Vascular cognitive impairment

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Vascular cognitive impairment (VCI) is a spectrum of cognitive impairments caused by various types of cerebrovascular disease that occurs as a result of interaction between a variety of vascular risk factors such as hypertension, obesity, dyslipidemia, diabetes mellitus, stroke and silent stroke. Included in this spectrum is Vascular Dementia (VaD), (the second leading cause of dementia after Alzheimer's disease (AD)) and Mild Vascular Cognitive Impairment (MVCI).[1][2][3]

VCI may result from clinical stroke of the large vessels or from microangiopathic changes in the small cerebral vessels. Radiological findings might include abnormally bright spots on a T2 weighted MRI scan in periventricular regions or in the deep white matter. This so-called "white matter disease" is commonly associated with vascular risk factors such as smoking and hypertension, and with subtle decline in cognitive performance with aging. Brain MRI might also show "lacunar infarcts" (spots which are hypointense on a T1 MRI scan) which are indicative of small "silent strokes", or hemorrhagic findings (small hemorrhagic findings are often referred to as "microbleeds"). The relative importance and precise aetiology of these findings remains a subject of debate.

Cognitive domains commonly affected by VCI include psychomotor processing speed, executive function and verbal memory.

References

  1. ↑ O'Brien JT, Erkinjuntti T, Reisberg B, et al. Vascular cognitive impairment. Lancet Neurol. 2003 Feb;2(2):89-98. PMID 12849265
  2. ↑ Erkinjuntti T, Gauthier S. The concept of vascular cognitive impairment. Front Neurol Neurosci. 2009;24:79-85. PMID 19182465
  3. ↑ Black S, Iadecola C. Stroke. Vascular cognitive impairment: small vessels, big toll: introduction. 2009 Mar;40(3 Suppl):S38-9. Epub 2008 Dec 8. PMID 19064766

External links

  • National Institute of Neurological Disorders and Stroke–Canadian Stroke Network Vascular Cognitive Impairment Harmonization Standards
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