Palabras clave
Demencia Vascular
Infarto Cerebral
Hipoxia
Terapéutica
Diagnóstico
Infarto Cerebral
Hipoxia
Terapéutica
Diagnóstico
Cómo citar
Castro Samur, M., Caamaño, B., Herrera Carvajal, H. H. C., & Guerro Bracho, D. (2012). Avances recientes en el diagnóstico y tratamiento de la demencia vascular. Médicas UIS, 25(3). Recuperado a partir de https://revistas.uis.edu.co/index.php/revistamedicasuis/article/view/3428
Resumen
Introducción: la demencia vascular es un síndrome adquirido y persistente causado por lesiones netamente vasculares a nivel del sistema nervioso central, alterando las funciones del intelecto y la cognición, indispensables para el equilibrio biológico, psicológico y social. Objetivo: describir los avances reciente en demencia vascular; criterios diagnósticos, factores predisponentes, epidemiología, neuropatología, perfil neurocognitivo y psiquiátrico y abordaje terapéutico integral. Metodología de búsqueda: revisión actualizada de la literatura, mediante búsqueda automatizada de artículos recientes en revistas indexadas en base de datos biomédicas, durante los meses de marzo a mayo del 2012. Resultados: se encontraron 55 artículos con información actualizada que consolidan los objetivos de la revisión. Conclusiones: la demencia vascular ha asumido un rol mórbido, especialmente en la población geriátrica, a consecuencia de la alta prevalencia de enfermedades cerebro-cardio vasculares; por lo cual su prevención, diagnóstico, tratamiento y rehabilitación deben ser prioridad en la práctica clínica, dada la importancia de la salud mental en esta población que en Colombia ha sido subvalorada. (MÉD.UIS. 2012;25(3):221-7).
Referencias
1. Téllez J. Demencia vascular: etiopatogenia, criterios clínicos y estrategias terapéuticas. Avances En Psiquiatría Biológica. 2008;9:143-65.
2. Rastas S, Pirttilä T, Mattilac K, Verkkoniemid A, Juva K, Niinistö L, et al. Vascular risk factors and dementia in the general population aged >85 years: prospective population-based study. Neurobiol Aging. 2010;31(1):1-7.
3. Sasaki Y, Mari Kasai, Satoshi Yamaguchi, Kyoko Akanuma, Mitsue Meguro, Hiroshi Ishii, et al. P2-120: Vascular risk factors are associated with vascular dementia or concomitant cerebrovascular diseases but not with. Alzheimer’s disease: The Osaki-Tajiri Project. Alzheimer’s and Dementia. 2008;4:T406.
4. Román GC. The epidemiology of vascular dementia. Handb Clin Neurol. 2008;89:639-58.
5. Dong MJ, Peng B, Lin XT, Zhao J, Zhou YR, Wang RH. The prevalence of dementia in the People’s Republic of China: a systematic analysis of 1980-2004 studies. Age Ageing. 2007;36(6):619-24.
6. Román GC. Facts, myths, and controversies in vascular dementia. J Neurol Sci. 2004;226(1-2):49-52.
7. Decarli C. Vascular factors in dementia: an overview. J Neurol Sci. 2004;226(1-2):19–23.
8. Kloppenborg RP, van den Berg E, Kappelle LJ, Biessels GJ. Diabetes and other vascular risk factors for dementia: which factor matters most? A systematic review. Eur J Pharmacol. 2008;585(1):97-108.
9. Azad NA, Al Bugami M, Loy-English I. Gender differences in dementia risk factors. Gend Med. 2007;4(2):120-9.
10. Patterson C, Feightner J, Garcia J, MacKnight C. General risk factors for dementia: a systematic evidence review. Alzheimers Dement. 2007;3:341-7.
11. Stella F, Banzato CE, Gasparetto EV, Scudeler JL, Pacheco JL, Kajita RT. Risk factors for vascular dementia in elderly psychiatric outpatients with preserved cognitive functions. J Neurol Sci. 2007;257(1-2):247–9.
