Potential biofluid biomarkers for vascular dementia

抄録

Vascular dementia (VaD) is the second most common causative disease of dementia, after Alzheimer’s disease (AD). Regarding the diagnosis of VaD, the presence of cerebrovascular impairments such as cerebral infarction and intracranial hemorrhage is confirmed by brain imaging and then followed by the temporal causality that cognitive dysfunction develops. As VaD has a wide range of pathologies and clinical symptoms, its diagnosis and the development of therapeutics specific to VaD could be difficult. The challenge is in searching for biomarkers that reflect the pathological conditions, prognosis, and severity of VaD and the detailed stratification of patients. Breakdown of the blood-brain barrier and extracellular matrix, along with axonal disorders, demyelinating disorders, and gliosis, plays a significant role in the pathogenesis of cerebrovascular impairment. Increased cerebrospinal fluid (CSF)/serum albumin quotient, decreased matrix metalloproteinase-2 index, and increased neurofilament light have been reported as biomarkers of these disorders. Measuring CSF amyloid-β 42 (Aβ42), tau, and phosphorylated tau (p-tau) as biomarkers of AD has proved useful, but the significance of these markers in VaD has not been investigated in detail. The complications of VaD and AD are common, so determining which is closer to the core of the pathological conditions is often difficult. Biomarkers specific to VaD are expected to be useful for the differential diagnosis and prognosis prediction of dementia.