Neuropathological substrates of dementia and depression in vascular dementia. with a particular focus on cases with small infarct volumes

The neuropathological substrates of dementia and depression were evaluated in 30 patients with cerebrovascular disease and significant cognitive impai rment (VaD), with a particular focus on patients with small infarct volumes (<15 ml). VaD patients with small infarct volumes had a similar degree of cognitive impairment to those with larger infarct volumes (>15 ml) but were significantly more likely to be depressed and to have areas of microinfarc tion. A review of individual cases with small infarct volumes suggested tha t the combination of microinfarction, diffuse white matter disease and peri vascular changes, or the overlap of neurodegenerative pathologies and micro vascular changes were particularly important. Microinfarction was also sign ificantly associated with major depression. Copyright (C) 2000 S. Karger AG , Basel.