scholarly journals Update on the Neurobiology of Vascular Cognitive Impairment: From Lab to Clinic

2020 ◽  
Vol 21 (8) ◽  
pp. 2977 ◽  
Author(s):  
Luisa Vinciguerra ◽  
Giuseppe Lanza ◽  
Valentina Puglisi ◽  
Francesco Fisicaro ◽  
Manuela Pennisi ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Disease Process ◽  
The Elderly ◽  
Vascular Cognitive Impairment ◽  
Cognitive Disorder ◽  
Vascular Lesion ◽  
Adaptive Plasticity ◽  
Disease Modifying Drugs ◽  
Neurophysiological Studies ◽  
Degenerative Dementia

In the last years, there has been a significant growth in the literature exploring the pathophysiology of vascular cognitive impairment (VCI). As an “umbrella term” encompassing any degree of vascular-related cognitive decline, VCI is deemed to be the most common cognitive disorder in the elderly, with a significant impact on social and healthcare expenses. Interestingly, some of the molecular, biochemical, and electrophysiological abnormalities detected in VCI seem to correlate with disease process and progression, eventually promoting an adaptive plasticity in some patients and a maladaptive, dysfunctional response in others. However, the exact relationships between vascular lesion, cognition, and neuroplasticity are not completely understood. Recent findings point out also the possibility to identify a panel of markers able to predict cognitive deterioration in the so-called “brain at risk” for vascular or mixed dementia. This will be of pivotal importance when designing trials of disease-modifying drugs or non-pharmacological approaches, including non-invasive neuromodulatory techniques. Taken together, these advances could make VCI a potentially preventable cause of both vascular and degenerative dementia in late life. This review provides a timely update on the recent serological, cerebrospinal fluid, histopathological, imaging, and neurophysiological studies on this “cutting-edge” topic, including the limitations, future perspectives and translational implications in the diagnosis and management of VCI patients.

scholarly journals Evaluation and Treatment of Vascular Cognitive Impairment by Transcranial Magnetic Stimulation

2020 ◽  
Vol 2020 ◽  
pp. 1-17
Author(s):  
Mariagiovanna Cantone ◽  
Giuseppe Lanza ◽  
Francesco Fisicaro ◽  
Manuela Pennisi ◽  
Rita Bella ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Synaptic Plasticity ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Cortical Excitability ◽  
Disease Process ◽  
Vascular Cognitive Impairment ◽  
Future Research ◽  
Disease Modifying Drugs

The exact relationship between cognitive functioning, cortical excitability, and synaptic plasticity in dementia is not completely understood. Vascular cognitive impairment (VCI) is deemed to be the most common cognitive disorder in the elderly since it encompasses any degree of vascular-based cognitive decline. In different cognitive disorders, including VCI, transcranial magnetic stimulation (TMS) can be exploited as a noninvasive tool able to evaluate in vivo the cortical excitability, the propension to undergo neural plastic phenomena, and the underlying transmission pathways. Overall, TMS in VCI revealed enhanced cortical excitability and synaptic plasticity that seem to correlate with the disease process and progression. In some patients, such plasticity may be considered as an adaptive response to disease progression, thus allowing the preservation of motor programming and execution. Recent findings also point out the possibility to employ TMS to predict cognitive deterioration in the so-called “brains at risk” for dementia, which may be those patients who benefit more of disease-modifying drugs and rehabilitative or neuromodulatory approaches, such as those based on repetitive TMS (rTMS). Finally, TMS can be exploited to select the responders to specific drugs in the attempt to maximize the response and to restore maladaptive plasticity. While no single TMS index owns enough specificity, a panel of TMS-derived measures can support VCI diagnosis and identify early markers of progression into dementia. This work reviews all TMS and rTMS studies on VCI. The aim is to evaluate how cortical excitability, plasticity, and connectivity interact in the pathophysiology of the impairment and to provide a translational perspective towards novel treatments of these patients. Current pitfalls and limitations of both studies and techniques are also discussed, together with possible solutions and future research agenda.

scholarly journals Vascular Cognitive Impairment through the Looking Glass of Transcranial Magnetic Stimulation

2017 ◽  
Vol 2017 ◽  
pp. 1-16 ◽  
Author(s):  
Giuseppe Lanza ◽  
Placido Bramanti ◽  
Mariagiovanna Cantone ◽  
Manuela Pennisi ◽  
Giovanni Pennisi ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Transcranial Magnetic Stimulation ◽  
Neural Plasticity ◽  
Magnetic Stimulation ◽  
Cortical Excitability ◽  
Disease Process ◽  
Vascular Cognitive Impairment ◽  
Vascular Lesions ◽  
Early Markers ◽  
Degenerative Dementia

