Towards the concept of disease-modifier in post-stroke or vascular cognitive impairment: a consensus report

• DOI: 10.1186/s12916-017-0869-6
• Publication Date: 2017-05-24T15:33:25Z
• Authors: Régis Bordet; Ralf Ihl; Amos D. Korczyn; Giuseppe Lanza; Jelka Jansa; Robert Hoerr; Alla Guekht
• Keywords: Stroke; Cognitive Decline

Vascular cognitive impairment (VCI) is a complex spectrum encompassing post-stroke (PSCI) and small vessel disease-related impairment. Despite the growing health, social, economic burden of VCI, to date, no specific treatment available, prompting introduction concept disease modifier. Within this clinical spectrum, VCI PSCI remain advancing conditions as neurodegenerative diseases with progression both vascular degenerative lesions accounting for decline. Disease-modifying strategies should integrate pharmacological non-pharmacological multimodal approaches, pleiotropic effects targeting (1) endothelial brain–blood barrier dysfunction; (2) neuronal death axonal loss; (3) cerebral plasticity compensatory mechanisms; (4) degenerative-related protein misfolding. Moreover, in or requires valid study designs clearly stating definition basic methodological issues, such instruments that be used measure eventual changes, biomarker-based stratification participants investigated, statistical tests, well inclusion exclusion criteria applied. A consensus emerged propose development disease-modifying strategy based on approaches.