Acta Scientific Neurology (ASNE) (ISSN: 2582-1121)

Research Article Volume 3 Issue 3

The Incidence of Cerebrovascular Lesions in Vascular Dementia Due to Arteriosclerosis and Due to Cerebral Amyloid Angiopathy: A Post-Mortem Neuropathological Study With 7.0-Tesla Magnetic Resonance Imaging

Jacques De Reuck*, Florent Auger, Nicolas Durieux, Claude-Alain Maurage, Vincent Deramecourt, Charlotte Cordonnier, Florence Pasquier, Didier Leys and Regis Bordet

Unitè 1171 “Degenerative and vascular cognitive disorders”, Université de Lille 2, Lille, France

*Corresponding Author: Jacques De Reuck, Unitè 1171 “Degenerative and vascular cognitive disorders”, Université de Lille 2, Lille, France.

Received: January 25, 2020; Published: February 29, 2020



Introduction and Purpose: Arteriosclerotic small vessel disease (Art) is the main cause of vascular dementia (VaD). Cerebral amyloid angiopathy (CAA) can also lead to VaD. However it is not known whether the responsible cerebrovascular lesions and their severity are the same in VaD-Art and VaD-CAA. The present post-mortem study with additional 7-tesla magnetic resonance imaging (MRI) compares the incidence and the distribution of these lesions in both VaD disease types. 

Material and Methods: 32 brains with pure VaD due to Art and due to CAA, and 31 with VaD-Art and VaD-CAA mixed with additional neurodegenerative pathology were compared separately. MRi was mainly used to compare the regional severity of the white matter changes (WMCs) and the incidence of cortical micro-infarcts (CoMIs) and cortical micro-bleeds (CoMBs) on serial cerebral hemispheric sections between both groups of VaD. 

Results: VaD-CAA was characterized by the more frequent occurrence of CoMIs and lobar haematomas while in VaD-Art lacunar infarcts predominated in the pure as well in the mixed forms. On MRI WMCs were more severe in the central section and to a minor degree in the mixed VaD-CAA, as well as CoMiBs in the frontal section. CoMIs were equally increased in the different sections. 

Conclusions: There are significant differences in the severity and the topographic distributions of cerebrovascular lesions between VaD-Art and VaD-CAA brains. However, the increased WMCs and CoMiBs in the mixed form of VaD-CAA could possibly be related to the additional neurodegenerative changes.

Keywords: Neuropathology; Post-Mortem Magnetic Resonance Imaging; Cerebrovascular Lesions; Arteriosclerotic Vascular Dementia; Vascular Dementia Due to Cerebral Amyloid Angiopathy



  1. McAleese KE., et al. “Post-mortem assessment in vascular dementia: advances and aspirations”. BMC Medicine 14. 01 (2016): 129. 
  2. Skrobot OA., et al. “Vascular cognitive impairment neuropathology guidelines (VCINFG): the contribution of cerebrovascular pathology to cognitive impairment”. Brain 139.11 (2016): 2957-2969.
  3. Jellinger KA. “Pathogenesis and treatment of vascular cognitive impairment”. Neurodegenerative Disease Management 04.06 (2014): 471-490.
  4. Kalaria RN. “The pathology and pathophysiology of vascular dementia”. Acta Neuropathologica 131.05 (2016): 659-685.
  5. Haglund M., et al. “Severe cerebral amyloid angiopathy characterizes an underestimated variant of vascular dementia”. Dementia and Geriatric Cognitive Disorders 18.02 (2004): 132-137.
  6. Vinters HV., et al. “Review: Vascular dementia: clinicopathologic and genetic considerations”. Neuropathology and Applied Neurobiology 44.03 (2018): 247-266.
  7. Charidimou A., et al. “Emerging concepts in sporadic cerebral amyloid angiopathy”. Brain140.07 (2017): 1829-1850.
  8. De Reuck J., et al. “Cerebrovasular lesions in mixed neurodegenerative dementia: A neuropathological and magnetic resonance study”. European Neurology 78.1-2 (2017): 1-5.
  9. De Reuck J., et al. “Aging and cerebrovascular lesions in pure and mixed neurodegenerative and vascular dementia brains: a neuropathological study”. Folia Neuropathologica 56.02 (2018): 81-87. 
  10. Love S., et al. “Development, appraisal, validation and implementation of a consensus protocol for the assessment of cerebral amyloid angiopathy in post-mortem brain tissue”. American Journal of Neurodegenerative Diseases 03.01 (2014): 19-32. 
  11. Braak H., et al. “Staging of Alzheimer-related cortical destruction”.  European Neurology 33.06 (1993): 403-408.
  12. De Reuck J., et al. “Comparison of 7.0-T T2* magnetic resonance imaging of cerebral bleeds in post-mortem brain sections of Alzheimer patients with their neuropathological correlates”. Cerebrovascular Disease 31.05 (2011): 511-517. 
  13. Jellinger KA and Attems J. “Is there pure vascular dementia in old age?”  Journal of Neurological Sciences 299.1-2 (2010): 150-154.
  14. Richardson K., et al. “The neuropathology of vascular disease in the Medical Research Council Cognitive Function and Ageing Study (MRC CFAS)”. Current Alzheimer Research 09.06 (2012): 687-696.
  15. Ince PG., et al. “Medical research council cognitive function and ageing neuropathology study”. Neuropathology and Applied Neurobiology 43.05 (2017): 409-418. 
  16. Haglund M., et al. “Cerebral amyloid angiopathy and cortical microinfarcts as putative substrates of vascular dementia”.  International Journal of Geriatric Psychiatry 21.07 (2006): 681-687.
  17. Kovari E., et al. “The relation between cerebral amyloid angiopathy and cortical microinfarcts in brain ageing and Alzheimer’s disease”.  Neuropathology and Applied Neurobiology 39.05 (2013): 498-509. 
  18. DeReuck J., et al. “Impact of mild Alzheimer changes in vascular dementia: A neuropathological study”. Acta Scientific Neurology 02.06 (2019): 37-42. 
  19. De Reuck J., et al. “Cerebrovascular lesions in cerebral amyloid angiopathy with and without Alzheimer’s disease: A neuropathological study with post-mortem 7.0-tesla magnetic resonance imaging”. EC Neurology 10.11 (2018): 954-960. 
  20. Leys D., et al. “Could Wallerian degeneration contribute to “leukoaraiosis” in subjects free of any vascular disorder?” Journal of Neurology, Neurosurgery and Psychiatry 54.01 (1991): 46-50. 
  21. Eseri M., et al. “Cerebral amyloid angiopathy, subcortical white matter disease and dementia: literature review and study in OPTIMA”. Brain Pathology 25.01 (2015): 51-62. 
  22. Polvikoski TM., et al. “Frontal lobe white matter hyperintensities and neurofibrillary pathology in the oldest old”. Neurology 75.23 (2010):  2071-2078. 
  23. De Reuck J. “The significance of small cerebral bleeds in neurodegenerative dementia syndromes”. Aging Disease 03.04 (2012):  307- 312.


Citation: Jacques De Reuck., et al. “The Incidence of Cerebrovascular Lesions in Vascular Dementia Due to Arteriosclerosis and Due to Cerebral Amyloid Angiopathy: A Post-Mortem Neuropathological Study With 7.0-Tesla Magnetic Resonance Imaging”. Acta Scientific Neurology 3.3 (2020): 27-32.


Acceptance rate32%
Acceptance to publication20-30 days

Indexed In

News and Events

  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is May 30, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US