on August 17, 2006
Published online before print August 17, 2006, doi: 10.1161/01.STR.0000237236.88823.47
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Submitted on March 24, 2006
From the London Health Sciences Centre (V.H.), University Campus, London, Ontario, Canada; the Department of Neurology and Neuroscience (C.I.), Division of Neurobiology, Weill Cornell Medical College, New York, NY; the Department of Neurology (R.C.P.), Mayo Clinic, Rochester, MN; the Department of Epidemiology and Biostatistics (M.M.B.), Erasmus Medical Center, Rotterdam, The Netherlands; the Department of Neurology and Rehabilitation (D.L.N.), University of Illinois at Chicago, Chicago, IL; the Division of Neurology Sunnybrook and Women’s College (S.E.B.), Health Sciences Centre, Toronto, Ontario, Canada; the Department of Neurology (W.J.P., D.M.H.), Washington University, School of Medicine, St. Louis, MO; the Department of Neurology (C.D.), University of California at Davis, Sacramento, CA; the Section on Stroke Diagnostics and Therapeutics (J.G.M.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD; the Wolfson Centre (Neuropathology), Institute for Ageing and Health (R.N.K.), Newcastle General Hospital, Newcastle upon Tyne, UK; the Department of Pathology and Laboratory Medicine (H.V.V.), Section of Neuropathology, University of California, Los Angeles, UCLA Medical Center, Los Angeles, CA; the Department of Neurology (G.A.R.), University of New Mexico, Albuquerque, NM; the Neurologische Klinik (M.D.), Ludwig-Maximilians-Universität München, Klinikum Grosshadern, München, Germany; and the National Institute of Neurological Disorders and Stroke (J.R.M., G.G.L.), National Institutes of Health, Bethesda, MD. * To whom correspondence should be addressed. E-mail: leblancg{at}ninds.nih.gov.
Background and Purpose--One in 3 individuals will experience a stroke, dementia or both. Moreover, twice as many individuals will have cognitive impairment short of dementia as either stroke or dementia. The commonly used stroke scales do not measure cognition, while dementia criteria focus on the late stages of cognitive impairment, and are heavily biased toward the diagnosis of Alzheimer disease. No commonly agreed standards exist for identifying and describing individuals with cognitive impairment, particularly in the early stages, and especially with cognitive impairment related to vascular factors, or vascular cognitive impairment. Methods--The National Institute for Neurological Disorders and Stroke (NINDS) and the Canadian Stroke Network (CSN) convened researchers in clinical diagnosis, epidemiology, neuropsychology, brain imaging, neuropathology, experimental models, biomarkers, genetics, and clinical trials to recommend minimum, common, clinical and research standards for the description and study of vascular cognitive impairment. Results--The results of these discussions are reported herein. Conclusions--The development of common standards represents a first step in a process of use, validation and refinement. Using the same standards will help identify individuals in the early stages of cognitive impairment, will make studies comparable, and by integrating knowledge, will accelerate the pace of progress.
Revised on May 24, 2006
Accepted on June 19, 2006
National Institute of Neurological Disorders and Stroke-Canadian Stroke Network Vascular Cognitive Impairment Harmonization Standards
Vladimir Hachinski MD, DSc;
Key words: Binswangers disease • CADASIL • syndrome • cerebral infarction • cerebrovascular disorders • dementia • genetics • ischemia • lacunar infarction • leukoaraiosis • neuropsychology • stroke • vascular dementia
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Stroke 2006 37: 2197.
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