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Recent Updates on Subcortical Ischemic Vascular Dementia

Vascular dementia (VaD) is a history-laden disease entity that dates back to the 19th century when arteriosclerotic brain atrophy due to hardening of the arteries was perceived as the major cause of senile dementia. Its existence had been overshadowed by the emergence of Alzheimer's disease (AD...

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Autores principales: Roh, Jee Hoon, Lee, Jae-Hong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Stroke Society 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3961819/
https://www.ncbi.nlm.nih.gov/pubmed/24741561
http://dx.doi.org/10.5853/jos.2014.16.1.18
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author Roh, Jee Hoon
Lee, Jae-Hong
author_facet Roh, Jee Hoon
Lee, Jae-Hong
author_sort Roh, Jee Hoon
collection PubMed
description Vascular dementia (VaD) is a history-laden disease entity that dates back to the 19th century when arteriosclerotic brain atrophy due to hardening of the arteries was perceived as the major cause of senile dementia. Its existence had been overshadowed by the emergence of Alzheimer's disease (AD) in the past century and research on AD dominated the field of dementia. Interest in VaD has been revived in recent years as vascular lesions have been shown to make great contributions to the development of dementia, particularly in the elderly. VaD has now evolved into the concept of vascular cognitive impairment (VCI), which encompasses not only VaD but also AD with cerebrovascular disorder and VCI with no dementia. The concept of VCI is intended to maximize the therapeutic potential in dementia management because the vascular component may be amenable to therapeutic intervention particularly in the early stages of cognitive impairment. Subcortical ischemic vascular dementia (SIVD) is pathologically driven by severe stenosis and the occlusion of small vessels that culminate into white matter ischemia and multiple lacunar infarctions in the subcortical structures. The relatively slow progression of symptoms and clinical manifestations associated with cholinergic deficits often make the differentiation of SIVD from AD difficult. The recent development of in vivo amyloid imaging enabled further pathological breakdown of SIVD into pure SIVD and mixed dementia with subcortical ischemia based on the absence or existence of amyloid pathology in the brain. In this article, the authors reviewed the emerging concepts of VaD/VCI and the clinical manifestations, biomarkers, treatments, and preclinical models of SIVD based on the pathophysiologic mechanisms of the disease.
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spelling pubmed-39618192014-04-16 Recent Updates on Subcortical Ischemic Vascular Dementia Roh, Jee Hoon Lee, Jae-Hong J Stroke Review Vascular dementia (VaD) is a history-laden disease entity that dates back to the 19th century when arteriosclerotic brain atrophy due to hardening of the arteries was perceived as the major cause of senile dementia. Its existence had been overshadowed by the emergence of Alzheimer's disease (AD) in the past century and research on AD dominated the field of dementia. Interest in VaD has been revived in recent years as vascular lesions have been shown to make great contributions to the development of dementia, particularly in the elderly. VaD has now evolved into the concept of vascular cognitive impairment (VCI), which encompasses not only VaD but also AD with cerebrovascular disorder and VCI with no dementia. The concept of VCI is intended to maximize the therapeutic potential in dementia management because the vascular component may be amenable to therapeutic intervention particularly in the early stages of cognitive impairment. Subcortical ischemic vascular dementia (SIVD) is pathologically driven by severe stenosis and the occlusion of small vessels that culminate into white matter ischemia and multiple lacunar infarctions in the subcortical structures. The relatively slow progression of symptoms and clinical manifestations associated with cholinergic deficits often make the differentiation of SIVD from AD difficult. The recent development of in vivo amyloid imaging enabled further pathological breakdown of SIVD into pure SIVD and mixed dementia with subcortical ischemia based on the absence or existence of amyloid pathology in the brain. In this article, the authors reviewed the emerging concepts of VaD/VCI and the clinical manifestations, biomarkers, treatments, and preclinical models of SIVD based on the pathophysiologic mechanisms of the disease. Korean Stroke Society 2014-01 2014-01-31 /pmc/articles/PMC3961819/ /pubmed/24741561 http://dx.doi.org/10.5853/jos.2014.16.1.18 Text en Copyright © 2014 Korean Stroke Society http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
Roh, Jee Hoon
Lee, Jae-Hong
Recent Updates on Subcortical Ischemic Vascular Dementia
title Recent Updates on Subcortical Ischemic Vascular Dementia
title_full Recent Updates on Subcortical Ischemic Vascular Dementia
title_fullStr Recent Updates on Subcortical Ischemic Vascular Dementia
title_full_unstemmed Recent Updates on Subcortical Ischemic Vascular Dementia
title_short Recent Updates on Subcortical Ischemic Vascular Dementia
title_sort recent updates on subcortical ischemic vascular dementia
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3961819/
https://www.ncbi.nlm.nih.gov/pubmed/24741561
http://dx.doi.org/10.5853/jos.2014.16.1.18
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