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Incidence of cerebrovascular lesions in Alzheimer's disease: a postmortem study

Published on Jan 1, 2003in Acta Neuropathologica 18.17
· DOI :10.1007/s00401-002-0634-5
K. Jelli60
Estimated H-index: 60
,
Johannes Attems44
Estimated H-index: 44
Cite
Abstract
Recent epidemiological and clinico-pathological data suggest overlaps between Alzheimer's disease (AD) and cerebrovascular lesions (CVL) that may show some synergistic effects, but the results of studies of the relationship between AD and stroke have been controversial. The objective of this study was to compare the frequency of cerebral infarcts, hemorrhages and minor cerebrovascular lesions in autopsy-confirmed AD and age-matched control brains. Using current routine and immunohistochemical methods 173 consecutive cases of autopsy-confirmed AD and 130 age-matched controls were compared. The total incidence of vascular pathology (56.5%) in AD was significantly less than in a previously reported smaller AD autopsy cohort (82.3%) (P<0.01), and was higher than in controls (42.4%). The incidence of severe CVL (old and recent infarcts, hemorrhages) in our cohort was slightly higher (12.7%) than in controls (8.5%), that of minor to moderate CVL (lacunes, cerebral amyloid angiopathy with or without minor vascular lesions) was more frequent in AD (43.8%) than in controls (33.9%), but the results were not statistically significant (P<0.03). The brain weight and severity of cognitive decline did not correspond to the degree of vascular pathology, but higher neuritic Braak scores and reduced brain weight contributed to the production of cognitive impairment. Like previous findings in Parkinson's disease, our data do not indicate a protective effect from stroke or a significantly greater susceptibility to death from stroke in AD in the population studied, but further prospective clinico-pathological studies are necessary.
  • References (18)
  • Citations (83)
Cite
References18
Newest
Published on Jul 1, 2002in Movement Disorders 8.06
F.L. Mastaglia60
Estimated H-index: 60
,
R. Johnsen16
Estimated H-index: 16
(RPH: Royal Perth Hospital),
Byron Kakulas30
Estimated H-index: 30
The results of previous epidemiological studies of the relationship between Parkinson's disease and stroke have been conflicting; some showing a reduced risk of ischaemic and haemorrhagic stroke during life, and others indicating an increased likelihood of stroke-related death. We compared the frequency of cerebral infarcts and haemorrhages at postmortem in 100 cases of pathologically verified idiopathic Parkinson's disease and 100 age-matched control brains. No significant differences were foun...
Published on May 1, 2002in Journal of Neural Transmission 2.90
K. A. Jellinger1
Estimated H-index: 1
Recent epidemiological and clinico-pathologic data suggest overlaps between Alzheimer disease (AD) and cerebrovascular lesions that may magnify the effect of mild AD pathology and promote progression of cognitive decline or even may precede neuronal damage and dementia.Vascular pathology in the aging brain and in AD includes: 1. cerebral amyloid angiopathy (CAA) with an incidence of 82–98% often associated with ApoEe2 and causing a) cerebral mass hemorrhages (around 70%, mainly in the frontal an...
Published on Apr 1, 2002in Stroke 6.05
Donald R. Royall38
Estimated H-index: 38
(University of Texas Health Science Center at San Antonio)
To the Editor: The recent review by de la Torre1 on the apparent overlap between Alzheimer’s disease (AD) and vascular dementia (VaD) neglects a fundamental difference between these disorders. AD pathology progresses in a well-described and hierarchically arranged spatial sequence, which begins in the mesiotemporal cortex and moves out, over decades, to affect the frontal, temporal, and parietal lobes.2 Any attempt to explain AD on the basis of vascular disorder must be capable of explaining its...
Published on Aug 1, 2001in JAMA Neurology 12.32
Dan Mungas58
Estimated H-index: 58
,
Bruce Reed57
Estimated H-index: 57
+ 1 AuthorsWilliam J. Jagust88
Estimated H-index: 88
(UC Davis: University of California, Davis)
Background Relatively little is known about how cerebrovascular disease affects progression of dementia. Previous studies have found no differences in progression of Alzheimer disease and vascular dementia, but these studies have not specifically examined age effects. Objective To test whether the rate of cognitive decline is different in Alzheimer disease compared with dementia with associated cerebrovascular disease in clinical and autopsy patient series. Patients and Methods We studied the lo...
