IPA Expert Consensus Conference “Vascular Burden of the Brain: New Therapeutic Directions” PATHOPHYSIOLOGY
Potential Biological Markers for Cerebrovascular Disease
Alexander Kurz a1, Matthias Riemenschneider a1andAnders Wallin a2 a1 Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany a2 Institute of Clinical Neuroscience, Göteborg University, Mölndal, Sweden
Cerebrovascular diseases can causes cognitive impairment and dementia by loss of neurons and synaptic connections, destruction of axons, and demyelinization. Biological markers including genetic tests, brain imaging techniques, and biochemical assays in the CSF are valuable for the identification and quantification of cerebrovascular diseases. Genetic tests may be used to detect mutations that cause hereditary cerebral amyloid angiopathies or cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). Structural CT and MR imaging is routinely used to visualize and quantify infarcts and white-matter changes. Functional SPET and PET imaging can demonstrate focal and remote effects of vascular lesions on cerebral blood flow and metabolism. Biochemical imaging using proton MRS is a nonspecific marker for neuronal and axonal damage. Among biochemical markers in the CSF, tau protein, phospho-tau, and beta amyloid protein are helpful to differentiate vascular dementia from Alzheimer's disease.