12. Takahashi PY, Caldwell C, Targonski C. Effect of alcohol and tobacco use on vascular dementia: a matched case control study. Vasc Health Risk Manag. 2011;7:685–91.
13. American Psychiatric Association. Manual Diagnóstico y Estadístico de los Trastornos Mentales. Breviario. 4th ed. Washington: American Psychiatric Association. 2000. p.81-2.
14. Wetterling T, Kanitz RD, Borgis KJ. Comparison of different diagnostic criteria for vascular dementia (ADDTC, DSM-IV, ICD-10, NINDS-AIREN). Stroke. 1996; 27:30-6.
15. Hachinski V, Iadecola C, Petersen RC, Breteler MM,Nyenhuis DL, Black SE,et al. National Institute of Neurological Disorders and Stroke-Canadian Stroke Network vascular cognitive impairment harmonization standards. Stroke. 2006;37(9):2220–41.
16. Jellinger KA.Morphologic diagnosis of “vascular dementia” - a critical update. J Neurol Sci. 2008;270(1-2):1–12.
17. Ravaglia G, Forti P, Maioli F, Martelli M, Servadei L, Brunetti N, et al. Incidence and etiology of dementia in a large elderly Italian population. Neurology. 2005;64:1525–30.
18. Jellinger KA. The pathology of ischemic-vascular dementia: an update. J Neurol Sci. 2002;203-204:153–7.
19. Smith EE, Schneider JA, Wardlaw JM, Greenberg SM.
Cerebral microinfarcts: the invisible lesions. Lancet Neurol. 2012;11(3):272-82.
20. Brundel M, de Bresser J, van Dillen JJ, Kappelle LJ, Biessels GJ. Cerebral microinfarcts: A systematic review of neuropathological studies. J Cereb Blood Flow Metab. 2012;32(3):425-36.
21. Román G, Benavente O. The neuropathology of vascular dementia. Seminars in Cerebrovascular Diseases and Stroke. 2008;4:87-96.
22. Iemolo F, Duro G, Rizzo C, Castiglia L, Hachinski V, Caruso C. Pathophysiology of vascular dementia. Immun Ageing. 2009;6:13.
23. Batti L, O’Connor JJ. Tumor necrosis factor-alpha impairs the recovery of synaptic transmission from hypoxia in rat hippocampal slices. J Neuroimmunol.2010;218(1-2):21-7.
24. Campbell IL, Hofer MJ, Pagenstecher A. Transgenic models for cytokine-induced neurological disease. Biochim Biophys Acta. 2010;1802(10):903-17.
25. Cañuelo A, Siles E, Martínez-Romero R, Peinado MA, Martínez-Lara E. The nitric oxide system response to hypoxia/reoxygenation in the aged cerebral cortex. Exp Gerontol. 2007;42(12):1137-45.
26. Dickstein DL, Kabaso D, Rocher AB, Luebke JL, Wearne SL, and Hof PR. Changes in the structural complexity of the aged brain. Aging Cell. 2007;6:275–84.
27. Ritz MF, Fluri F, Engelter ST, Schaeren-Wiemers N, Lyrer PA. Cortical and putamen age-related changes in the microvessel density and astrocyte deficiency in spontaneously hypertensive and stroke-prone spontaneously hypertensive rats. Curr Neurovasc Res. 2009;6(4):279–87.
28. SzirmaiI ,Vastagh I, Szombathelyi E, Kamondi A. Strategic infarcts of the thalamus in vascular dementia. J Neurol Sci. 2002;203-204:91–7.
29. Del Ser T, Bermejo F, Portera A, Arredondo JM, Bouras C, Constantinidis J. Vascular dementia: a clinicopathological study. J Neurol Sci. 1990;96:1-17.
30. Nagata K, Saito H, Ueno T, Sato M, Nakase T, Maeda T, et al. Clinical diagnosis of vascular dementia. J Neurol Sci. 2007;256:44-8.
31. Borroni B, Ghezzi S, Agosti C, Archetti S, Fenoglio C, Galimberti D, et al. Preliminary evidence that VEGF genetic variability confers susceptibility to frontotemporal lobar degeneration. Rejuvenation Res. 2008; 11:773-80.
