From the CERVO Brain Research Center, Quebec City, Quebec, Canada.
Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada.
J Neuropathol Exp Neurol. 2022 Jan 29;81(2):97-105. doi: 10.1093/jnen/nlab125.
Cerebrovascular disease (CVD) has been associated with cognitive impairment. Yet, our understanding of vascular contribution to cognitive decline has been limited by heterogeneity of definitions and assessment, as well as its occurrence in cognitively healthy aging. Therefore, we aimed to establish the natural progression of CVD associated with aging. We conducted a retrospective observational study of 63 cognitively healthy participants aged 19-84 years selected through the histological archives of the CHU de Québec. Assessment of CVD lesions was performed independently by 3 observers blinded to clinical data using the Vascular Cognitive Impairment Neuropathology Guidelines (VCING). We found moderate to almost perfect interobserver agreement for most regional CVD scores. Atherosclerosis (ρ = 0.758) and arteriolosclerosis (ρ = 0.708) showed the greatest significant association with age, followed by perivascular hemosiderin deposits (ρ = 0.432) and cerebral amyloid angiopathy (CAA; ρ = 0.392). Amyloid and tau pathologies were both associated with higher CVD load, but only CAA remained significantly associated with amyloid plaques after controlling for age. Altogether, these findings support the presence of multiple CVD lesions in the brains of cognitively healthy adults, the burden of which increases with age and can be quantified in a reproducible manner using standardized histological scales such as the VCING.
脑血管疾病（CVD）与认知障碍有关。然而，由于定义和评估的异质性，以及在认知健康的衰老中发生，我们对血管对认知能力下降的贡献的理解受到限制。因此，我们旨在确定与衰老相关的 CVD 的自然进展。我们通过魁北克大学健康中心的组织学档案，对 63 名认知健康的 19-84 岁参与者进行了回顾性观察研究。通过血管性认知障碍神经病理学指南（VCING），由 3 名观察者独立对 CVD 病变进行评估，他们对临床数据一无所知。我们发现，大多数区域 CVD 评分的观察者间一致性为中度至几乎完美。动脉粥样硬化（ρ=0.758）和小动脉硬化（ρ=0.708）与年龄的关联最大，其次是血管周围含铁血黄素沉积（ρ=0.432）和脑淀粉样血管病（CAA；ρ=0.392）。淀粉样蛋白和 tau 病理学都与更高的 CVD 负荷相关，但只有 CAA 在控制年龄后仍与淀粉样斑块显著相关。总的来说，这些发现支持认知健康成年人的大脑中存在多种 CVD 病变，其负担随着年龄的增长而增加，并可以使用标准化的组织学量表（如 VCING）以可重复的方式进行量化。
