title: Risk and Determinants of Dementia in Patients with Mild Cognitive Impairment and Brain Subcortical Vascular Changes: A Study of Clinical, Neuroimaging, and Biological Markers-The VMCI-Tuscany Study: Rationale, Design, and Methodology.
abstract: Dementia is one of the most disabling conditions. Alzheimer's disease and vascular dementia (VaD) are the most frequent causes. Subcortical VaD is consequent to deep-brain small vessel disease (SVD) and is the most frequent form of VaD. Its pathological hallmarks are ischemic white matter changes and lacunar infarcts. Degenerative and vascular changes often coexist, but mechanisms of interaction are incompletely understood. The term mild cognitive impairment defines a transitional state between normal ageing and dementia. Pre-dementia stages of VaD are also acknowledged (vascular mild cognitive impairment, VMCI). Progression relates mostly to the subcortical VaD type, but determinants of such transition are unknown. Variability of phenotypic expression is not fully explained by severity grade of lesions, as depicted by conventional MRI that is not sensitive to microstructural and metabolic alterations. Advanced neuroimaging techniques seem able to achieve this. Beside hypoperfusion, blood-brain-barrier dysfunction has been also demonstrated in subcortical VaD. The aim of the Vascular Mild Cognitive Impairment Tuscany Study is to expand knowledge about determinants of transition from mild cognitive impairment to dementia in patients with cerebral SVD. This paper summarizes the main aims and methodological aspects of this multicenter, ongoing, observational study enrolling patients affected by VMCI with SVD.
authors.affiliation: Department of Neurological and Psychiatric Sciences, University of Florence, Largo Brambilla 3, 50134 Florence, Italy.
authors.forename: Anna
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authors.lastname: Poggesi
authors.forename: Emilia
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authors.lastname: Salvadori
authors.forename: Leonardo
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authors.lastname: Pantoni
authors.forename: Giovanni
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authors.lastname: Pracucci
authors.forename: Francesca
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authors.lastname: Cesari
authors.forename: Alberto
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authors.lastname: Chiti
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authors.lastname: Ciolli
authors.forename: Mirco
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authors.forename: Alessandra
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authors.lastname: Del Bene
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authors.forename: Stefano
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authors.lastname: Diciotti
authors.forename: Maria Teresa
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authors.lastname: Dotti
authors.forename: Andrea
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authors.lastname: Ginestroni
authors.forename: Betti
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authors.lastname: Giusti
authors.forename: Anna Maria
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authors.lastname: Gori
authors.forename: Serena
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authors.lastname: Nannucci
authors.forename: Giovanni
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authors.forename: Francesca
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authors.lastname: Pescini
authors.forename: Raffaella
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authors.lastname: Valenti
authors.forename: Rosanna
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authors.lastname: Abbate
authors.forename: Antonio
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authors.lastname: Federico
authors.forename: Mario
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authors.lastname: Mascalchi
authors.forename: Luigi
authors.initials: L
authors.lastname: Murri
authors.forename: Domenico
authors.initials: D
authors.lastname: Inzitari