Transcranial Doppler Study in elderly patients at risk for virtual vascular dementia

Background and Aims: cerebral White Matter Lesions (WMLs) are considered a condition at risk for future vascular dementia, although data on the cerebral hemodynamic changes are scarce. We test and compare Transcranial Doppler (TCD) features in patients with WMLs with or without associated cognitive impairment. Methods: a sample of elderly patients with WMLs were consecutively recruited. TCD parameters investigared were mean blood flow velocity (MBFV) and pulsatility index (PI) recorded from the middle cerebral artery. Global cognitive status, neuropsychological tests evaluating frontal lobe abilities, and WMLs severity were also assessed. Results: 114 patients satisfying the clinical criteria for vascular cognitive impairment-no dementia (VCI-ND) were age-matched with 81 controls without cognitive deficit. Patients exhibited a decrease of MBFV and an increase of PI compared to controls. Moreover, a significant correlation between MBFV, PI, and severity of executive dysfunction was observed, whereas PI significantly correlated with WMLs load. Conclusions: a significant correlation between TCD parameters and clinical-neuroradiological features of VCI-ND was observed in elderly patients with WMLs, highlighting the role of impaired cerebrovascular hemodynamics in VCI-ND pathogenesis. Serial TCD assessment may provide useful insights on the disease process and progress.