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(Stroke. 2006;37:2197.)
© 2006 American Heart Association, Inc.

Editorials

Welcome Harmonizations

José M. Ferro, MD, PhD

From the Department of Neurosciences, Hospital de Santa Maria, University of Lisboa, Lisboa, Portugal.

Correspondence to José M. Ferro, MD, PhD, the Department of Neurosciences, Hospital de Santa Maria, University of Lisboa, Av. Egas Moniz, 1649-035 Lisboa, Portugal. E-mail jmferro@fm.ul.pt

Key Words: vascular dementia

An extract of the first 250 words of the full text is provided, because this article has no abstract.

See related article, pages 2220–2241

Cerebrovascular disease is the second most common cause of acquired cognitive impairment and dementia and contributes to cognitive decline in the neurodegenerative dementias.¹ The narrow definition of vascular dementia was broadened to include any cognitive impairment associated not only with clinically evident stroke, but also with neuroimaging or neuropathological evidence of brain lesions, related to vascular and circulatory diseases and to vascular risk factors, including genetic ones. Cerebrovascular disease impacts the whole brain, causing cognitive deficits, mood and personality changes, and gait and balance problems. Focus has moved from the "end-stage" condition—vascular dementia—to the "brain-at-risk" concept—individuals exposed to vascular risk factors or whose neuroimaging tests show mild assymptomatic lesions of vascular origin.

Significant progress in the field of vascular dementia resulted from the publication of the NINDS-AIREN diagnostic criteria for vascular dementia.² Time has come to produce a similar document in relation to the broader concept of vascular cognitive impairment. In fact, harmonization standards are a prerequisite to observational or experimental studies in vascular cognitive impairment.

The publication of the NINDS-CNS Vascular Cognitive Impairment Harmonization standards³ is therefore an important step forward. Both the authors and the NIH deserve to be congratulated by this initiative.

The publication successively addresses clinical and epidemiological issues, neuropsychology, neuroimaging, neuropathology, experimental models, biomarkers, genetics and methodological aspects of clinical trials. An innovative aspect of the proposed standards is their possibility to be adapted to different setting of research. For example, in the clinical section an abbreviated clinical evaluation . . . [Full Text of this Article]

Related Article:

National Institute of Neurological Disorders and Stroke–Canadian Stroke Network Vascular Cognitive Impairment Harmonization Standards

Vladimir Hachinski, Costantino Iadecola, Ron C. Petersen, Monique M. Breteler, David L. Nyenhuis, Sandra E. Black, William J. Powers, Charles DeCarli, Jose G. Merino, Raj N. Kalaria, Harry V. Vinters, David M. Holtzman, Gary A. Rosenberg, Anders Wallin, Martin Dichgans, John R. Marler, and Gabrielle G. Leblanc
Stroke 2006 37: 2220-2241. [Abstract] [Full Text] [PDF]