observed between the CSVD-CI and CSVD-without cognitive impairment groups.
  • Hcy and hs-CRP demonstrated potential as reliable circulating markers for identifying cognitive impairment in CSVD.

Conclusions:

  • Homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) are identified as promising circulating biomarkers for cognitive impairment associated with cerebral small vessel disease.
  • These biomarkers may facilitate earlier clinical detection and diagnosis of CSVD-CI.
  • Further research can explore the integration of Hcy and hs-CRP into clinical practice for managing CSVD patients.

Keywords:
blood biomarkercerebral small vessel diseasecognitive impairmentdementiameta-analysis

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