Distribution Of Cerebral Vessel Disease-related Pathology In Postmortem Human Brain Tissue And The Correlation With Antemortem Cognition Performance

BACKGROUNDAs life span rises,age related cognitive impairment has become a growing public health issue.Many theories on the cause have surfaced over the last century.An improved understanding of the contribution of vascular diseases to cognitive decline originates from studies combining imaging studies,epidemiologic studies and genetics,with relatively less pathological study.Most pathological studies focus on infarcts and cognition,the relationship between cognitive decline and other type of cerebrovascular disease remains uncertain.Also,there is a lack of consensus in the best way to quantify vascular pathology.OBJECTIVEThis study aimed to investigate the distribution of 7 different cerebral vessel disease-related pathologies and the correlations between the antemortem clinical cognitive performances and the postmortem neuropathological changes in the brains in the CAMS/PUMC Human Brain Bank.Exploring the automatic identification of vascular pathological changes and calculating the corresponding area with neural network,in order to develop a rating scheme for cerebrovascular lesions of postmortem brains.METHODSA total of 122 human brains with antemortem cognitive status information[Everyday Cognition(ECog)]and ABC pathological score of Alzheimer's disease(AD)were collected through the willed donation program in CAMS/PUMC Human Brain Bank.After HE staining and GFAP staining,cerebrovascular pathological changes were evaluated with improved cerebrovascular rating scheme.The clinicopathological relationship was analyzed with non-parameter method with SPSS 25.0.A U-net model was built with Python 3.7.3 to do machine learning and test.RESULTSIn CAMS/PUMC Human Brain Bank,17 cased of vascular dementia were diagnosed.The prevalence was 13.94%.Enlarged perivascular space(ePVS)is the most common,and arteriolosclerosis,microbleeds(MBs),perivascular increased cells(PIC)are the next common.Lacunar infarcts,arteriolosclerosis,enlarged perivascular space,microbleeds and perivascular increased cells were associated with lower scores for ECog global cognition(P<0.05).Each level increase in the severity of some cerebrovascular pathology may correlate with cognitive dysfunction.With the growth staging of lacunar infarcts,arteriolosclerosis,perivascular increased cells and enlarged perivascular space,the Global ECog score and ECog domain scores mounted up.AD related pathological changes combined with cerebrovascular pathology may aggravate the cognitive dysfunction.Artificial intelligence can recognize the enlarged perivascular space with relatively high accuracy.CONCLUSIONThe sensitivity of vascular dementia(VaD)diagnosis according to the medical history is low.Several cerebrovascular pathologies were associated with lower scores for global cognition.AD related pathological changes combined with cerebrovascular pathology may aggravate the cognitive dysfunction.