Published on Oct 1, 2000in JAMA Neurology 12.32
Jae Hong Lee2
Estimated H-index: 2
(UOU: University of Ulsan),
John M. Olichney35
Estimated H-index: 35
+ 2 AuthorsLeon J. Thal86
Estimated H-index: 86
Objective To determine the relation between concomitant small cerebral infarction and clinical progression of Alzheimer disease (AD). Design A retrospective clinicopathologic study of patients with AD. Methods We searched the databases of the University of California, San Diego, Alzheimer's Disease Research Center, La Jolla, for patients with an autopsy diagnosis of definite AD with or without a concomitant small cerebral infarction. Clinical and neuropsychologic data obtained during longitudina...
Published on Mar 1, 2000in Neurobiology of Aging 4.40
Raj N. Kalaria9
Estimated H-index: 9
(University of Newcastle)
Abstract The Alzheimer type of dementia and stroke are known to increase at comparable rates with age. Recent advances suggest that vascular risk factors linked to cerebrovascular disease and stroke in the elderly significantly increase the risk of developing Alzheimer’s disease (AD). These include atherosclerosis, atrial fibrillation, coronary artery disease, hypertension, and diabetes mellitus. Moreover, review of various autopsy series shows that 60–90% of AD cases exhibit variable cerebrovas...
Published on Sep 1, 1999in The Lancet 59.10
Margaret M. Esiri77
Estimated H-index: 77
,
Zsuzsanna Nagy14
Estimated H-index: 14
+ 2 AuthorsA. David Smith34
Estimated H-index: 34
Summary Cerebrovascular disease and Alzheimer's disease commonly occur together in the elderly and each may contribute to dementia. Here we present evidence that Cerebrovascular disease significantly worsens cognitive performance in the earliest stages of Alzheimer's disease.
Published on Jul 1, 1998in Neurology 8.69
Albert Heyman53
Estimated H-index: 53
,
Gerda G. Fillenbaum61
Estimated H-index: 61
+ 5 AuthorsCarl F. Pieper76
Estimated H-index: 76
Objective: To study the relation between cerebral infarction and clinical and neuropsychologic manifestations in patients with autopsy-proven Alzheimer9s disease (AD) enrolled in the Consortium to Establish a Registry for Alzheimer9s Disease (CERAD). Background: Prior studies report that subjects with neuropathologic evidence of AD and concomitant brain infarcts had poorer cognitive function and higher frequency of dementia than those with AD alone. Methods: Clinical and neuropsychologic manifes...
Published on Dec 1, 1997in Journal of Neurology, Neurosurgery, and Psychiatry 8.27
Margaret M. Esiri77
Estimated H-index: 77
,
G K Wilcock1
Estimated H-index: 1
,
J H Morris1
Estimated H-index: 1
OBJECTIVES—To better define the neuropathology of vascular dementia. METHODS—The neuropathological findings in 18 elderly, undemented subjects free of cerebrovascular disease were compared with 19 elderly undemented subjects who had cerebrovascular disease (many of whom had had a "stroke") and 24 elderly demented subjects who had cerebrovascular disease, but no other pathology to account for dementia. Cases in all groups were selected for absence or no more than very mild Alzheimer type patholog...
Cited By83
Newest
Published on Jun 25, 2019in Frontiers in Neurology 2.63
Haiyan Zhu , Wenxiao Wang1
Estimated H-index: 1
+ 6 AuthorsYaojing Chen10
Estimated H-index: 10
Published on Apr 1, 2019in International Journal of Stroke 4.47
Catherine Humphreys1
Estimated H-index: 1
(Edin.: University of Edinburgh),
Maurits A. Jansen15
Estimated H-index: 15
(Edin.: University of Edinburgh)
+ 6 AuthorsColin Smith5
Estimated H-index: 5
(Edin.: University of Edinburgh)
RationaleNeuroimaging and clinical studies have defined human sporadic cerebral small vessel disease but the pathophysiology remains relatively poorly understood. To develop effective therapies and preventative strategies, we must better understand the heterogeneity and development of small vessel disease at a cellular level.HypothesisSmall vessel disease lesions as seen on neuroimaging have specific neuropathological correlates.Methods and designStandard histological samples are taken from stra...
Published on Apr 1, 2019in Brain and behavior 2.07
Yi Zhang4
Estimated H-index: 4
(CQMU: Chongqing Medical University),
Fenglei Chao7
Estimated H-index: 7
(CQMU: Chongqing Medical University)
+ 6 AuthorsYong Tang13
Estimated H-index: 13
(CQMU: Chongqing Medical University)
Published on Dec 1, 2018in Scientific Reports 4.01
Hyemin Jang5
Estimated H-index: 5
(SMC: Samsung Medical Center),
Jong Yun Park1
Estimated H-index: 1
(KU: Korea University)
+ 7 AuthorsSang Won Seo30
Estimated H-index: 30
Amyloid-β (Aβ) and cerebral small vessel disease (CSVD) commonly coexist. They can occur independently by chance, or may interact with each other. We aimed to determine whether the distribution of Aβ in subcortical vascular cognitive impairments (SVCI) patients can be classified by the underlying pathobiologies. A total of 45 11C-Pittsburgh compound B PET positive (PiB(+)) SVCI patients were included in this study. They were classified using a new cluster analysis method which adopted the Louvai...
