With the progress in global demography of aging, dementia has become a great world health-care issue that require urgent attention and settlement. Demen-tia can arise from a variety of factors, such as neuronal degene...With the progress in global demography of aging, dementia has become a great world health-care issue that require urgent attention and settlement. Demen-tia can arise from a variety of factors, such as neuronal degeneration for Alzheimer’s disease （AD）, vascular risk factors and multiple infarcts for vascular dementia （VaD）, and both degeneration and vascular factors for mixed de-mentia （MD）. Pathophysiology of AD includes the amy-loid and tau protein hypothesis, and infammation-related mechanisms are also widespread mentioned. Subcortical ischemic vascular dementia （SIVD）, a subtype of VaD, is commonly caused by complete or incomplete lacunar infarction of VaD pathology. MD involves both degenera-tion and vascular factors, and the interaction between the two results in the complication of the pathological mech-anism and clinical phenotype. The clinical manifestationsof AD are often divided into four stages according to the progress of the disease, while the phenotypes of SIVD usually has two categories. As for MD, the phenotypes are complex and diverse. Several clinical studies showedthat its symptoms and signs are more similar to SIVD than AD. This article aims to analyze and compare the differ-ent aspects of the three kinds of dementia.展开更多
Objectives: Subcortical ischaemic vascular disease (SIVD) is a subtype of vascular cognitive impairment characterised by extensive white matter lesions and multiple lacunar infarcts. Radiologically defined diagnostic ...Objectives: Subcortical ischaemic vascular disease (SIVD) is a subtype of vascular cognitive impairment characterised by extensive white matter lesions and multiple lacunar infarcts. Radiologically defined diagnostic criteria for SIVD have been introduced, but only a few studies have presented empirical data on its clinical and cognitive features. The aim of this study is to describe in detail the neuropsychological characteristics of patients with SIVD from a large well defined stroke cohort. Methods: A sample of 323 consecutive patients with ischaemic stroke, aged 55- 85 years, was investigated using neuropsychological examination and magnetic resonance imaging (MRI). Patients fulfilling the MRI criteria of SIVD (n = 85) were compared to the other stroke patients (n=238) and to normal control subjects (n = 38). Results: Cognitive performance of the SIVD group was inferior to that of the normal control group throughout all domains. As compared to the other stroke patients, the SIVD group performed significantly worse in tests measuring executive functions and delayed memory recall. Adjusting for depression had no effect on these results. Instead, after controlling for medial temporal lobe atrophy, the differences disappeared for delayed memory but remained significant for executive functions. Conclusion: Executive deficits are the most prominent cognitive characteristic associated with SIVD. Patients with SIVD also exhibit subtle deficits in delayed memory, which is explained in part by medial temporal lobe atrophy. Cognitive and mood changes seem to be parallel but independent processes related to SIVD. The results support the concept of SIVD as a separate clinical entity.展开更多
文摘With the progress in global demography of aging, dementia has become a great world health-care issue that require urgent attention and settlement. Demen-tia can arise from a variety of factors, such as neuronal degeneration for Alzheimer’s disease （AD）, vascular risk factors and multiple infarcts for vascular dementia （VaD）, and both degeneration and vascular factors for mixed de-mentia （MD）. Pathophysiology of AD includes the amy-loid and tau protein hypothesis, and infammation-related mechanisms are also widespread mentioned. Subcortical ischemic vascular dementia （SIVD）, a subtype of VaD, is commonly caused by complete or incomplete lacunar infarction of VaD pathology. MD involves both degenera-tion and vascular factors, and the interaction between the two results in the complication of the pathological mech-anism and clinical phenotype. The clinical manifestationsof AD are often divided into four stages according to the progress of the disease, while the phenotypes of SIVD usually has two categories. As for MD, the phenotypes are complex and diverse. Several clinical studies showedthat its symptoms and signs are more similar to SIVD than AD. This article aims to analyze and compare the differ-ent aspects of the three kinds of dementia.
文摘Objectives: Subcortical ischaemic vascular disease (SIVD) is a subtype of vascular cognitive impairment characterised by extensive white matter lesions and multiple lacunar infarcts. Radiologically defined diagnostic criteria for SIVD have been introduced, but only a few studies have presented empirical data on its clinical and cognitive features. The aim of this study is to describe in detail the neuropsychological characteristics of patients with SIVD from a large well defined stroke cohort. Methods: A sample of 323 consecutive patients with ischaemic stroke, aged 55- 85 years, was investigated using neuropsychological examination and magnetic resonance imaging (MRI). Patients fulfilling the MRI criteria of SIVD (n = 85) were compared to the other stroke patients (n=238) and to normal control subjects (n = 38). Results: Cognitive performance of the SIVD group was inferior to that of the normal control group throughout all domains. As compared to the other stroke patients, the SIVD group performed significantly worse in tests measuring executive functions and delayed memory recall. Adjusting for depression had no effect on these results. Instead, after controlling for medial temporal lobe atrophy, the differences disappeared for delayed memory but remained significant for executive functions. Conclusion: Executive deficits are the most prominent cognitive characteristic associated with SIVD. Patients with SIVD also exhibit subtle deficits in delayed memory, which is explained in part by medial temporal lobe atrophy. Cognitive and mood changes seem to be parallel but independent processes related to SIVD. The results support the concept of SIVD as a separate clinical entity.
