Atherosclerotic burden and cerebral small vessel disease: exploring the link through microvascular aging and cerebral microhemorrhages.

Aging Arteriosclerosis Atherosclerosis Blood–brain barrier Leukoaraiosis Microbleed Peripheral artery disease Stroke Vascular dementia White matter hyperintensities White matter injury

Journal

GeroScience

ISSN: 2509-2723

Titre abrégé: Geroscience

Pays: Switzerland

ID NLM: 101686284

Informations de publication

Date de publication:
19 Apr 2024

Historique:

received: 20 02 2024

accepted: 14 03 2024

medline: 19 4 2024

pubmed: 19 4 2024

entrez: 19 4 2024

Statut: aheadofprint

Résumé

Cerebral microhemorrhages (CMHs, also known as cerebral microbleeds) are a critical but frequently underestimated aspect of cerebral small vessel disease (CSVD), bearing substantial clinical consequences. Detectable through sensitive neuroimaging techniques, CMHs reveal an extensive pathological landscape. They are prevalent in the aging population, with multiple CMHs often being observed in a given individual. CMHs are closely associated with accelerated cognitive decline and are increasingly recognized as key contributors to the pathogenesis of vascular cognitive impairment and dementia (VCID) and Alzheimer's disease (AD). This review paper delves into the hypothesis that atherosclerosis, a prevalent age-related large vessel disease, extends its pathological influence into the cerebral microcirculation, thereby contributing to the development and progression of CSVD, with a specific focus on CMHs. We explore the concept of vascular aging as a continuum, bridging macrovascular pathologies like atherosclerosis with microvascular abnormalities characteristic of CSVD. We posit that the same risk factors precipitating accelerated aging in large vessels (i.e., atherogenesis), primarily through oxidative stress and inflammatory pathways, similarly instigate accelerated microvascular aging. Accelerated microvascular aging leads to increased microvascular fragility, which in turn predisposes to the formation of CMHs. The presence of hypertension and amyloid pathology further intensifies this process. We comprehensively overview the current body of evidence supporting this interconnected vascular hypothesis. Our review includes an examination of epidemiological data, which provides insights into the prevalence and impact of CMHs in the context of atherosclerosis and CSVD. Furthermore, we explore the shared mechanisms between large vessel aging, atherogenesis, microvascular aging, and CSVD, particularly focusing on how these intertwined processes contribute to the genesis of CMHs. By highlighting the role of vascular aging in the pathophysiology of CMHs, this review seeks to enhance the understanding of CSVD and its links to systemic vascular disorders. Our aim is to provide insights that could inform future therapeutic approaches and research directions in the realm of neurovascular health.

Identifiants

DOI: 10.1007/s11357-024-01139-7 PMID: 38639833

pubmed: 38639833

doi: 10.1007/s11357-024-01139-7

pii: 10.1007/s11357-024-01139-7

doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : NIA NIH HHS

ID : R01AG068295

Pays : United States

Informations de copyright

© 2024. The Author(s).

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Auteurs

Anna Csiszar (A)

Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.

Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA.

Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.

Anna Ungvari (A)

Department of Public Health, Semmelweis University, Semmelweis University, Budapest, Hungary. Ungann2004@gmail.com.

Roland Patai (R)

Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.

Rafal Gulej (R)

Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.

Andriy Yabluchanskiy (A)

Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.

Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA.

Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.

Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.

International Training Program in Geroscience, Doctoral College/Department of Public Health, Semmelweis University, Budapest, Hungary.

Zoltan Benyo (Z)

Institute of Translational Medicine, Semmelweis University, 1094, Budapest, Hungary.

Cerebrovascular and Neurocognitive Disorders Research Group, HUN-REN, Semmelweis University, 1094, Budapest, Hungary.

Illes Kovacs (I)

Department of Ophthalmology, Semmelweis University, 1085, Budapest, Hungary.

Department of Ophthalmology, Weill Cornell Medical College, New York, NY, 10021, USA.

Peter Sotonyi (P)

Department of Vascular and Endovascular Surgery, Heart and Vascular Centre, Semmelweis University, 1122, Budapest, Hungary.

Angelia C Kirkpartrick (AC)

Veterans Affairs Medical Center, Oklahoma City, OK, USA.

Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.

Calin I Prodan (CI)

Veterans Affairs Medical Center, Oklahoma City, OK, USA.

Department of Neurology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.

Eric M Liotta (EM)

International Training Program in Geroscience, Doctoral College/Department of Public Health, Semmelweis University, Budapest, Hungary.

Department of Neurology, Division of Stroke and Neurocritical Care, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Xin A Zhang (XA)

Department of Physiology, University of Oklahoma Health Science Center, Oklahoma City, OK, USA.

Peter Toth (P)

Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.

Department of Public Health, Semmelweis University, Semmelweis University, Budapest, Hungary.

Department of Neurosurgery, Medical School, University of Pecs, Pecs, Hungary.

Neurotrauma Research Group, Szentagothai Research Centre, University of Pecs, Pecs, Hungary.

ELKH-PTE Clinical Neuroscience MR Research Group, University of Pecs, Pecs, Hungary.

Stefano Tarantini (S)

Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.

Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA.

Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.

Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.

International Training Program in Geroscience, Doctoral College/Department of Public Health, Semmelweis University, Budapest, Hungary.

Farzaneh A Sorond (FA)

Department of Neurology, Division of Stroke and Neurocritical Care, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Zoltan Ungvari (Z)

Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.

Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA.

Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.

Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.

International Training Program in Geroscience, Doctoral College/Department of Public Health, Semmelweis University, Budapest, Hungary.

Classifications MeSH