32. Hota SK, Barhwal K, Singh SB, Ilavazhagan G. Chronic hypobaric hypoxia induced apoptosis in CA1 region of hippocampus: a possible role of NMDAR mediated p75NTR upregulation. Exp Neurol. 2008;212:5-13.
33. Kennedy KM, Rodrigue KM, Land SJ, Raz N. BDNF Val66Met polymorphism influences age differences in microstructure of the Corpus Callosum. Front Hum Neurosci. 2009;3:19.
34. Munro C, Saxton J, Butters M. Alcohol dementia: “cortical” or “subcortical” dementia? Arch ClinNeuropsychol. 2001;16:523-33.
35. Shim YS, Yang DS, Kim BS, Shon YM, Chung YA. Comparison of regional cerebral blood flow in two subsets of subcortical ischemic vascular dementia:statistical parametric mapping analysis of SPECT. J of the Neurol Sci. 2006;250:85-91.
36. Vernooij MW, Ikram MA, Wielopolski PA, Krestin GP, Breteler MM, van der Lugt A. Cerebral microbleeds: accelerated 3D T2*-weighted GRE MR imaging versus conventional 2D T2*-weighted GRE MR imaging for detection. Radiology. 2008;248(1):272-7.
37. Tomimoto H. Subcortical vascular dementia. Neurosci Res. 2011;71:193-9.
38. Wu Z, Mittal S, Kish K, Yu Y, Hu J, Haacke EM. Identification of calcification with MRI using susceptibility-weighted imaging: a case study. J Magn Reson Imaging. 2009;29(1):177-82.
39. Silverman DH, Small GW, Chang CY, Lu CS, Kung De Aburto MA, Chen W, et al. Positron emission tomography in evaluation of dementia: Regional brain metabolism and long-term outcome. JAMA. 2001;286:2120-2.
40. Ayaz M, Boikov A, Haacke E, Kido DK, Kirsch W. Imaging cerebral microbleeds using susceptibility weighted imaging: one step toward detecting vascular dementia. J Magn Reson Imaging. 2010;31:142-8.
41. Schuff N, Matsumoto S, Kmiecik J, Studholme C, Du A, Ezekiel F, et al. Cerebral blood flow in ischemic vascular dementia and Alzheimer’s disease,measured by arterial spin-labeling magnetic resonance imaging. Alzheimers Dement. 2009;5:454-62.
42. Martínez MC, Arana E, Martí L, Martínez B, Celda B. Deterioro cognitivo: clasificación mediante espectroscopia de resonancia magnética de protón y contribución de la imagen convencional. Radiología. 2006;48(5):301-7.
43. Korczyn AD, Halperin I. Depression and dementia. J Neurol Sci. 2009;283:139-42.
44. Ballard C, Neill D, O’Brien J, McKeith IG, Ince P, Perry R. Anxiety, depression and psychosis in vascular dementia: prevalence and associations. J Affect Disord. 2000;59:97-106.
45. Samaras N,Rossi G, Giannakopoulos P, Gold G. Vascular depression. An age-related mood disorder. Eur Geriatr Med. 2010;1:220-5.
46. Wang LY,Li G, Shofer JB, Thompson ML, Bowen JD, McCormick W. Depression symptoms and risk of Alzheimer›s disease, vascular dementia, and other types of dementia. Alzheimers Dement. 2010;6:S461-2.
47. Hopkins MW, Libon DJ. Neuropsychological functioning of dementia patients with psychosis. Arch Clin Neuropsychol. 2005;20:771-83.
48. Dettmore D, Kolanowski A, Boustani M. Aggression in Persons with Dementia: Use of Nursing Theory to Guide Clinical Practice. Geriatr Nurs. 2009; 30:8-17.
49. Lüders S, Stöve S, Schrader J. Prevention of vascular dementia: Evidence and practice. Internist (Berl). 2012;53(2):223-31.
