scholarly journals Small Vessel Disease-Related Dementia: An Invalid Neurovascular Coupling?

2020 ◽  
Vol 21 (3) ◽  
pp. 1095 ◽  
Author(s):  
Rita Moretti ◽  
Paola Caruso
Keyword(s):  
Vascular Dementia ◽  
Vascular Function ◽  
Aging Process ◽  
Healthy Aging ◽  
Inflammatory Responses ◽  
Small Vessel Disease ◽  
Neurovascular Coupling ◽  
Small Vessel ◽  
Vessel Disease ◽  
Subcortical Vascular Dementia

The arteriosclerosis-dependent alteration of brain perfusion is one of the major determinants in small vessel disease, since small vessels have a pivotal role in the brain’s autoregulation. Nevertheless, as far as we know, endothelium distress can potentiate the flow dysregulation and lead to subcortical vascular dementia that is related to small vessel disease (SVD), also being defined as subcortical vascular dementia (sVAD), as well as microglia activation, chronic hypoxia and hypoperfusion, vessel-tone dysregulation, altered astrocytes, and pericytes functioning blood-brain barrier disruption. The molecular basis of this pathology remains controversial. The apparent consequence (or a first event, too) is the macroscopic alteration of the neurovascular coupling. Here, we examined the possible mechanisms that lead a healthy aging process towards subcortical dementia. We remarked that SVD and white matter abnormalities related to age could be accelerated and potentiated by different vascular risk factors. Vascular function changes can be heavily influenced by genetic and epigenetic factors, which are, to the best of our knowledge, mostly unknown. Metabolic demands, active neurovascular coupling, correct glymphatic process, and adequate oxidative and inflammatory responses could be bulwarks in defense of the correct aging process; their impairments lead to a potentially catastrophic and non-reversible condition.

Statistical Parametric Analysis of Cerebral Blood Flow in Vascular Dementia with Small-Vessel Disease Using 99mTc-HMPAO SPECT

2008 ◽  
Vol 26 (5) ◽  
pp. 556-562 ◽  
Author(s):  
Hiroki Kato ◽  
Takuya Yoshikawa ◽  
Naohiko Oku ◽  
Masao Imaizumi ◽  
Masashi Takasawa ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Vascular Dementia ◽  
Parametric Analysis ◽  
Small Vessel Disease ◽  
Small Vessel ◽  
Vessel Disease ◽  
Hmpao Spect

Statistical parametric analysis of cerebral blood flow in vascular dementia due to small-vessel disease using 99mTc-HMPAO SPECT

2005 ◽  
Vol 25 (1_suppl) ◽  
pp. S154-S154
Author(s):  
Hiroki Kato ◽  
Takuya Yoshikawa ◽  
Naohiko Oku ◽  
Yasuyuki Kimura ◽  
Katsufumi Kajimoto ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Vascular Dementia ◽  
Parametric Analysis ◽  
Small Vessel Disease ◽  
Small Vessel ◽  
Vessel Disease ◽  
Hmpao Spect ◽  
99Mtc Hmpao

scholarly journals Identifying preclinical vascular dementia in symptomatic small vessel disease using MRI

2018 ◽  
Vol 19 ◽  
pp. 925-938 ◽  
Author(s):  
Christian Lambert ◽  
Eva Zeestraten ◽  
Owen Williams ◽  
Philip Benjamin ◽  
Andrew J. Lawrence ◽  
...  
Keyword(s):  
Vascular Dementia ◽  
Small Vessel Disease ◽  
Small Vessel ◽  
Vessel Disease

scholarly journals Use of MRI to identify preclinical vascular dementia in symptomatic small vessel disease

The Lancet ◽  
2017 ◽  
Vol 389 ◽  
pp. S58 ◽  
Author(s):  
Christian Lambert ◽  
Eva Zeestraten ◽  
Owen Williams ◽  
Philip Benjamin ◽  
Andrew Lawrence ◽  
...  
Keyword(s):  
Vascular Dementia ◽  
Small Vessel Disease ◽  
Small Vessel ◽  
Vessel Disease

scholarly journals Neuroimaging in an older adult inpatient psychiatric unit

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S95-S95
Author(s):  
Aoife Nechowska
Keyword(s):  
Vascular Dementia ◽  
Older Adult ◽  
Small Vessel Disease ◽  
Small Vessel ◽  
Geriatric Population ◽  
Vessel Disease ◽  
Good Imaging ◽  
Imaging Results ◽  
Adult Inpatient ◽  
Mri Scans

