Management of cognitive impairment of vascular origin

Background: Prurigo nodularis (PN) is a chronic refractory itchy dermatosis. Although psychiatric comorbidity is known, research in cognitive impairment is lacking. We evaluated the occurrence and types of cognitive impairment in a series of inpatients with PN. Methods: This was a retrospective chart review of all the patients with PN admitted to a referral neurological institute from September 2018 to March 2021. Any neurological and psychiatric disorder, along with neuroactive drugs taken, were concomitantly assessed. Results: A total of 16 patients with PN (median age: 70 years, two males) were selected from a total of 1806 hospital admissions. Most of them had a neurodegenerative cognitive disorder, from mild cognitive impairment (8) to Alzheimer’s disease (1), followed by mixed disorder (degenerative and vascular) in six and vascular dementia in one. Comorbid psychiatric diseases (anxiety and depression) were more common than either individual condition, followed by bipolar disorder, whereas two patients did not show psychiatric manifestations. Most patients were on combined treatment with benzodiazepines and antidepressants. Conclusion: Cognitive impairment can be observed in PN. In addition to screening for psychiatric comorbidity and initiating appropriate treatment or referral, clinicians may also consider the presence of cognitive impairment in PN of both degenerative and vascular origin.

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Management of cognitive impairment of vascular origin

Psychiatric Bulletin ◽

10.1192/pb.22.5.285 ◽

1998 ◽

Vol 22 (5) ◽

pp. 285-287 ◽

Cited By ~ 6

Author(s):

Michael Dennis ◽

Ann Boyle

Keyword(s):

Atrial Fibrillation ◽

Blood Pressure ◽

Cognitive Impairment ◽

Clinical Signs ◽

Postal Questionnaire ◽

Advanced Dementia ◽

Computerised Tomography ◽

Treatment Target ◽

Vascular Origin ◽

History Of

A postal questionnaire concerning the management of cognitive impairment of vascular origin was completed by 88 psychogeriatricians and 100 geriatricians. Aspirin was considered an important part of management, and clinically indicated with: a history, or clinical signs of stroke; computerised tomography (CT) scan changes suggestive of cerebrovascular disease; and atrial fibrillation. Advanced dementia was seen as a contraindication for treatment. Eighty per cent of responders indicated they would institute antihypertensive therapy in an elderly patient with a history of raised blood pressure and cognitive impairment. The median lower limit of systolic blood pressure requiring treatment was 160 mmHg, with a treatment target blood pressure of 150 mmHg.

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Role of White Matter Lesions in Cognitive Impairment of Vascular Origin

Alzheimer Disease & Associated Disorders ◽

10.1097/00002093-199912003-00008 ◽

1999 ◽

Vol 13 (Supplement 3) ◽

pp. S49-S54 ◽

Cited By ~ 7

Author(s):

Leonardo Pantoni ◽

Didier Leys ◽

Franz Fazekas ◽

Will T. Longstreth ◽

Domenico Inzitari ◽

...

Keyword(s):

Cognitive Impairment ◽

White Matter ◽

White Matter Lesions ◽

Vascular Origin

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Cognitive impairment of vascular origin: Neuropathology of cognitive impairment of vascular origin

Journal of the Neurological Sciences ◽

10.1016/j.jns.2010.08.039 ◽

2010 ◽

Vol 299 (1-2) ◽

pp. 139-149 ◽

Cited By ~ 44

Author(s):

Isidre Ferrer

Keyword(s):

Cognitive Impairment ◽

Vascular Origin

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Cerebral small vessel disease and cognitive impairment

Journal of Neurorestoratology ◽

10.26599/jnr.2019.9040023 ◽

2019 ◽

Vol 07 (04) ◽

pp. 184-195

Author(s):

Lifang Meng ◽

Jianhua Zhao ◽

Junli Liu ◽

Shaomin Li

Keyword(s):

Cognitive Impairment ◽

Cognitive Dysfunction ◽

Small Vessel Disease ◽

Early Recognition ◽

Cerebral Small Vessel Disease ◽

Small Vessel ◽

Perivascular Spaces ◽

Imaging Features ◽

Vessel Disease ◽

Vascular Origin

Cerebral small vessel disease (CSVD) is a pathophysiological process involving small arteries such as cerebellar arteries, arterioles, capillaries, and veinlets. Imaging features vary; they are mainly composed of recent subcortical infarcts, lacunes of presumed vascular origin, white matter hyperintensities (WMHs) of presumed vascular origin, cerebral microbleeds, enlarged perivascular spaces, and global and regional brain atrophy. CSVD is a common cause of vascular cognitive dysfunction, and in its end stage, dementia often develops. CSVD has been a major research hotspot; however, its causes are poorly understood. Neuroimaging markers of CSVD can be used as the basis for etiological analysis. This review highlights the relevance of neuroimaging markers and cognitive impairment, providing a new direction for the early recognition, treatment, and prevention of cognitive dysfunction in small cerebral angiopathy.

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Role of White Matter Hyperintensities and Related Risk Factors in Vascular Cognitive Impairment: A Review

Biomolecules ◽

10.3390/biom11081102 ◽

2021 ◽

Vol 11 (8) ◽

pp. 1102

Author(s):

Yiyi Chen ◽

Xing Wang ◽

Ling Guan ◽

Yilong Wang

Keyword(s):

Cognitive Impairment ◽

White Matter ◽

White Matter Hyperintensities ◽

Small Vessel Disease ◽

Treatment Strategies ◽

Vascular Cognitive Impairment ◽

Older Individuals ◽

The Status ◽

Vascular Origin ◽

Detection And Diagnosis

White matter hyperintensities (WMHs) of presumed vascular origin are one of the imaging markers of cerebral small-vessel disease, which is prevalent in older individuals and closely associated with the occurrence and development of cognitive impairment. The heterogeneous nature of the imaging manifestations of WMHs creates difficulties for early detection and diagnosis of vascular cognitive impairment (VCI) associated with WMHs. Because the underlying pathological processes and biomarkers of WMHs and their development in cognitive impairment remain uncertain, progress in prevention and treatment is lagging. For this reason, this paper reviews the status of research on the features of WMHs related to VCI, as well as mediators associated with both WMHs and VCI, and summarizes potential treatment strategies for the prevention and intervention in WMHs associated with VCI.

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