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Post-mortem assessment in vascular dementia: advances and aspirations

Lookup NU author(s): Dr Kirsty McAleese, Professor Raj KalariaORCiD, Professor Johannes Attems



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Background: Cerebrovascular lesions are a frequent finding in the elderly population. However, the impact of these lesions on cognitive performance, the prevalence of vascular dementia, and the pathophysiology behind characteristic in vivo imaging findings are subject to controversy. Moreover, there are no standardised criteria for the neuropathological assessment of cerebrovascular disease or its related lesions in human post-mortem brains, and conventional histological techniques may indeed be insufficient to fully reflect the consequences of cerebrovascular disease.Discussion: Here, we review and discuss both the neuropathological and in vivo imaging characteristics of cerebrovascular disease, prevalence rates of vascular dementia, and clinico-pathological correlations. We also discuss the frequent comorbidity of cerebrovascular pathology and Alzheimer's disease pathology, as well as the difficult and controversial issue of clinically differentiating between Alzheimer's disease, vascular dementia and mixed Alzheimer's disease/vascular dementia. Finally, we consider additional novel approaches to complement and enhance current post-mortem assessment of cerebral human tissue.Conclusion: Elucidation of the pathophysiology of cerebrovascular disease, clarification of characteristic findings of in vivo imaging and knowledge about the impact of combined pathologies are needed to improve the diagnostic accuracy of clinical diagnoses.

Publication metadata

Author(s): McAleese KE, Alafuzoff I, Charidimou A, De Reuck J, Grinberg LT, Hainsworth AH, Hortobagyi T, Ince P, Jellinger K, Gao J, Kalaria RN, Kovacs GG, Kovari E, Love S, Popovic M, Skrobot O, Taipa R, Thal DR, Werring D, Wharton SB, Attems J

Publication type: Article

Publication status: Published

Journal: BMC Medicine

Year: 2016

Volume: 14

Online publication date: 26/08/2016

Acceptance date: 19/08/2016

Date deposited: 26/10/2016

ISSN (electronic): 1741-7015

Publisher: BioMed Central


DOI: 10.1186/s12916-016-0676-5


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Funder referenceFunder name
Alzheimer's Society, UK
Brains for Dementia research
G0400074UK Medical Research Council
KTIA_13_NAP-A-II/7Hungarian Brain Research Program
R01 AG040311NIH
R01 AG040311