Vascular Cognitive Disorder

Paradise, Matthew; Sachdev, Perminder S.

doi:10.1055/s-0039-1678582

Cited by 21 publications

(22 citation statements)

References 117 publications

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“…The diagnosis of vascular dementia requires not only sufficient clinical information but also pathological examinations, neuropsychological examinations, and imaging data [21]. However, when ALI patients develop MCI, the low level of cognitive impairment is not insufficient to interfere with the independence of their lives and does not significantly affect daily abilities [22]; therefore, it often goes unnoticed. Once MCI progresses to clinical discovery or significant neuroimaging (MRI or CT) evidence of cerebrovascular disease, the optimal treatment period has been missed [23].…”

Section: Discussionmentioning

confidence: 99%

Association between Ankle Brachial Index, Brachial-Ankle Pulse Wave Velocity, and Mild Cognitive Impairment in Patients with Acute Lacunar Infarction

et al. 2020

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Background: The link between arterial stiffness and mild cognitive impairment (MCI) is receiving increasing attention, and the goal of this study was to explore the relationship among the ankle brachial index (ABI), brachial-ankle pulse wave velocity (Ba-PWV), and MCI in patients with acute lacunar infarction (ALI). Methods: A total of 103 hospitalized patients with ALI were divided into a non-MCI group (n = 41) and an MCI group (n = 62) according to their Montreal Cognitive Assessment (MoCA) scores. A binary logistic regression model was used to assess the association among ABI, Ba-PWV, and MCI after adjusting for confounding factors. Spearman correlation was utilized to analyse the correlations between ABI, Ba-PWV, and MoCA total scores and sub-scores in ALI patients. Results: Participants with cognitive impairment had significantly higher Ba-PWV and lower ABI than those with normal cognition. Correlation analysis suggested that Ba-PWV (r = −0.854, p < 0.05) and ABI (r = 0.734, p < 0.05) were correlated with MoCA total scores; of all MoCA sub-scores, visuospatial/executive function was the most strongly correlated with the vascular variables. In the binary logistic regression analysis, Ba-PWV (odds ratio [OR] = 4.507, 95% confidence interval [CI] = 2.152–9.441) and ABI (OR = 1.124, 95% CI = 1.015–1.254) were significantly associated with MCI, even after adjusting for lipoprotein (a) and systolic and diastolic blood pressure. Conclusion: The present study suggested that a higher Ba-PWV and a lower ABI were independent risk factors for MCI in patients with ALI.

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Section: Discussionmentioning

confidence: 99%

Association between Ankle Brachial Index, Brachial-Ankle Pulse Wave Velocity, and Mild Cognitive Impairment in Patients with Acute Lacunar Infarction

et al. 2020

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“…Meanwhile, the further research (GO and pathway enrichment analysis) showed that the mechanism of MBHD to treat VD is mainly related to neuronal apoptosis, nitric oxide synthesis and metabolism, platelet activation, NF-κB signaling pathway-mediated inflammation, oxidative stress, angiogenesis, etc. Current studies have shown that the pathogenesis of VD mainly includes (1) hypoperfusion and hypoxia caused by microvascular circulatory disorders, (2) increased blood-brain barrier permeability caused by endothelial dysfunction, (3) inflammation and oxidative stress damage the nutritional interaction between neurovascular unit cells, (4) ROS and inflammation inhibit the survival of neurons (neuron apoptosis), and (5) the destruction and demyelination of myelin tablets caused by the oxidative and proinflammatory environment caused by cerebral ischemia and hypoperfusion and the breakdown of the blood-brain barrier [1,49,50].…”

mentioning

confidence: 99%

Exploring the Oxidative Stress Mechanism of Buyang Huanwu Decoction in Intervention of Vascular Dementia Based on Systems Biology Strategy

