Combining biomarkers can identify common cognitive disorders

In recent years, subcortical small vessel disease has become an increasingly common cognitive diagnosis

Subcortical small vessel disease is one of the most common cognitive disorders, along with Alzheimer's disease and mixed dementia, a form of Alzheimer's disease that occurs with damage to blood vessels in the brain

Petronella Kettunen, associate professor of neurobiology at the University of Gothenburg and project manager of the Mild Cognitive Impairment Study in Gothenburg, is the lead author of this article:

"So far, we have had no markers for subcortical small vessel disease, which means the disease cannot be easily identified by testing spinal fluid or blood samples

In the study, researchers at the University of Gothenburg examined several biomarkers in spinal fluid and blood samples to see if they could be used to differentiate between these three common cognitive disorders

Identifying subcortical small vessel disease

The study confirmed that biomarkers of vascular injury, based on the ratio of the protein albumin in spinal fluid and blood, were significantly higher in patients with subcortical small vessel disease

"When we combined biomarkers of vascular injury with the protein fragments we identified, the potential to separate patients with subcortical small vessel disease from controls, patients with Alzheimer's disease and mixed dementia," Kettunen said.

A well-defined research base

The finding also raises the possibility of refining patient cohorts in clinical trials of new drugs

"For example, for Alzheimer's treatment studies, you need to know that all patients have Alzheimer's and not other cognitive diseases, otherwise the results will be inaccurate

Alzheimer's disease and subcortical small vessel disease

• Alzheimer's disease develops gradually

  
  

• In contrast, subcortical small vessel disease affects blood vessels deep in the brain, below the cerebral cortex, making cognitive symptoms different

  
  

• Small vessel disease can be accompanied by hypertension, and patients often present with vascular damage such as small white matter infarcts

  
  

The findings were published in Alzheimer's and Dementia: Diagnosis, Evaluation and Disease Surveillance, the scientific journal of the Alzheimer's Association of America

article title

Blood-brain barrier dysfunction and reduced cerebrospinal fluid levels of soluble amyloid precursor protein-β in patients with subcortical small-vessel disease