Published on Dec 1, 2018in Acta Neuropathologica 18.17
Amanda M. Liesinger13
Estimated H-index: 13
(Mayo Clinic),
Neill R. Graff-Radford72
Estimated H-index: 72
(Mayo Clinic)
+ 11 AuthorsAdel Aziz1
Estimated H-index: 1
(Mayo Clinic)
Women reportedly make up two-thirds of Alzheimer’s disease (AD) dementia sufferers. Many estimates regarding AD, however, are based on clinical series lacking autopsy confirmation. The Florida Autopsied Multi-Ethnic (FLAME) cohort was queried for AD cases with a total of 1625 identified ranging in age from 53 to 102 years at death. Standard neuropathologic procedures were employed and clinical information was retrospectively collected. Clinicopathologic and genetic data (MAPT and APOE) were stra...
Published on Jan 1, 2018
Ana Verdelho17
Estimated H-index: 17
(University of Lisbon)
Vascular risk factors and cerebrovascular disease are recognized factors implicated in the evolution towards dementia, not only of vascular origin, but also of degenerative dementia as Alzheimer’s disease. Even among nondemented subjects, hypertension, diabetes, and stroke are associated with worse performance in attention, speed and motor control, and executive functions. Influence of vascular risk factors in cognition starts early in life. Recently, several publications expressed that interven...
Published on Oct 1, 2017in Brain Behavior and Immunity 6.17
Junling Yang4
Estimated H-index: 4
(UIC: University of Illinois at Chicago),
Jinghong Kou8
Estimated H-index: 8
(UIC: University of Illinois at Chicago)
+ 1 AuthorsKen Ichiro Fukuchi27
Estimated H-index: 27
(UIC: University of Illinois at Chicago)
Abstract Neuroinflammation is a pervasive feature of Alzheimer’s disease (AD) and characterized by activated microglia, increased proinflammatory cytokines and/or infiltrating immune cells. T helper 17 (Th17) cells are found in AD brain parenchyma and interleukin-17A (IL-17A) is identified around deposits of aggregated amyloid β protein (Aβ). However, the role of IL-17A in AD pathogenesis remains elusive. We overexpressed IL-17A in an AD mouse model via recombinant adeno-associated virus serotyp...
Published on May 1, 2016in Acta Neuropathologica 18.17
Seth Love54
Estimated H-index: 54
(UoB: University of Bristol),
J. Scott Miners16
Estimated H-index: 16
(UoB: University of Bristol)
Cerebrovascular disease (CVD) and Alzheimer’s disease (AD) have more in common than their association with ageing. They share risk factors and overlap neuropathologically. Most patients with AD have Aβ amyloid angiopathy and degenerative changes affecting capillaries, and many have ischaemic parenchymal abnormalities. Structural vascular disease contributes to the ischaemic abnormalities in some patients with AD. However, the stereotyped progression of hypoperfusion in this disease, affecting fi...
Published on Jan 1, 2016in Disease Markers 2.76
Kyung Hee Yoon3
Estimated H-index: 3
,
So Yeon Kim4
Estimated H-index: 4
+ 3 AuthorsDo Hoon Kim14
Estimated H-index: 14
Objectives. Growing evidence suggests that angiogenic vascular factors may be involved in the pathogenic mechanism of Alzheimer's disease (AD), and recently endocan has been proposed as an angiogenic biomarker. The aim of this study was to measure serum endocan levels according to the presence of depression in AD and to investigate the association among the serum endocan levels, cognitive function, and depression in these patients. Methods. Serum endocan levels were measured in 26 AD patients wi...
Published on Jan 1, 2016in Frontiers of neurology and neuroscience
Solène Moulin8
Estimated H-index: 8
,
Charlotte Cordonnier34
Estimated H-index: 34
Spontaneous intracerebral haemorrhage (ICH) accounts for approximately 15% of all strokes and is a leading cause of disability, with a one-month mortality rate of 40%. Whereas factors predicting short-term mortality are well known, data regarding long-term outcome are scarce and imprecise. The two main underlying vasculopathies responsible for ICH, i.e. deep perforating vasculopathy and cerebral amyloid angiopathy, might have an impact on the overall prognosis of ICH survivors. ICH survivors are...