CEREBRAL MICROVASCULAR SYSTEM
C-SVD. C-SVD refers to a group of pathological processes with various etiologies that affect the small arteries, arterioles, and capillaries. Chronic hypoperfusion due to arteriolosclerosis of long penetrating small arteries and arterioles is believed to be responsible for the initial ischemic changes in white matter.[19] White matter is highly sensitive to changes in cerebral blood flow[20] and hypoxic-ischemic injury.[21] Over time, some but not all white matter ischemic changes increase the risk of developing lacunar infarcts, white matter lesions (WMLs), white matter integrity abnormality, and subsequent demyelination and axonal damage. [22, 23] Neuroimaging studies suggest that these pathological changes in the brain are associated with depression and cognitive impairment.[24-26]
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Blood-brain barrier dysfunction. Intact blood-brain barrier (BBB) is required for proper functioning of neuronal circuits, synaptic functions, angiogenesis, and neurogenesis in the brain.[27] Cerebral endothelial dysfunction causes BBB dysfunction and BBB hyperpermeability, which precedes neuronal damage, neuron degeneration, and ischemic damage in the white matter.[27-29] Studies have suggested that disruption of the BBB is a biological mechanism for the development of C-SVD[28, 30] and neurodegenerative diseases.[27, 29,
C-SVD. C-SVD refers to a group of pathological processes with various etiologies that affect the small arteries, arterioles, and capillaries. Chronic hypoperfusion due to arteriolosclerosis of long penetrating small arteries and arterioles is believed to be responsible for the initial ischemic changes in white matter.[19] White matter is highly sensitive to changes in cerebral blood flow[20] and hypoxic-ischemic injury.[21] Over time, some but not all white matter ischemic changes increase the risk of developing lacunar infarcts, white matter lesions (WMLs), white matter integrity abnormality, and subsequent demyelination and axonal damage. [22, 23] Neuroimaging studies suggest that these pathological changes in the brain are associated with depression and cognitive impairment.[24-26]
. …show more content…
Blood-brain barrier dysfunction. Intact blood-brain barrier (BBB) is required for proper functioning of neuronal circuits, synaptic functions, angiogenesis, and neurogenesis in the brain.[27] Cerebral endothelial dysfunction causes BBB dysfunction and BBB hyperpermeability, which precedes neuronal damage, neuron degeneration, and ischemic damage in the white matter.[27-29] Studies have suggested that disruption of the BBB is a biological mechanism for the development of C-SVD[28, 30] and neurodegenerative diseases.[27, 29,