@article{deramecourt_staging_2012,
	title = {Staging and natural history of cerebrovascular pathology in dementia},
	abstract = {Objective: Most pathologic studies indicate that significant vascular changes are found in the J.Y. Slade, BSc majority of elderly persons, either alone or in association with neurodegenerative processes such A.E. Oakley, MBiol as Alzheimer disease (AD) or dementia with Lewy bodies (DLB). Cumulative burden of cerebrovasR.H. Perry, FRCPath cular lesions can explain cognitive decline described as vascular cognitive impairment, but beP.G. Ince, FRCPath cause there is a lack of consensus in the best way to quantify vascular pathology, the relationship C.-A. Maurage, MD, between cognitive decline and cerebrovascular disease remains uncertain. We developed a rating PhD scheme for cerebrovascular lesions using postmortem brains from patients with dementia from 2 Seeed R.N. Kalaria, FRCPath European tertiary care memory clinics. Correspondence \& reprint requests to Dr. Kalaria: r.n.kalaria@ncl.ac.uk
Methods: A total of 135 brains with a neuropathologic diagnosis of vascular dementia (VaD) (n ϭ 26), AD ϩ VaD (n ϭ 39), DLB ϩ VaD (n ϭ 21), AD ϩ DLB ϩ VaD (n ϭ 9), AD (n ϭ 19), and DLB (n ϭ 21) were investigated in this study. Cerebrovascular lesions were rated on large sections from the hippocampus, the temporal lobe, the frontal lobe, and basal ganglia.
Results: In patients with dementia, vessel wall modifications such as arteriolosclerosis or amyloid angiopathy are the most common and presumably the earliest changes. Modifications in perivascular spaces and myelin loss are the next most common. Lacunar or regional infarcts may occur as a consequence of an independent process or in the final phase of small vessel diseases.
Conclusion: A staging system based on this conceptual model of cerebrovascular pathology could enable the neuropathologic quantification of the cerebrovascular burden in dementia. Further studies are needed to determine whether this system can be used in large-scale studies to understand clinical–cerebrovascular pathologic correlations. Neurology® 2012;78:1–1},
	language = {en},
	author = {Deramecourt, V and Slade, J Y and Oakley, A E and Perry, R H and Ince, P G},
	year = {2012},
	keywords = {Aged, Aged, 80 and over, Brain, Cerebrovascular Disorders, Dementia, Female, Humans, Male},
	pages = {9},
}

{"_id":"rk5C3WTX7NmqiYp3L","bibbaseid":"deramecourt-slade-oakley-perry-ince-stagingandnaturalhistoryofcerebrovascularpathologyindementia-2012","authorIDs":[],"author_short":["Deramecourt, V","Slade, J Y","Oakley, A E","Perry, R H","Ince, P G"],"bibdata":{"bibtype":"article","type":"article","title":"Staging and natural history of cerebrovascular pathology in dementia","abstract":"Objective: Most pathologic studies indicate that significant vascular changes are found in the J.Y. Slade, BSc majority of elderly persons, either alone or in association with neurodegenerative processes such A.E. Oakley, MBiol as Alzheimer disease (AD) or dementia with Lewy bodies (DLB). Cumulative burden of cerebrovasR.H. Perry, FRCPath cular lesions can explain cognitive decline described as vascular cognitive impairment, but beP.G. Ince, FRCPath cause there is a lack of consensus in the best way to quantify vascular pathology, the relationship C.-A. Maurage, MD, between cognitive decline and cerebrovascular disease remains uncertain. We developed a rating PhD scheme for cerebrovascular lesions using postmortem brains from patients with dementia from 2 Seeed R.N. Kalaria, FRCPath European tertiary care memory clinics. Correspondence & reprint requests to Dr. Kalaria: r.n.kalaria@ncl.ac.uk Methods: A total of 135 brains with a neuropathologic diagnosis of vascular dementia (VaD) (n ϭ 26), AD ϩ VaD (n ϭ 39), DLB ϩ VaD (n ϭ 21), AD ϩ DLB ϩ VaD (n ϭ 9), AD (n ϭ 19), and DLB (n ϭ 21) were investigated in this study. Cerebrovascular lesions were rated on large sections from the hippocampus, the temporal lobe, the frontal lobe, and basal ganglia. Results: In patients with dementia, vessel wall modifications such as arteriolosclerosis or amyloid angiopathy are the most common and presumably the earliest changes. Modifications in perivascular spaces and myelin loss are the next most common. Lacunar or regional infarcts may occur as a consequence of an independent process or in the final phase of small vessel diseases. Conclusion: A staging system based on this conceptual model of cerebrovascular pathology could enable the neuropathologic quantification of the cerebrovascular burden in dementia. Further studies are needed to determine whether this system can be used in large-scale studies to understand clinical–cerebrovascular pathologic correlations. Neurology® 2012;78:1–1","language":"en","author":[{"propositions":[],"lastnames":["Deramecourt"],"firstnames":["V"],"suffixes":[]},{"propositions":[],"lastnames":["Slade"],"firstnames":["J","Y"],"suffixes":[]},{"propositions":[],"lastnames":["Oakley"],"firstnames":["A","E"],"suffixes":[]},{"propositions":[],"lastnames":["Perry"],"firstnames":["R","H"],"suffixes":[]},{"propositions":[],"lastnames":["Ince"],"firstnames":["P","G"],"suffixes":[]}],"year":"2012","keywords":"Aged, Aged, 80 and over, Brain, Cerebrovascular Disorders, Dementia, Female, Humans, Male","pages":"9","bibtex":"@article{deramecourt_staging_2012,\n\ttitle = {Staging and natural history of cerebrovascular pathology in dementia},\n\tabstract = {Objective: Most pathologic studies indicate that significant vascular changes are found in the J.Y. Slade, BSc majority of elderly persons, either alone or in association with neurodegenerative processes such A.E. Oakley, MBiol as Alzheimer disease (AD) or dementia with Lewy bodies (DLB). Cumulative burden of cerebrovasR.H. Perry, FRCPath cular lesions can explain cognitive decline described as vascular cognitive impairment, but beP.G. Ince, FRCPath cause there is a lack of consensus in the best way to quantify vascular pathology, the relationship C.-A. Maurage, MD, between cognitive decline and cerebrovascular disease remains uncertain. We developed a rating PhD scheme for cerebrovascular lesions using postmortem brains from patients with dementia from 2 Seeed R.N. Kalaria, FRCPath European tertiary care memory clinics. Correspondence \\& reprint requests to Dr. Kalaria: r.n.kalaria@ncl.ac.uk\nMethods: A total of 135 brains with a neuropathologic diagnosis of vascular dementia (VaD) (n ϭ 26), AD ϩ VaD (n ϭ 39), DLB ϩ VaD (n ϭ 21), AD ϩ DLB ϩ VaD (n ϭ 9), AD (n ϭ 19), and DLB (n ϭ 21) were investigated in this study. Cerebrovascular lesions were rated on large sections from the hippocampus, the temporal lobe, the frontal lobe, and basal ganglia.\nResults: In patients with dementia, vessel wall modifications such as arteriolosclerosis or amyloid angiopathy are the most common and presumably the earliest changes. Modifications in perivascular spaces and myelin loss are the next most common. Lacunar or regional infarcts may occur as a consequence of an independent process or in the final phase of small vessel diseases.\nConclusion: A staging system based on this conceptual model of cerebrovascular pathology could enable the neuropathologic quantification of the cerebrovascular burden in dementia. Further studies are needed to determine whether this system can be used in large-scale studies to understand clinical–cerebrovascular pathologic correlations. 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