In the last years, there has been a significant growth in the literature exploiting transcranial magnetic stimulation (TMS) with the aim at gaining further insights into the electrophysiological and neurochemical basis underlying vascular cognitive impairment (VCI). Overall, TMS points at enhanced brain cortical excitability and synaptic plasticity in VCI, especially in patients with overt dementia, and neurophysiological changes seem to correlate with disease process and progress. These findings have been interpreted as part of a glutamate-mediated compensatory effect in response to vascular lesions. Although a single TMS parameter owns low specificity, a panel of measures can support the VCI diagnosis, predict progression, and possibly identify early markers of “brain at risk” for future dementia, thus making VCI a potentially preventable cause of both vascular and degenerative dementia in late life. Moreover, TMS can be also exploited to select and evaluate the responders to specific drugs, as well as to become an innovative rehabilitative tool in the attempt to restore impaired neural plasticity. The present review provides a perspective of the different TMS techniques by further understanding the cortical electrophysiology and the role of distinctive neurotransmission pathways and networks involved in the pathogenesis and pathophysiology of VCI and its subtypes.

scholarly journals Mild Cognitive Impairment in Clinical Practice: A Review Article

2018 ◽  
Vol 33 (8) ◽  
pp. 500-507 ◽  
Author(s):  
Sukanya Jongsiriyanyong ◽  
Panita Limpawattana
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Preventive Intervention ◽  
Lifestyle Modification ◽  
The Elderly ◽  
Vascular Cognitive Impairment ◽  
Review Article ◽  
Subjective Cognitive Impairment ◽  
Rate Of Progression

The spectrum of cognitive decline in the elderly ranges from what can be classified as normal cognitive decline with aging to subjective cognitive impairment to mild cognitive impairment (MCI) to dementia. This article reviewed the up-to-date evidence of MCI including the diagnostic criteria of MCI due to Alzheimer’s disease, vascular cognitive impairment and MCI due to Parkinson disease, management and preventive intervention of MCI. There are various etiologies of MCI, and a large number of studies have been conducted to ascertain the practical modalities of preserving cognition in predementia stages. Lifestyle modification, such as aerobic exercise, is an approved modality to preserve cognitive ability and decrease the rate of progression to dementia, as well as being recommended for frailty prevention.

scholarly journals The role of inflammasomes in vascular cognitive impairment

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Luting Poh ◽  
Wei Liang Sim ◽  
Dong-Gyu Jo ◽  
Quynh Nhu Dinh ◽  
Grant R. Drummond ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Critical Role ◽  
Disease Onset ◽  
The Elderly ◽  
Vascular Cognitive Impairment ◽  
Cerebral Hypoperfusion ◽  
Early Event ◽  
Cellular Mechanisms ◽  
Structural Brain Damage

AbstractThere is an increasing prevalence of Vascular Cognitive Impairment (VCI) worldwide, and several studies have suggested that Chronic Cerebral Hypoperfusion (CCH) plays a critical role in disease onset and progression. However, there is a limited understanding of the underlying pathophysiology of VCI, especially in relation to CCH. Neuroinflammation is a significant contributor in the progression of VCI as increased systemic levels of the proinflammatory cytokine interleukin-1β (IL-1β) has been extensively reported in VCI patients. Recently it has been established that CCH can activate the inflammasome signaling pathways, involving NLRP3 and AIM2 inflammasomes that critically regulate IL-1β production. Given that neuroinflammation is an early event in VCI, it is important that we understand its molecular and cellular mechanisms to enable development of disease-modifying treatments to reduce the structural brain damage and cognitive deficits that are observed clinically in the elderly. Hence, this review aims to provide a comprehensive insight into the molecular and cellular mechanisms involved in the pathogenesis of CCH-induced inflammasome signaling in VCI.

Post-stroke cognitive impairment

2020 ◽  
pp. 381-398
Author(s):  
Sandeep Ankolekar ◽  
Michela Simoni
Keyword(s):  
Cognitive Impairment ◽  
Vascular Dementia ◽  
Vascular Cognitive Impairment ◽  
International Classification Of Diseases ◽  
Great Depth ◽  
Cognitive Disorder ◽  
Post Stroke ◽  
Classification Of Diseases ◽  
Icd 10

‘Post-stroke cognitive impairment’ explores in great depth the burden of post-stroke cognitive impairment, its pathological substrates and clinical characteristics, the causes of these impairments, post-stroke dementia, and the risk factors implicated. The chapter examines common definitions (vascular cognitive impairment, vascular dementia, post-stroke cognitive impairment), the DSM-5 criteria (Diagnostic and Statistical Manual of Mental Disorders-5), ICD-10 criteria (International Classification of Diseases), NINDS-AIREN criteria (National Institute of Neurological Disorders and Stroke and the Association Internationale pour la Recherche et l’Enseignement en Neurosciences) for vascular dementia, and vascular mild cognitive impairment. The VASCOG (vascular cognitive disorder) criteria are also described. A pragmatic approach to investigations and various assessment scales, a description of important clinical trials, and the management of these disorders are also included.