50. Pattersona C, Feightnerb J, Garciac A, MacKnightd C. Primary prevention of dementia. Alzheimers Dement. 2007;3:348-54.
51. Bocti C, Black S, Frank C. Management of dementia with a cerebrovascular component. Alzheimers Dement. 2007;3:398-403.
52. Olivares D, Deshpande VK, Shi Y, Lahiri DK, Greig NH, Rogers JT, et al. N-Methyl D-Aspartate (NMDA) receptor antagonists and memantine treatment for Alzheimer›s disease, vascular dementia and Parkinson›s disease. Curr Alzheimer Res. 2011 Aug 30. [Epub ahead of print].
53. Brunoni AR, Benseñor IM, Alves TC. Therapeutic interventions for vascular depression: a systematic review. Rev Bras Psiquiatr. 2011;33(4):400-9.
54. Erkinjuntti T, Román G, Gauthier S. Treatment of vascular dementia-evidence from clinical trials with cholinesterase inhibitors. J Neurol Sci. 2004;226(12):63-6.
2. Rastas S, Pirttilä T, Mattilac K, Verkkoniemid A, Juva K, Niinistö L, et al. Vascular risk factors and dementia in the general population aged >85 years: prospective population-based study. Neurobiol Aging. 2010;31(1):1-7.
3. Sasaki Y, Mari Kasai, Satoshi Yamaguchi, Kyoko Akanuma, Mitsue Meguro, Hiroshi Ishii, et al. P2-120: Vascular risk factors are associated with vascular dementia or concomitant cerebrovascular diseases but not with. Alzheimer’s disease: The Osaki-Tajiri Project. Alzheimer’s and Dementia. 2008;4:T406.
4. Román GC. The epidemiology of vascular dementia. Handb Clin Neurol. 2008;89:639-58.
5. Dong MJ, Peng B, Lin XT, Zhao J, Zhou YR, Wang RH. The prevalence of dementia in the People’s Republic of China: a systematic analysis of 1980-2004 studies. Age Ageing. 2007;36(6):619-24.
6. Román GC. Facts, myths, and controversies in vascular dementia. J Neurol Sci. 2004;226(1-2):49-52.
7. Decarli C. Vascular factors in dementia: an overview. J Neurol Sci. 2004;226(1-2):19–23.
8. Kloppenborg RP, van den Berg E, Kappelle LJ, Biessels GJ. Diabetes and other vascular risk factors for dementia: which factor matters most? A systematic review. Eur J Pharmacol. 2008;585(1):97-108.
9. Azad NA, Al Bugami M, Loy-English I. Gender differences in dementia risk factors. Gend Med. 2007;4(2):120-9.
10. Patterson C, Feightner J, Garcia J, MacKnight C. General risk factors for dementia: a systematic evidence review. Alzheimers Dement. 2007;3:341-7.
11. Stella F, Banzato CE, Gasparetto EV, Scudeler JL, Pacheco JL, Kajita RT. Risk factors for vascular dementia in elderly psychiatric outpatients with preserved cognitive functions. J Neurol Sci. 2007;257(1-2):247–9.
12. Takahashi PY, Caldwell C, Targonski C. Effect of alcohol and tobacco use on vascular dementia: a matched case control study. Vasc Health Risk Manag. 2011;7:685–91.
13. American Psychiatric Association. Manual Diagnóstico y Estadístico de los Trastornos Mentales. Breviario. 4th ed. Washington: American Psychiatric Association. 2000. p.81-2.
14. Wetterling T, Kanitz RD, Borgis KJ. Comparison of different diagnostic criteria for vascular dementia (ADDTC, DSM-IV, ICD-10, NINDS-AIREN). Stroke. 1996; 27:30-6.
15. Hachinski V, Iadecola C, Petersen RC, Breteler MM,Nyenhuis DL, Black SE,et al. National Institute of Neurological Disorders and Stroke-Canadian Stroke Network vascular cognitive impairment harmonization standards. Stroke. 2006;37(9):2220–41.
