Research criteria for subcortical vascular dementia in clinical trials

  • Timo Erkinjuntti
  • D. Inzitari
  • L. Pantoni
  • A. Wallin
  • P. Scheltens
  • K. Rockwood
  • G. C. Roman
  • H. Chui
  • D. W. Desmond
Conference paper


Vascular dementia (VaD) incorporate different vascular mechanisms and changes in the brain, and have different causes and clinical manifestations. Variation in defining the cognitive syndrome, in vascular etiologies, and allowable brain changes in current clinical definitions of VaD have resulted in variable estimates of prevalence, of groups of subjects, and of the types and distribution of putative causal brain lesions. Thus current criteria for VaD select an etiologically and clinically heterogeneous group. This definitional heterogeneity may have been a factor in “negative” clinical trials. An alternative for clinical drug trials is to focus on a more homogenous group, such as those with subcortical (ischemic) VaD. This designation incorporates two small vessel clinical entities “Binswanger’s disease” and “the lacunar state”. It comprises small vessel disease as the primary vascular etiology, lacunar infarct(s) and ischaemic white matter lesions as the primary type of brain lesions, and subcortical location as the primary location of lesions. The subcortical clinical syndrome is the primary clinical manifestation, a definition which still requires additional empirical data. We expect that subcortical VaD show a more predictable clinical picture, natural history, outcome, and treatment responses. We propose a modification of the NINDS-AIREN criteria as a new research criteria for subcortical VaD.


Vascular Dementia White Matter Lesion Small Vessel Disease Lacunar Infarct Deep White Matter Lesion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag 2000

Authors and Affiliations

  • Timo Erkinjuntti
    • 1
    • 9
  • D. Inzitari
    • 2
  • L. Pantoni
    • 2
  • A. Wallin
    • 3
  • P. Scheltens
    • 4
  • K. Rockwood
    • 5
  • G. C. Roman
    • 6
  • H. Chui
    • 7
  • D. W. Desmond
    • 8
  1. 1.Department of Clinical NeurosciencesHelsinki University Central HospitalHelsinkiFinland
  2. 2.Department of Neurological and Psychiatric SciencesUniversity of FlorenceFlorenceItaly
  3. 3.Institute of Clinical NeuroscienceGothenburg UniversityMülndalSweden
  4. 4.Department of NeurologyAcademisch Ziekenhuis VUAmsterdamNetherlands
  5. 5.Divisions of Geriatric Medicine and NeurologyDepartment of Medicine, Dalhousie UniversityHalifaxCanada
  6. 6.The University of Texas Health Science Center at San Antonio, San AntonioUSA
  7. 7.University of Southern CaliforniaLos AngelesUSA
  8. 8.Department of Neurology, Columbia University, College of Physicians and Surgeons, New YorkNew YorkUSA
  9. 9.Chief Memory Research Unit, Department of Clinical NeurosciencesHelsinki University Central HospitalFinland

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