AimsThis audit aimed to analyse the use of neuroimaging and its effect on treatment in an older adult inpatient psychiatry unit over the period of one year.BackgroundBrain imaging can be used as a diagnostic tool in psychiatry. According to NICE guidelines, structural imaging, such as magnetic resonance imaging (MRI) or computed topography (CT), can be used in the workup for dementia diagnosis in order to exclude non-dementia pathology and identify dementia subtype. This is important in the geriatric population where evidence of small vessel disease has an impact on treatment options and management of polypharmacy.MethodA list of patients from the past year (January to December 2019) was accessed. Patient records were then analysed to see if neuroimaging had been accessed during their admission at The Meadows Hospital, Surrey and Borders Partnership. This included imaging from prior to admission. Analysis was divided into type of imaging, comments and impact on diagnosis.ResultOverall numbers for the audit were small. A total of 74 patients were admitted onto the unit, of which 3 were readmissions. There was missing information for 8 patients, giving a total of 63 patients. CT scans were accessed for 35 patients (56% of total); 3 of these were done during the admission. MRI scans were completed for 21 patients (33%), with one requested during admission. A total of 9 patients (14%) had both CT and MRI scans. Neuroimaging results led to a change in diagnosis for 6 patients (10%). In all cases this reflected the finding of small vessel disease and a change of diagnosis to either vascular dementia or mixed dementia.Diagnoses were also analysed. The Meadows Hospital has 2 dementia wards (male and female) and 1 functional ward (for females). A total of 36 patients (57%) were diagnosed with dementia, of which the biggest groups were: Alzheimer's dementia (13 patients, 36%) and Vascular dementia (11 patients, 31%).ConclusionThe majority of the patients were admitted with established diagnoses and so only a small number had changes made following review of imaging. Good imaging results and reports help to differentiate types of dementia. Although neuroimaging is not gold standard in diagnosing dementia syndromes, it is now an important aspect in the diagnostic pathway. Getting the diagnosis correct will help with treating individuals appropriately and avoid unnecessary prescribing.

Abstract P213: Vascular Dysfunction and Aberrant Vascular NOTCH3 Signalling in Hypertension and Cerebral Autosomal Dominant Subcortical Infarcts and Leukoencephalopathy (CADASIL)

Hypertension ◽  
2016 ◽  
Vol 68 (suppl_1) ◽  
Author(s):  
Adam Harvey ◽  
Fiona Moreton ◽  
Augusto C Montezano ◽  
Aurelie Nguyen Dinh Cat ◽  
Paul Rocchiccioli ◽  
...  
Keyword(s):  
Er Stress ◽  
Vascular Function ◽  
Small Vessel Disease ◽  
Vascular Dysfunction ◽  
Gene Array ◽  
Rho Kinase ◽  
Small Vessel ◽  
Vessel Disease ◽  
Stress Markers ◽  
Clinical Conditions

Hypertension (HT) and CADASIL are clinical conditions of small vessel disease. Vascular dementia is a major feature in CADASIL, and a serious consequence of HT. CADASIL is a monogenic condition due to mutations in NOTCH3 , which is expressed almost exclusively in VSMCs. We hypothesised that altered NOTCH3 signalling in CADASIL and HT are associated with small vessel disease. Small arteries from gluteal biopsies from CADASIL patients (n=14), HT patients (n=3) and healthy controls (n=10) were investigated. Vascular function was assessed by myography. Cultured VSMCs were used to assess signaling through NOTCH3, NO, ER stress (gene array) and Rho kinase (ELISA). CADASIL and HT patients exhibited endothelial dysfunction (Max response: CADASIL 41.7±3%, HT 54.1±2% vs Control 98.2±4%). Pre-incubation with N-acetyl-cysteine ameliorated vasorelaxation. Only CADASIL displayed impaired endothelium-independent relaxation (Max response: CADASIL 53±1.9% vs Control 93±8.9%) and contraction (Max response: CADASIL 78±1.3% vs control 102±5%) (p<0.05). AngII-induced contraction was elevated in HT (98%), yet reduced in CADASIL (28%) (vs control 64% max contraction: p<0.05), despite VSMCs from both conditions displaying increased AT 1 R mRNA expression (HT: 5.1; CADASIL: 3.8; fold vs control; p<0.05). VSMCs from CADASIL and HT have decreased expression of CAMK1, SIRT2 and VEGFA; important in NO signalling (0.5 fold; p<0.05 vs control). VSMC levels of NOTCH3 and NOTCH ligand, JAG1, were increased in CADASIL (3.5, 2.5 fold) and HT (3.0, 2.6 fold, p<0.05). Downstream targets, HEY1 and HEYL, were elevated in CADASIL (3.8, 4.2 fold) and HT (1.9, 2.6 fold) (p<0.05). CADASIL but not HT VSMCs exhibited increased expression of ER stress markers. Rho kinase activity was increased in VSMCs from CADASIL (2.5 fold) and HT (2 fold) vs control (p<0.05). These data demonstrate that in CADASIL and HT, vascular dysfunction, is associated with aberrant NOTCH3 and Rho kinase signalling. In CADASIL, but not HT, endothelium-independent relaxation and ER stress were increased. Our results demonstrate a putative role for NOTCH3 -Rho kinase in vascular dysfunction in conditions of small vessel disease and suggest that ER stress and oxidative stress may be important in vascular injury in CADASIL.

Impaired neurovascular coupling in ischaemic stroke patients with large or small vessel disease

2010 ◽  
Vol 18 (5) ◽  
pp. 731-736 ◽  
Author(s):  
W. H. Lin ◽  
Q. Hao ◽  
B. Rosengarten ◽  
W. H. Leung ◽  
K. S. Wong
Keyword(s):  
Ischaemic Stroke ◽  
Small Vessel Disease ◽  
Neurovascular Coupling ◽  
Small Vessel ◽  
Stroke Patients ◽  
Vessel Disease
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