Mechanisms of sporadic cerebral small vessel disease: insights from neuroimaging
Reads0
Chats0
TLDR
Potential mechanisms, detectable with neuroimaging, that might better fit the available evidence and provide testable hypotheses for future study are discussed.Abstract:
The term cerebral small vessel disease (SVD) describes a range of neuroimaging, pathological, and associated clinical features. Clinical features range from none, to discrete focal neurological symptoms (eg, stroke), to insidious global neurological dysfunction and dementia. The burden on public health is substantial. The pathogenesis of SVD is largely unknown. Although the pathological processes leading to the arteriolar disease are associated with vascular risk factors and are believed to result from an intrinsic cerebral arteriolar occlusive disease, little is known about how these processes result in brain disease, how SVD lesions contribute to neurological or cognitive symptoms, and the association with risk factors. Pathology often shows end-stage disease, which makes identification of the earliest stages difficult. Neuroimaging provides considerable insights; although the small vessels are not easily seen themselves, the effects of their malfunction on the brain can be tracked with detailed brain imaging. We discuss potential mechanisms, detectable with neuroimaging, that might better fit the available evidence and provide testable hypotheses for future study.read more
Citations
More filters
Journal ArticleDOI
The pathobiology of vascular dementia
TL;DR: This review will examine how vascular damage disrupts vital homeostatic interactions in brain health, focusing on the hemispheric white matter, a region at heightened risk for vascular damage, and on the interplay between vascular factors and Alzheimer's disease.
Journal ArticleDOI
Embolic strokes of undetermined source: the case for a new clinical construct
Robert G. Hart,Hans-Christoph Diener,Shelagh B. Coutts,J. Donald Easton,Christopher B. Granger,Martin O'Donnell,Ralph L. Sacco,Stuart J. Connolly +7 more
TL;DR: In this article, the authors proposed that embolic strokes of undetermined source are a therapeutically relevant entity, which are defined as a non-lacunar brain infarct without proximal arterial stenosis or cardioembolic sources, with a clear indication for anticoagulation.
Journal ArticleDOI
Small vessel disease: mechanisms and clinical implications
TL;DR: The determination of which vascular dysfunctions are most important in pathogenesis, which abnormalities are reversible, and why lesion progression and symptomatology are so variable will help to identify potential targets for intervention and improve risk prediction for individuals with small vessel disease.
Journal ArticleDOI
Early-Onset Stroke and Vasculopathy Associated with Mutations in ADA2
Qing Zhou,Dan Yang,Amanda K. Ombrello,Andrey Zavialov,Camilo Toro,Anton V. Zavialov,Deborah L. Stone,Jae Jin Chae,Sergio D. Rosenzweig,Kevin Bishop,Karyl S. Barron,Hye Sun Kuehn,Patrycja Hoffmann,Alejandra Negro,Wanxia L. Tsai,Edward W. Cowen,Wuhong Pei,Joshua D. Milner,Christopher Silvin,Theo Heller,David T. Chin,Nicholas J. Patronas,John S. Barber,Chyi-Chia Richard Lee,Geryl Wood,Alexander Ling,Susan J. Kelly,David E. Kleiner,James C. Mullikin,Nancy J. Ganson,Heidi H. Kong,Sophie Hambleton,Fabio Candotti,Martha Quezado,Katherine R. Calvo,Hawwa Alao,Beverly K. Barham,Anne Jones,James F. Meschia,Bradford B. Worrall,Scott E. Kasner,Stephen S. Rich,Raphaela Goldbach-Mansky,Mario Abinun,Elizabeth Chalom,Alisa Gotte,Marilynn Punaro,Virginia Pascual,James W. Verbsky,Troy R. Torgerson,Nora G. Singer,Timothy R. Gershon,Seza Ozen,Omer Karadag,Thomas A. Fleisher,Elaine F. Remmers,Shawn M. Burgess,Susan Moir,Massimo Gadina,Raman Sood,Michael S. Hershfield,Manfred Boehm,Daniel L. Kastner,Ivona Aksentijevich +63 more
TL;DR: Loss-of-function mutations in CECR1 were associated with a spectrum of vascular and inflammatory phenotypes, ranging from early-onset recurrent stroke to systemic vasculopathy or vasculitis, and were prevented by coinjection with nonmutated (but not with mutated) human C ECR1.
