Post-mortem assessment in vascular dementia: Advances and aspirations

Kirsty E. McAleese, Irina Alafuzoff, Andreas Charidimou, Jacques De Reuck, Lea T. Grinberg, Atticus H. Hainsworth, Tibor Hortobagyi, Paul Ince, Kurt Jellinger, Jing Gao, Raj N. Kalaria, Gabor G. Kovacs, Enikö Kövari, Seth Love, Mara Popovic, Olivia Skrobot, Ricardo Taipa, Dietmar R. Thal, David Werring, Stephen B. WhartonJohannes Attems

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Abstract

Background: Cerebrovascular lesions are a frequent finding in the elderly population. However, the impact of these lesions on cognitive performance, the prevalence of vascular dementia, and the pathophysiology behind characteristic in vivo imaging findings are subject to controversy. Moreover, there are no standardised criteria for the neuropathological assessment of cerebrovascular disease or its related lesions in human post-mortem brains, and conventional histological techniques may indeed be insufficient to fully reflect the consequences of cerebrovascular disease. Discussion: Here, we review and discuss both the neuropathological and in vivo imaging characteristics of cerebrovascular disease, prevalence rates of vascular dementia, and clinico-pathological correlations. We also discuss the frequent comorbidity of cerebrovascular pathology and Alzheimer's disease pathology, as well as the difficult and controversial issue of clinically differentiating between Alzheimer's disease, vascular dementia and mixed Alzheimer's disease/vascular dementia. Finally, we consider additional novel approaches to complement and enhance current post-mortem assessment of cerebral human tissue. Conclusion: Elucidation of the pathophysiology of cerebrovascular disease, clarification of characteristic findings of in vivo imaging and knowledge about the impact of combined pathologies are needed to improve the diagnostic accuracy of clinical diagnoses.

Original languageEnglish
Article number129
JournalBMC Medicine
Volume14
Issue number1
DOIs
Publication statusPublished - Aug 26 2016

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Keywords

  • Cerebrovascular disease
  • Cerebrovascular lesions
  • Magnetic resonance imaging
  • Mixed dementia
  • Neuropathology
  • Post-mortem MRI
  • Vascular cognitive impairment
  • Vascular dementia

ASJC Scopus subject areas

  • Medicine(all)

Cite this

McAleese, K. E., Alafuzoff, I., Charidimou, A., De Reuck, J., Grinberg, L. T., Hainsworth, A. H., Hortobagyi, T., Ince, P., Jellinger, K., Gao, J., Kalaria, R. N., Kovacs, G. G., Kövari, E., Love, S., Popovic, M., Skrobot, O., Taipa, R., Thal, D. R., Werring, D., ... Attems, J. (2016). Post-mortem assessment in vascular dementia: Advances and aspirations. BMC Medicine, 14(1), [129]. https://doi.org/10.1186/s12916-016-0676-5