Caracterización del funcionamiento cerebral, su estructura y la cognición asociados al daño cerebrovascular en el envejecimiento

Abstract

Major vascular cognitive impairment (VCI), also referred as Vascular Dementia (VaD), is responsible for up to 20% of cases of dementia worldwide (Kalaria, 2018). Besides from pure VaD, cerebrovascular diseases are also important comorbid contributors to the progression of other dementias (Wardlaw et al., 2019). Although cerebrovascular damage, specially white matter hyperintensities (WMH) is intrinsic to ageing, the accumulation or severity of these conditions represent an important cause of cognitive decline (Zimmerman et al., 2021). Nevertheless, there is ample evidence that the progression of cerebrovascular degradation can be slowed by controlling vascular risk factors and treating underlying pathologies (Zimmerman et al., 2021). Consequently, early detection and differentiation of the vascular origin of the cognitive impairment becomes a crucial scientific and clinical goal, and the ultimate purpose of this thesis. The study of electrophysiological brain signatures have been well established for early detection and prognosis in different neurodegenerative disorders (López-Sanz et al., 2019). The biochemical alterations that occur in VCI can modify cell membrane polarity, action potentials, and cell-to-cell communication, completely altering the electrophysiological functioning of the brain. Therefore, it seems reasonable to search for new potential electrophysiological biomarkers for the early differentiation of VCI. After an extensive systematic review of the literature, we were able to ascertain that they were not yet ready for inclusion in diagnosis criteria because the results were not robust enough to be used as clinical biomarkers. The motivation and objectives of the research project presented here arise from this scientific context, trying to offer specific solutions to the limitations perceived of the previous literature and heading towards the search for useful electrophysiological biomarkers for VCI...