| Review: cerebral microvascular pathology in ageing and neurodegeneration. | |
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MedLine Citation:
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PMID: 20946471 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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This review of age-related brain microvascular pathologies focuses on topics studied by this laboratory, including anatomy of the blood supply, tortuous vessels, venous collagenosis, capillary remnants, vascular density and microembolic brain injury. Our studies feature thick sections, large blocks embedded in celloidin, and vascular staining by alkaline phosphatase. This permits study of the vascular network in three dimensions, and the differentiation of afferent from efferent vessels. Current evidence suggests that there is decreased vascular density in ageing, Alzheimer's disease and leukoaraiosis, and cerebrovascular dysfunction precedes and accompanies cognitive dysfunction and neurodegeneration. A decline in cerebrovascular angiogenesis may inhibit recovery from hypoxia-induced capillary loss. Cerebral blood flow is inhibited by tortuous arterioles and deposition of excessive collagen in veins and venules. Misery perfusion due to capillary loss appears to occur before cell loss in leukoaraiosis, and cerebral blood flow is also reduced in the normal-appearing white matter. Hypoperfusion occurs early in Alzheimer's disease, inducing white matter lesions and correlating with dementia. In vascular dementia, cholinergic reductions are correlated with cognitive impairment, and cholinesterase inhibitors have some benefit. Most lipid microemboli from cardiac surgery pass through the brain in a few days, but some remain for weeks. They can cause what appears to be a type of vascular dementia years after surgery. Donepezil has shown some benefit. Emboli, such as clots, cholesterol crystals and microspheres can be extruded through the walls of cerebral vessels, but there is no evidence yet that lipid emboli undergo such extravasation. |
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Authors:
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W R Brown; C R Thore |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Review |
Journal Detail:
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Title: Neuropathology and applied neurobiology Volume: 37 ISSN: 1365-2990 ISO Abbreviation: Neuropathol. Appl. Neurobiol. Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-01-12 Completed Date: 2011-05-04 Revised Date: 2012-02-02 |
Medline Journal Info:
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Nlm Unique ID: 7609829 Medline TA: Neuropathol Appl Neurobiol Country: England |
Other Details:
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Languages: eng Pagination: 56-74 Citation Subset: IM |
Copyright Information:
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© 2011 The Authors. Neuropathology and Applied Neurobiology © 2011 British Neuropathological Society. |
Affiliation:
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Department of Radiology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, USA. wibrown@wfubmc.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aging
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pathology* Alzheimer Disease / pathology Animals Anoxia / etiology, pathology Arterioles / pathology Basement Membrane / pathology Brain / pathology* Capillaries / pathology* Cerebral Veins / pathology Cerebrovascular Circulation / physiology Cholinergic Agents / pharmacology, therapeutic use Cognition Disorders / etiology, pathology Collagen / metabolism Dementia, Vascular / pathology Humans Hypertension / pathology Intracranial Embolism / pathology Leukoaraiosis / pathology Nerve Degeneration / pathology* Parasympathetic Nervous System / physiology |
| Grant Support | |
ID/Acronym/Agency:
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CA113321/CA/NCI NIH HHS; NS 36780/NS/NINDS NIH HHS; NS20618/NS/NINDS NIH HHS; R01 CA113321-04/CA/NCI NIH HHS; R01 NS020618-25A2/NS/NINDS NIH HHS; R01 NS020618-26/NS/NINDS NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Cholinergic Agents; 9007-34-5/Collagen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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