16. Jellinger KA.Morphologic diagnosis of “vascular dementia” - a critical update. J Neurol Sci. 2008;270(1-2):1–12.
17. Ravaglia G, Forti P, Maioli F, Martelli M, Servadei L, Brunetti N, et al. Incidence and etiology of dementia in a large elderly Italian population. Neurology. 2005;64:1525–30.
18. Jellinger KA. The pathology of ischemic-vascular dementia: an update. J Neurol Sci. 2002;203-204:153–7.
19. Smith EE, Schneider JA, Wardlaw JM, Greenberg SM.
Cerebral microinfarcts: the invisible lesions. Lancet Neurol. 2012;11(3):272-82.
20. Brundel M, de Bresser J, van Dillen JJ, Kappelle LJ, Biessels GJ. Cerebral microinfarcts: A systematic review of neuropathological studies. J Cereb Blood Flow Metab. 2012;32(3):425-36.
21. Román G, Benavente O. The neuropathology of vascular dementia. Seminars in Cerebrovascular Diseases and Stroke. 2008;4:87-96.
22. Iemolo F, Duro G, Rizzo C, Castiglia L, Hachinski V, Caruso C. Pathophysiology of vascular dementia. Immun Ageing. 2009;6:13.
23. Batti L, O’Connor JJ. Tumor necrosis factor-alpha impairs the recovery of synaptic transmission from hypoxia in rat hippocampal slices. J Neuroimmunol.2010;218(1-2):21-7.
24. Campbell IL, Hofer MJ, Pagenstecher A. Transgenic models for cytokine-induced neurological disease. Biochim Biophys Acta. 2010;1802(10):903-17.
25. Cañuelo A, Siles E, Martínez-Romero R, Peinado MA, Martínez-Lara E. The nitric oxide system response to hypoxia/reoxygenation in the aged cerebral cortex. Exp Gerontol. 2007;42(12):1137-45.
26. Dickstein DL, Kabaso D, Rocher AB, Luebke JL, Wearne SL, and Hof PR. Changes in the structural complexity of the aged brain. Aging Cell. 2007;6:275–84.
27. Ritz MF, Fluri F, Engelter ST, Schaeren-Wiemers N, Lyrer PA. Cortical and putamen age-related changes in the microvessel density and astrocyte deficiency in spontaneously hypertensive and stroke-prone spontaneously hypertensive rats. Curr Neurovasc Res. 2009;6(4):279–87.
28. SzirmaiI ,Vastagh I, Szombathelyi E, Kamondi A. Strategic infarcts of the thalamus in vascular dementia. J Neurol Sci. 2002;203-204:91–7.
29. Del Ser T, Bermejo F, Portera A, Arredondo JM, Bouras C, Constantinidis J. Vascular dementia: a clinicopathological study. J Neurol Sci. 1990;96:1-17.
30. Nagata K, Saito H, Ueno T, Sato M, Nakase T, Maeda T, et al. Clinical diagnosis of vascular dementia. J Neurol Sci. 2007;256:44-8.
31. Borroni B, Ghezzi S, Agosti C, Archetti S, Fenoglio C, Galimberti D, et al. Preliminary evidence that VEGF genetic variability confers susceptibility to frontotemporal lobar degeneration. Rejuvenation Res. 2008; 11:773-80.
32. Hota SK, Barhwal K, Singh SB, Ilavazhagan G. Chronic hypobaric hypoxia induced apoptosis in CA1 region of hippocampus: a possible role of NMDAR mediated p75NTR upregulation. Exp Neurol. 2008;212:5-13.
33. Kennedy KM, Rodrigue KM, Land SJ, Raz N. BDNF Val66Met polymorphism influences age differences in microstructure of the Corpus Callosum. Front Hum Neurosci. 2009;3:19.
34. Munro C, Saxton J, Butters M. Alcohol dementia: “cortical” or “subcortical” dementia? Arch ClinNeuropsychol. 2001;16:523-33.
35. Shim YS, Yang DS, Kim BS, Shon YM, Chung YA. Comparison of regional cerebral blood flow in two subsets of subcortical ischemic vascular dementia:statistical parametric mapping analysis of SPECT. J of the Neurol Sci. 2006;250:85-91.
