Review: Subcortical Vascular Ischaemic Dementia

The featured paper is ‘Subcortical Vascular Ischemic Dementia’ by Helena Chui and freely available here. This is a prepublication manuscript and so is amenable to editorial changes before publication. Chui has achieved a thorough coverage of a difficult topic in the relatively short space of this review. Chui looks at Subcortical Vascular Ischaemic Dementia, a very specific subtype of vascular dementia and breaks down the review into several parts covering the history of the diagnosis, anatomical considerations as well as prevention and treatment in addition to other topics. In her review, Chui  includes strategic infarcts as one of the main categories while other authors have included this under the more general rubric of ischaemic vascular dementia although this latter distinction lies perhaps more in semantics. Given the broad scope of the review, a methodology would be difficult to justify and would in any case be too unwieldy. Chui uses her knowledge of the field to select highly relevant articles in the main subject areas allowing the novice an opportunity to quickly familiarise themselves with the field. The section on frontal cortical-subcortical loops show some of the difficulties inherent in the field as it is difficult to interpret these findings in terms of symptoms without a detailed understanding of the functional neuroanatomy. This in turn is dependent upon a detailed understanding of frontal cortical functioning and there are numerous detailed models to choose from which however have limited predictive powers. Here however Chui points out some interesting neuroanatomical findings relating to interruption of white matter tracts. Chui also does an impressive job of drawing together epidemiological studies looking at neuropsychological functioning in relation to imaging findings. These are particularly useful as they have reasonable sample sizes and are longitudinal although on the whole tending to show various cortical changes as being significantly correlated with neuropsychological parameters. The sections on prevention are clinically relevant and show some promising results while the section on treatment is relatively brief perhaps reflecting the current state in the field. This is a useful overview for those with an interest in subcortical ischaemic vascular dementia.

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Disclaimer

The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

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