The increasing impact of cerebral amyloid angiopathy: essential new insights for clinical practice.
The increasing impact of cerebral amyloid angiopathy: essential new insights for clinical practice.
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DOI：
10.1136/jnnp-2016-314697
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发表时间：
2017-11
期刊：
影响因子：
--
通讯作者：
Werring DJ
中科院分区：
文献类型：
--
作者：
Banerjee G;Carare R;Cordonnier C;Greenberg SM;Schneider JA;Smith EE;Buchem MV;Grond JV;Verbeek MM;Werring DJ
大脑淀粉样血管病(CAA)从来没有像现在这样相关。在过去的5年里，随着 、淀粉样正电子发射断层扫描和脑脊液生物标记物分析的进步，该领域的出版物和研究迅速增加，开发了用于该疾病的新生物标记物。在接受淀粉样β免疫疗法治疗阿尔茨海默病的患者中，无意中出现了CAA样病理，这突显了确定CAA是如何以及为什么发生的重要性；如果没有这些信息，这些治疗方法的使用可能会受到不必要的限制。我们对CAA的临床和放射学谱的了解在继续发展，对于CAA在衰老和脑出血以及阿尔茨海默氏症和其他痴呆的背景下对认知的独立影响有了新的见解。虽然CAA和脑叶出血之间的联系(具有很高的复发风险)现在已经得到了很好的认识，但仍然存在一些管理难题，特别是在考虑使用抗血栓药、抗凝剂和他汀类药物时。波士顿CAA标准在过去20年中一直以一种或另一种形式使用，现在正在被审查，以反映这些新的广泛的临床和放射学发现。这篇综述旨在提供这些最新进展的5年更新，以及对CAA研究和临床实践的未来方向的展望。
Cerebral amyloid angiopathy (CAA) has never been more relevant. The last 5 years have seen a rapid increase in publications and research in the field, with the development of new biomarkers for the disease, thanks to advances in MRI, amyloid positron emission tomography and cerebrospinal fluid biomarker analysis. The inadvertent development of CAA-like pathology in patients treated with amyloid-beta immunotherapy for Alzheimer’s disease has highlighted the importance of establishing how and why CAA develops; without this information, the use of these treatments may be unnecessarily restricted. Our understanding of the clinical and radiological spectrum of CAA has continued to evolve, and there are new insights into the independent impact that CAA has on cognition in the context of ageing and intracerebral haemorrhage, as well as in Alzheimer’s and other dementias. While the association between CAA and lobar intracerebral haemorrhage (with its high recurrence risk) is now well recognised, a number of management dilemmas remain, particularly when considering the use of antithrombotics, anticoagulants and statins. The Boston criteria for CAA, in use in one form or another for the last 20 years, are now being reviewed to reflect these new wide-ranging clinical and radiological findings. This review aims to provide a 5-year update on these recent advances, as well as a look towards future directions for CAA research and clinical practice.
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影响因子：
29
作者：
Biffi A;Bailey D;Anderson CD;Ayres AM;Gurol EM;Greenberg SM;Rosand J;Viswanathan A
通讯作者：
Viswanathan A
影响因子：
5.8
作者：
Al-Shawi, Raya;Tennent, Glenys A.;Pepys, Mark B.
通讯作者：
Pepys, Mark B.
影响因子：
29
作者：
Charidimou A;Martinez-Ramirez S;Reijmer YD;Oliveira-Filho J;Lauer A;Roongpiboonsopit D;Frosch M;Vashkevich A;Ayres A;Rosand J;Gurol ME;Greenberg SM;Viswanathan A
通讯作者：
Viswanathan A
影响因子：
11.2
作者：
Bosche, Bert;Graf, Rudolf;Ernestus, Ralf-Ingo;Dohmen, Christian;Reithmeier, Thomas;Brinker, Gerrit;Strong, Anthony J.;Dreier, Jens P.;Woitzik, Johannes
通讯作者：
Woitzik, Johannes
影响因子：
8.3
作者：
Arima, Hisatomi;Tzourio, Christophe;Chalmers, John
通讯作者：
Chalmers, John