36. Vernooij MW, Ikram MA, Wielopolski PA, Krestin GP, Breteler MM, van der Lugt A. Cerebral microbleeds: accelerated 3D T2*-weighted GRE MR imaging versus conventional 2D T2*-weighted GRE MR imaging for detection. Radiology. 2008;248(1):272-7.
37. Tomimoto H. Subcortical vascular dementia. Neurosci Res. 2011;71:193-9.
38. Wu Z, Mittal S, Kish K, Yu Y, Hu J, Haacke EM. Identification of calcification with MRI using susceptibility-weighted imaging: a case study. J Magn Reson Imaging. 2009;29(1):177-82.
39. Silverman DH, Small GW, Chang CY, Lu CS, Kung De Aburto MA, Chen W, et al. Positron emission tomography in evaluation of dementia: Regional brain metabolism and long-term outcome. JAMA. 2001;286:2120-2.
40. Ayaz M, Boikov A, Haacke E, Kido DK, Kirsch W. Imaging cerebral microbleeds using susceptibility weighted imaging: one step toward detecting vascular dementia. J Magn Reson Imaging. 2010;31:142-8.
41. Schuff N, Matsumoto S, Kmiecik J, Studholme C, Du A, Ezekiel F, et al. Cerebral blood flow in ischemic vascular dementia and Alzheimer’s disease,measured by arterial spin-labeling magnetic resonance imaging. Alzheimers Dement. 2009;5:454-62.
42. Martínez MC, Arana E, Martí L, Martínez B, Celda B. Deterioro cognitivo: clasificación mediante espectroscopia de resonancia magnética de protón y contribución de la imagen convencional. Radiología. 2006;48(5):301-7.
43. Korczyn AD, Halperin I. Depression and dementia. J Neurol Sci. 2009;283:139-42.
44. Ballard C, Neill D, O’Brien J, McKeith IG, Ince P, Perry R. Anxiety, depression and psychosis in vascular dementia: prevalence and associations. J Affect Disord. 2000;59:97-106.
45. Samaras N,Rossi G, Giannakopoulos P, Gold G. Vascular depression. An age-related mood disorder. Eur Geriatr Med. 2010;1:220-5.
46. Wang LY,Li G, Shofer JB, Thompson ML, Bowen JD, McCormick W. Depression symptoms and risk of Alzheimer›s disease, vascular dementia, and other types of dementia. Alzheimers Dement. 2010;6:S461-2.
47. Hopkins MW, Libon DJ. Neuropsychological functioning of dementia patients with psychosis. Arch Clin Neuropsychol. 2005;20:771-83.
48. Dettmore D, Kolanowski A, Boustani M. Aggression in Persons with Dementia: Use of Nursing Theory to Guide Clinical Practice. Geriatr Nurs. 2009; 30:8-17.
49. Lüders S, Stöve S, Schrader J. Prevention of vascular dementia: Evidence and practice. Internist (Berl). 2012;53(2):223-31.
50. Pattersona C, Feightnerb J, Garciac A, MacKnightd C. Primary prevention of dementia. Alzheimers Dement. 2007;3:348-54.
51. Bocti C, Black S, Frank C. Management of dementia with a cerebrovascular component. Alzheimers Dement. 2007;3:398-403.
52. Olivares D, Deshpande VK, Shi Y, Lahiri DK, Greig NH, Rogers JT, et al. N-Methyl D-Aspartate (NMDA) receptor antagonists and memantine treatment for Alzheimer›s disease, vascular dementia and Parkinson›s disease. Curr Alzheimer Res. 2011 Aug 30. [Epub ahead of print].
53. Brunoni AR, Benseñor IM, Alves TC. Therapeutic interventions for vascular depression: a systematic review. Rev Bras Psiquiatr. 2011;33(4):400-9.
54. Erkinjuntti T, Román G, Gauthier S. Treatment of vascular dementia-evidence from clinical trials with cholinesterase inhibitors. J Neurol Sci. 2004;226(12):63-6.
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