Vascular cognitive disorder: a new diagnostic category updating vascular cognitive impairment and vascular dementia

2004 ◽  
Vol 226 (1-2) ◽  
pp. 81-87 ◽  
Author(s):  
Gustavo C. Román ◽  
Perminder Sachdev ◽  
Donald R. Royall ◽  
Roger A. Bullock ◽  
Jean-Marc Orgogozo ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Vascular Dementia ◽  
Diagnostic Category ◽  
Vascular Cognitive Impairment ◽  
Cognitive Disorder ◽  
Vascular Cognitive Disorder

Vascular Cognitive Impairment: Perspective and Review

2007 ◽  
Vol 35 (3) ◽  
pp. 325-364 ◽  
Author(s):  
Lee Hyer ◽  
Jill Damon ◽  
Zeba Nizam
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Vascular Dementia ◽  
Vascular Disease ◽  
Disease Process ◽  
Vascular Cognitive Impairment ◽  
Cerebral Vascular Disease ◽  
Heterogeneous Condition ◽  
Potential Problems ◽  
The Many

Mild Cognitive Impairment (MCI) is a construct that has received considerable interest in the last 15 years. One variant of MCI is Vascular Cognitive Impairment (VCI), a relatively new idea with considerable importance. VCI is a reflection of cerebral vascular disease and is a prodrome of Vascular dementia. It is both prevalent and represents a marker that can be addressed and even prevented. Its presence suggests further decline, as well as current problems. In this article we address this heterogeneous condition and present a context. We discuss both Alzheimer's disease and vascular dementia, and consider the many variables related to vascular problems. We then consider MCI itself, with a focus on the relatively unstudied concept of mild vascular cognitive impairment. We address the cognitive features of this disease process and its implications for adjustment and potential problems. To illustrate these concepts, we will present a case, ways to assess it, and implications for treatment. We conclude by considering assessment and the issue of competence specific to VCI.

scholarly journals Plasma osteopontin as a biomarker of Alzheimer’s disease and vascular cognitive impairment

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yuek Ling Chai ◽  
Joyce R. Chong ◽  
Ainiah R. Raquib ◽  
Xin Xu ◽  
Saima Hilal ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Inflammatory Cytokines ◽  
Inflammatory Marker ◽  
Vascular Diseases ◽  
The Elderly ◽  
Vascular Cognitive Impairment ◽  
Cross Sectional Study ◽  
Cross Sectional

AbstractCerebrovascular disease (CeVD) and neurodegenerative dementia such as Alzheimer’s disease (AD) are frequently associated comorbidities in the elderly, sharing common risk factors and pathophysiological mechanisms including neuroinflammation. Osteopontin (OPN) is an inflammatory marker found upregulated in vascular diseases as well as in AD. However, its involvement in vascular dementia (VaD) and pre-dementia stages, namely cognitive impairment no dementia (CIND), both of which fall under the spectrum of vascular cognitive impairment (VCI), has yet to be examined. Its correlations with inflammatory cytokines in cognitive impairment also await investigation. 80 subjects with no cognitive impairment (NCI), 160 with CIND and 144 with dementia were included in a cross-sectional study on a Singapore-based memory clinic cohort. All subjects underwent comprehensive clinical, neuropsychological and brain neuroimaging assessments, together with clinical diagnoses based on established criteria. Blood samples were collected and OPN as well as inflammatory cytokines interleukin (IL)-6, IL-8 and tumor necrosis factor (TNF) were measured using immunoassays. Multivariate regression analyses showed significant associations between increased OPN and VCI groups, namely CIND with CeVD, AD with CeVD and VaD. Interestingly, higher OPN was also significantly associated with AD even in the absence of CeVD. We further showed that increased OPN significantly associated with neuroimaging markers of CeVD and neurodegeneration, including cortical infarcts, lacunes, white matter hyperintensities and brain atrophy. OPN also correlated with elevated levels of IL-6, IL-8 and TNF. Our findings suggest that OPN may play a role in both VCI and neurodegenerative dementias. Further longitudinal analyses are needed to assess the prognostic utility of OPN in disease prediction and monitoring.

scholarly journals Strategy of membrane protection in pharmacotherapy of vascular cognitive impairment

2021 ◽  
Vol 16 (8) ◽  
pp. 37-42
Author(s):  
S.G. Burchinsky
Keyword(s):  
Cognitive Impairment ◽  
Cerebrovascular Disorders ◽  
The Elderly ◽  
Vascular Cognitive Impairment ◽  
Mechanisms Of Action ◽  
Point Of View ◽  
Clinical Use ◽  
Mild Cognitive Impairment Syndrome ◽  
Selection Of ◽  
Membrane Protection

The article considers modern views on the problem of vascular cognitive dysfunction, in particular, on the nature and options of treatment of mild cognitive impairment syndrome as one of the most common forms of cognitive decline in the elderly and senile patients. From this point of view, the requirements for the selection of the optimal pharmacological tool for pharmacotherapy and pharmacoprophylaxis of this syndrome, especially the strategy of membrane protection, are analyzed. Particular attention is paid to the mechanisms of action and features of clinical use of Lira (citicoline) — a drug with unique clinical and pharmacological properties that allow implementing a strategy of pathogenetically sound neuro- and geroprotective pharmacotherapy in cerebrovascular disorders. Mechanisms of action, clinical efficacy of Lira (citicoline), safety characteristics and recommendations for practical use of the drug are considered in detail.

Sign in / Sign up

Export Citation Format

Share Document