Risk and Determinants of Dementia in Patients with Mild Cognitive Impairment and Brain Subcortical Vascular Changes: A Study of Clinical, Neuroimaging, and Biological Markers-The VMCI-Tuscany Study: Rationale, Design, and Methodology

Anna Poggesi, Emilia Salvadori, Leonardo Pantoni, Giovanni Pracucci, Francesca Cesari, Alberto Chiti, Laura Ciolli, Mirco Cosottini, Alessandra Del Bene, Nicola De Stefano, Stefano Diciotti, Maria Teresa Dotti, Andrea Ginestroni, Betti Giusti, Anna Maria Gori, Serena Nannucci, Giovanni Orlandi, Francesca Pescini, Raffaella Valenti, Rosanna Abbate, Antonio Federico, Mario Mascalchi, Luigi Murri, Domenico Inzitari, Anna Poggesi, Emilia Salvadori, Leonardo Pantoni, Giovanni Pracucci, Francesca Cesari, Alberto Chiti, Laura Ciolli, Mirco Cosottini, Alessandra Del Bene, Nicola De Stefano, Stefano Diciotti, Maria Teresa Dotti, Andrea Ginestroni, Betti Giusti, Anna Maria Gori, Serena Nannucci, Giovanni Orlandi, Francesca Pescini, Raffaella Valenti, Rosanna Abbate, Antonio Federico, Mario Mascalchi, Luigi Murri, Domenico Inzitari

Abstract

Dementia is one of the most disabling conditions. Alzheimer's disease and vascular dementia (VaD) are the most frequent causes. Subcortical VaD is consequent to deep-brain small vessel disease (SVD) and is the most frequent form of VaD. Its pathological hallmarks are ischemic white matter changes and lacunar infarcts. Degenerative and vascular changes often coexist, but mechanisms of interaction are incompletely understood. The term mild cognitive impairment defines a transitional state between normal ageing and dementia. Pre-dementia stages of VaD are also acknowledged (vascular mild cognitive impairment, VMCI). Progression relates mostly to the subcortical VaD type, but determinants of such transition are unknown. Variability of phenotypic expression is not fully explained by severity grade of lesions, as depicted by conventional MRI that is not sensitive to microstructural and metabolic alterations. Advanced neuroimaging techniques seem able to achieve this. Beside hypoperfusion, blood-brain-barrier dysfunction has been also demonstrated in subcortical VaD. The aim of the Vascular Mild Cognitive Impairment Tuscany Study is to expand knowledge about determinants of transition from mild cognitive impairment to dementia in patients with cerebral SVD. This paper summarizes the main aims and methodological aspects of this multicenter, ongoing, observational study enrolling patients affected by VMCI with SVD.

Figures

Figure 1
Figure 1
Cerebral white matter changes: examples of mild, moderate, and severe groups according to the modified Fazekas' scale. Only patients with moderate or severe degrees were included in the study.
Figure 2
Figure 2
List of participating centers and personnel in the VMCI-Tuscany. University of Florence: (Coordinating Center): Domenico Inzitari (study coordinator), Rosanna Abbate, Manuela Bandinelli, Maria Boddi, Francesca Cesari, Laura Ciolli, Mirella Coppo, Alessandra Del Bene, Stefano Diciotti, Andrea Ginestroni, Betti Giusti, Anna Maria Gori, Mario Mascalchi, Serena Nannucci, Leonardo Pantoni, Marco Pasi, Francesca Pescini, Anna Poggesi, Giovanni Pracucci, Emilia Salvadori, Raffaella Valenti. University of Pisa: Luigi Murri, Ubaldo Bonucelli, Paolo Cecchi, Alberto Chiti, Mirco Cosottini, Giovanni Orlandi, Cristina Pagni, Gabriele Siciliano, Gloria Tognoni. University of Siena: Antonio Federico, Nicola De Stefano, Maria Teresa Dotti, Patrizia Formichi, Claudia Gambetti, Antonio Giorgio, Francesca Rossi, Laura Stromillo, Enza Zicari. Tuscany region: Arezzo (Paolo Zolo, Alessandro Tiezzi); Empoli (Elisabetta Bertini, Stefania Brotini, Leonello Guidi, Maria Lombardi, Stefania Mugnai, Antonella Notarelli); Florence (Laura Bracco, Massimo Cadelo, Renzo Cisbani, Luciano Gabbani, Guido Gori, Lorella Lambertucci, Luca Massacesi, Enrico Mossello, Marco Paganini, Maristella Piccininni, Francesco Pinto, Claudia Pozzi, Sandro Sorbi, Gaetano Zaccara); Grosseto (Tiziano Borgogni, Mario Mancuso, Roberto Marconi); Lucca (Monica Mazzoni, Marco Vista); Livorno (Giuseppe Meucci, Giovanna Bellini); Massa Carrara (Luciano Gabrielli); Pisa (Cristina Frittelli, Renato Galli, Gianna Gambaccini); Pistoia (Stefano Bartolini, Carlo Biagini, Veronica Caleri, Paola Vanni); Prato (Donatella Calvani, Carla Giorgi, Stefano Magnolfi, Pasquale Palumbo, Carlo Valente); Siena (Alessandro Rossi, Rossana Tassi, Stefania Boschi); Viareggio (Filippo Baldacci; Ubaldo Bonuccelli).

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Source: PubMed

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