Consensus statement for diagnosis of subcortical small vessel disease

Author:

Rosenberg Gary A1,Wallin Anders2,Wardlaw Joanna M3,Markus Hugh S4,Montaner Joan5,Wolfson Leslie6,Iadecola Costantino7,Zlokovic Berislav V8,Joutel Anne9,Dichgans Martin10,Duering Marco11,Schmidt Reinhold11,Korczyn Amos D12,Grinberg Lea T1314,Chui Helena C15,Hachinski Vladimir16

Affiliation:

1. Department of Neurology, University of New Mexico, Albuquerque, New Mexico, USA

2. Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden

3. Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK

4. Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK

5. Neurovascular Research Laboratory, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain

6. Department of Neurology, University of Connecticut Health Center, Farmington, Connecticut, USA

7. Feil Family Brain and Mind Research Institute, Weill Cornell Medical College, New York, New York, USA

8. Department of Physiology and Biophysics, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA

9. INSERM, U1161, Paris, France

10. Institute for Stroke and Dementia Research, Klinikum der Universität München, Munich, Germany

11. Department of Neurology, Medical University of Graz, Graz, Austria

12. Tel-Aviv University Medical School, Ramat Aviv, Israel

13. Department of Neurology, Memory and Aging Center and Department of Pathology, University of California, San Francisco, California, USA

14. University of Sao Paulo Medical School, Sao Paulo, Brazil

15. Department of Neurology, University of Southern California Medical School, Los Angeles, California, USA

16. Department of Clinical Neurological Sciences, University Hospital, University of Western Ontario, London, Ontario, Canada

Abstract

Vascular cognitive impairment (VCI) is the diagnostic term used to describe a heterogeneous group of sporadic and hereditary diseases of the large and small blood vessels. Subcortical small vessel disease (SVD) leads to lacunar infarcts and progressive damage to the white matter. Patients with progressive damage to the white matter, referred to as Binswanger’s disease (BD), constitute a spectrum from pure vascular disease to a mixture with neurodegenerative changes. Binswanger’s disease patients are a relatively homogeneous subgroup with hypoxic hypoperfusion, lacunar infarcts, and inflammation that act synergistically to disrupt the blood–brain barrier (BBB) and break down myelin. Identification of this subgroup can be facilitated by multimodal disease markers obtained from clinical, cerebrospinal fluid, neuropsychological, and imaging studies. This consensus statement identifies a potential set of biomarkers based on underlying pathologic changes that could facilitate diagnosis and aid patient selection for future collaborative treatment trials.

Publisher

SAGE Publications

Subject

Cardiology and Cardiovascular Medicine,Neurology (clinical),Neurology

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