Yang

Zeng

et al. 2021

Oxidative Medicine and Cellular Longevity

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Objective. To explore the oxidative stress mechanism of modified Buyang Huanwu decoction (MBHD) in intervention of vascular dementia (VD) based on systems biology strategy. Methods. In this study, through the reverse virtual target prediction technology and transcriptomics integration strategy, the active ingredients and potential targets of MBHD treatment of VD were analyzed, and the drug-disease protein-protein interaction (PPI) network was constructed. Then, bioinformatics analysis methods are used for Gene Ontology (GO) enrichment analysis and pathway enrichment analysis, and finally find the core biological process. After that, in animal models, low-throughput technology is used to detect gene expression and protein expression of key molecular targets in oxidative stress-mediated inflammation and apoptosis signaling pathways to verify the mechanism of MBHD treatment of VD rats. Finally, the potential interaction relationship between MBHD and VD-related molecules is further explored through molecular docking technology. Results. There are a total of 54 MBHD components, 252 potential targets, and 360 VD genes. The results of GO enrichment analysis and pathway enrichment analysis showed that MBHD may regulate neuronal apoptosis, nitric oxide synthesis and metabolism, platelet activation, NF-κB signaling pathway-mediated inflammation, oxidative stress, angiogenesis, etc. Among them, SIRT1, NF-κB, BAX, BCL-2, CASP3, and APP may be important targets for MBHD to treat VD. Low-throughput technology (qRT-PCR/WB/immunohistochemical technology) detects oxidative stress-mediated inflammation and apoptosis-related signaling pathway molecules. The molecular docking results showed that 64474-51-7, cycloartenol, ferulic acid, formononetin, kaempferol, liquiritigenin, senkyunone, wallichilide, xanthinin, and other molecules can directly interact with NF-κB p65, BAX, BCL-2, and CASP3. Conclusion. The active compounds of MBHD interact with multiple targets and multiple pathways in a synergistic manner, and have important therapeutic effects on VD mainly by balancing oxidative stress/anti-inflammatory and antiapoptotic, enhancing metabolism, and enhancing the immune system.

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“…Other molecules have shown a limited benefit in patients with CI due to CVD (dl-3-n-butylphthalide, gingko biloba extract, cerebrolysin, actogevin). 72,98 The results were obtained in small samples or only in subgroups of individuals and were not replicated at large scale. Therefore, we see no evidence to recommend these drugs in patients with CI due to CVD.…”

Section: Treatment To Improve Cognition In Patients With CI Due To Cvdmentioning

confidence: 95%

Cognitive impairment in patients with cerebrovascular disease: A white paper from the links between stroke ESO Dementia Committee

Verdelho

Pavlovic

Pantoni

et al. 2021

European Stroke Journal

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Purpose Many daily-life clinical decisions in patients with cerebrovascular disease and cognitive impairment are complex. Evidence-based information sustaining these decisions is frequently lacking. The aim of this paper is to propose a practical clinical approach to cognitive impairments in patients with known cerebrovascular disease. Methods The document was produced by the Dementia Committee of the European Stroke Organisation (ESO), based on evidence from the literature where available and on the clinical experience of the Committee members. This paper was endorsed by the ESO. Findings Many patients with stroke or other cerebrovascular disease have cognitive impairment, but this is often not recognized. With improvement in acute stroke care, and with the ageing of populations, it is expected that more stroke survivors and more patients with cerebrovascular disease will need adequate management of cognitive impairment of vascular etiology. This document was conceived for the use of strokologists and for those clinicians involved in cerebrovascular disease, with specific and practical hints concerning diagnostic tools, cognitive impairment management and decision on some therapeutic options. Discussion and conclusions: It is essential to consider a possible cognitive deterioration in every patient who experiences a stroke. Neuropsychological evaluation should be adapted to the clinical status. Brain imaging is the most informative biomarker concerning prognosis. Treatment should always include adequate secondary prevention.

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Vascular Cognitive Disorder

Cited by 21 publications

References 117 publications

Association between Ankle Brachial Index, Brachial-Ankle Pulse Wave Velocity, and Mild Cognitive Impairment in Patients with Acute Lacunar Infarction

Association between Ankle Brachial Index, Brachial-Ankle Pulse Wave Velocity, and Mild Cognitive Impairment in Patients with Acute Lacunar Infarction

Exploring the Oxidative Stress Mechanism of Buyang Huanwu Decoction in Intervention of Vascular Dementia Based on Systems Biology Strategy

Cognitive impairment in patients with cerebrovascular disease: A white paper from the links between stroke ESO Dementia Committee

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