Vascular Cognitive Impairment Neuropathology Guidelines (VCING)
In addition to developing a clinical assessment of vascular cognitive impairment (VCI) in VICCCS, we also conducted a related study, VCING, which aims to develop consensus guidelines for post-mortem neuropathological assessment of cerebrovascular disease in relation to VCI. Currently there are no widely accepted assessment criteria for post-mortem diagnosis of VCI or vascular dementia, unlike for other types of dementia. VCING aims to address this by reviewing and building upon post-mortem studies and previous proposals for diagnosing vascular dementia, to develop a single set of guidelines that will be used universally.
As in VICCCS, we used the Delphi method, involving iterative rounds of anonymous surveys accessed online. The participants were neuropathologists, mainly from the Brains for Dementia Research (BDR) group. In keeping with the BDR aim of setting the 'gold standard' for brain tissue banking across 7 UK centres, the first intention of the study is to standardise the protocol used in BDR centres to: (i) assess, (ii) report and (iii) comment on the possible or likely contribution of cerebrovascular disease to cognitive impairment.
VCING started in December 2011, led by Principal Investigator Seth Love and coordinated by Alzheimer’s Society and Alzheimer’s Research UK-funded researcher Olivia Skrobot. The surveys gathered information on familiarity and use of the different published protocols for neuropathological assessment of cerebrovascular pathology likely to cause or contribute to cognitive impairment, and obtained feedback from a range of neuropathologists on the suitability of the different approaches for use in BDR centres. The initial rounds of the survey prioritised the published protocols that would form the basis of the VCING protocol, and progress was made on the standardisation of pathological definitions, sampling methods, and assessment and quantification of pathology. The VCING was completed in October 2012, after 9 rounds of Delphi surveys.
A subsequent UK multi-centre study, supported by an ARUK 2013 Network cooperation grant, was conducted by the neuropathologists to test the reproducibility and validity of the VCING. Very good agreement was found in scoring between the neuropathologists. The consensus VCING were then used to evaluate which vascular pathologies, among a broad range, best predict cognitive impairment. The findings suggest that neuropathologists can use a combination of three main determinants to assign a low, intermediate or high likelihood that cerebrovascular disease contributed to cognitive impairment in an individual case. These guidelines have been published in the journal Brain to encourage wider use internationally and further validation in a large clinical cohort.
READ THE PAPER: http://dx.doi.org/10.1093/brain/aww214
The author accepted document can be requested from the University of Bristol website: Explore Bristol Research
In addition to developing a clinical assessment of vascular cognitive impairment (VCI) in VICCCS, we also conducted a related study, VCING, which aims to develop consensus guidelines for post-mortem neuropathological assessment of cerebrovascular disease in relation to VCI. Currently there are no widely accepted assessment criteria for post-mortem diagnosis of VCI or vascular dementia, unlike for other types of dementia. VCING aims to address this by reviewing and building upon post-mortem studies and previous proposals for diagnosing vascular dementia, to develop a single set of guidelines that will be used universally.
As in VICCCS, we used the Delphi method, involving iterative rounds of anonymous surveys accessed online. The participants were neuropathologists, mainly from the Brains for Dementia Research (BDR) group. In keeping with the BDR aim of setting the 'gold standard' for brain tissue banking across 7 UK centres, the first intention of the study is to standardise the protocol used in BDR centres to: (i) assess, (ii) report and (iii) comment on the possible or likely contribution of cerebrovascular disease to cognitive impairment.
VCING started in December 2011, led by Principal Investigator Seth Love and coordinated by Alzheimer’s Society and Alzheimer’s Research UK-funded researcher Olivia Skrobot. The surveys gathered information on familiarity and use of the different published protocols for neuropathological assessment of cerebrovascular pathology likely to cause or contribute to cognitive impairment, and obtained feedback from a range of neuropathologists on the suitability of the different approaches for use in BDR centres. The initial rounds of the survey prioritised the published protocols that would form the basis of the VCING protocol, and progress was made on the standardisation of pathological definitions, sampling methods, and assessment and quantification of pathology. The VCING was completed in October 2012, after 9 rounds of Delphi surveys.
A subsequent UK multi-centre study, supported by an ARUK 2013 Network cooperation grant, was conducted by the neuropathologists to test the reproducibility and validity of the VCING. Very good agreement was found in scoring between the neuropathologists. The consensus VCING were then used to evaluate which vascular pathologies, among a broad range, best predict cognitive impairment. The findings suggest that neuropathologists can use a combination of three main determinants to assign a low, intermediate or high likelihood that cerebrovascular disease contributed to cognitive impairment in an individual case. These guidelines have been published in the journal Brain to encourage wider use internationally and further validation in a large clinical cohort.
READ THE PAPER: http://dx.doi.org/10.1093/brain/aww214
The author accepted document can be requested from the University of Bristol website: Explore Bristol Research
