TY - JOUR
T1 - Cerebral small vessel disease alters neurovascular unit regulation of microcirculation integrity involved in vascular cognitive impairment
AU - Yang, Qin
AU - Wei, Xiaobo
AU - Deng, Bin
AU - Chang, Zihan
AU - Jin, Dana
AU - Huang, Yonghua
AU - Zhang, John H.
AU - Yenari, Midori A.
AU - Jin, Kunlin
AU - Wang, Qing
N1 - Funding Information:
This work was supported by the National Natural Science Foundation of China (NO: 81873777 , 82071414 ), Guangdong Provincial Key Laboratory of Shock and Microcirculation, Initiated Foundation of Zhujiang Hospital (NO: 02020318005 ), Science and Technology Program of Guangdong of China (NO: 2020A0505100037 ), and Leading Talent in Talents Project Guangdong High-level Personnel of Special Support Program to Q.W.; and National Natural Science Foundation of China (NO: 81901310 ) to Q. Y.
Publisher Copyright:
© 2021
PY - 2022/8
Y1 - 2022/8
N2 - Cerebral small vessel disease (CSVD) is a generic term used for intracranial vascular disorders caused by the structural changes of cerebral microvessels, including the small arteries, arterioles, capillaries and venules. CSVD exhibits various neuroimaging features and is associated clinical characteristics. Although CSVD is recognized as the leading cause of vascular cognitive impairment (VCI), the underlying mechanism(s) remains elusive. Growing evidence indicates a significant association between altered neurovascular unit (NVU) functioning and the pathophysiology of evolving CSVD-induced VCI. Therefore, research is required to understand how NVU dysregulation contributes to cognitive impairment due to CSVD. In this review, we describe the link between the neuroimaging focal lesions and cognitive alterations. We also discuss the potential pathological role of NVU dysregulation in the entry of pathogens from the blood into the parenchyma by altering the blood-brain barrier (BBB), affecting the cerebral microvascular and consequently cause VCI. Next, we review the coupling of neural activity with cerebral blood flow to control the microvascular perfusion; and the disrupted clearance of metabolic byproducts with CSF-ISF exchange via perivascular pathways and glymphatic system. Finally, we discussed the possible therapeutic interventions in CSVD.
AB - Cerebral small vessel disease (CSVD) is a generic term used for intracranial vascular disorders caused by the structural changes of cerebral microvessels, including the small arteries, arterioles, capillaries and venules. CSVD exhibits various neuroimaging features and is associated clinical characteristics. Although CSVD is recognized as the leading cause of vascular cognitive impairment (VCI), the underlying mechanism(s) remains elusive. Growing evidence indicates a significant association between altered neurovascular unit (NVU) functioning and the pathophysiology of evolving CSVD-induced VCI. Therefore, research is required to understand how NVU dysregulation contributes to cognitive impairment due to CSVD. In this review, we describe the link between the neuroimaging focal lesions and cognitive alterations. We also discuss the potential pathological role of NVU dysregulation in the entry of pathogens from the blood into the parenchyma by altering the blood-brain barrier (BBB), affecting the cerebral microvascular and consequently cause VCI. Next, we review the coupling of neural activity with cerebral blood flow to control the microvascular perfusion; and the disrupted clearance of metabolic byproducts with CSF-ISF exchange via perivascular pathways and glymphatic system. Finally, we discussed the possible therapeutic interventions in CSVD.
KW - Cerebral small vessel disease
KW - Cognitive impairment
KW - Microcirculation
KW - Neuroimaging markers
KW - Neurovascular unit
UR - http://www.scopus.com/inward/record.url?scp=85130518621&partnerID=8YFLogxK
U2 - 10.1016/j.nbd.2022.105750
DO - 10.1016/j.nbd.2022.105750
M3 - Review article
C2 - 35580816
AN - SCOPUS:85130518621
SN - 0969-9961
VL - 170
JO - Neurobiology of Disease
JF - Neurobiology of Disease
M1 - 105750
ER -