Journal ArticleDOI
Cognitive decline and dementia in diabetes mellitus: mechanisms and clinical implications.
Geert Jan Biessels,Florin Despa +1 more
TL;DR: The evolving insights from studies on risk factors, brain imaging and neuropathology are reviewed, which provide important clues on mechanisms of both the subtle cognitive decrements and the more severe stages of cognitive dysfunction.
References
More filters
Journal ArticleDOI
Astrocyte–endothelial interactions at the blood–brain barrier
TL;DR: Specific interactions between the brain endothelium, astrocytes and neurons that may regulate blood–brain barrier function are explored to lead to the development of new protective and restorative therapies.
Journal ArticleDOI
The Blood-Brain Barrier in Health and Chronic Neurodegenerative Disorders
TL;DR: These findings support developments of new therapeutic approaches for chronic neurodegenerative disorders directed at the blood-brain barrier and other nonneuronal cells of the neurovascular unit.
Journal ArticleDOI
Vascular Contributions to Cognitive Impairment and Dementia A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association
Philip B. Gorelick,Angelo Scuteri,Sandra E. Black,Charles DeCarli,Steven M. Greenberg,Costantino Iadecola,Lenore J. Launer,Stéphane Laurent,Oscar L. Lopez,David L. Nyenhuis,Ronald C. Petersen,Julie A. Schneider,Christophe Tzourio,Donna K. Arnett,David A. Bennett,Helena C. Chui,Randall T. Higashida,Ruth Lindquist,Peter M. Nilsson,Gustavo C. Román,Frank W. Sellke,Sudha Seshadri +21 more
TL;DR: This scientific statement provides an overview of the evidence on vascular contributions to cognitive impairment and dementia and provides evidence that subcortical forms of VCI with white matter hyperintensities and small deep infarcts are common and risk markers for VCI are the same as traditional risk factors for stroke.
Journal ArticleDOI
The economy of brain network organization
Edward T. Bullmore,Olaf Sporns +1 more
TL;DR: It is proposed that brain organization is shaped by an economic trade-off between minimizing costs and allowing the emergence of adaptively valuable topological patterns of anatomical or functional connectivity between multiple neuronal populations.
Journal ArticleDOI
The Blood-Brain Barrier/Neurovascular Unit in Health and Disease
Brian T. Hawkins,Thomas P. Davis +1 more
TL;DR: Understanding how BBB TJ might be affected by various factors holds significant promise for the prevention and treatment of neurological diseases.
Related Papers (5)
Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration
Joanna M. Wardlaw,Eric E. Smith,Geert J. Biessels,Charlotte Cordonnier,Franz Fazekas,Richard Frayne,Richard I. Lindley,John T. O'Brien,Frederik Barkhof,Oscar R. Benavente,Sandra E. Black,Carol Brayne,Monique M.B. Breteler,Hugues Chabriat,Charles DeCarli,Frank-Erik de Leeuw,Fergus N. Doubal,Marco Duering,Nick C. Fox,Steven M. Greenberg,Vladimir Hachinski,Ingo Kilimann,Vincent Mok,Robert J. van Oostenbrugge,Leonardo Pantoni,Oliver Speck,Blossom C. M. Stephan,Stefan J. Teipel,Anand Viswanathan,David J. Werring,Christopher Chen,Colin Smith,Mark A. van Buchem,Bo Norrving,Philip B. Gorelick,Martin Dichgans +35 more
Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges.
The clinical importance of white matter hyperintensities on brain magnetic resonance imaging: systematic review and meta-analysis
Stéphanie Debette,Hugh S. Markus +1 more
Vascular Contributions to Cognitive Impairment and Dementia A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association
Philip B. Gorelick,Angelo Scuteri,Sandra E. Black,Charles DeCarli,Steven M. Greenberg,Costantino Iadecola,Lenore J. Launer,Stéphane Laurent,Oscar L. Lopez,David L. Nyenhuis,Ronald C. Petersen,Julie A. Schneider,Christophe Tzourio,Donna K. Arnett,David A. Bennett,Helena C. Chui,Randall T. Higashida,Ruth Lindquist,Peter M. Nilsson,Gustavo C. Román,Frank W. Sellke,Sudha Seshadri +21 more