Characteristic clinical presentation and CSF biomarker pattern in cerebral small vessel disease
Characteristic clinical presentation and CSF biomarker pattern in cerebral small vessel disease
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DOI：
10.1016/j.jns.2012.07.068
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发表时间：
2012-11-15
影响因子：
4.4
通讯作者：
Bjerke, Maria
中科院分区：
文献类型：
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作者：
Wallin, Anders;Ohrfelt, Annika;Bjerke, Maria
为了能够过上美好、独立的生活，认知功能需要完好无损。痴呆、中风和神经精神疾病是导致残疾的主要疾病。中风通常是持续较长时间的潜在血管壁疾病的结果。这种血管壁疾病通常是无症状的或没有明显症状。衰老和高血压以及糖尿病和遗传脆弱性等其他因素引起的大脑穿通小动脉损伤、动脉硬化，在白质变化的起源中起着重要作用。病理性血管壁过程导致管腔收缩、根据代谢需要改变管腔直径的能力受损，以及长穿透动脉的脆弱血管结构末端区域可能发生缺血缺氧组织损伤。动脉硬化血管与细胞外基质的炎症和重塑有关。与此过程相关的酶也被发现参与脱髓鞘和血脑屏障开放，而且还参与血管生成和神经发生的修复过程。反映这些过程的生化变化可能是小血管疾病的早期指标，从而增加对疾病特征机制的了解。此外，监测疾病缓解治疗效果可能是小血管疾病特异性生化标记物的重要应用。 (c) 2012 Elsevier B.V. 保留所有权利。
To be able to live a good, independent life cognitive functions need to be intact. Dementia, stroke and neuropsychiatric disorders are the major disorders underlying disability. Stroke is usually a consequence of an underlying vessel wall disease that has lasted for a longer period. This vessel wall disease is commonly silent or without prominent symptoms. Damage to the small penetrating arterioles of the brain, arteriolosclerosis, induced by aging and hypertension, as well as other factors such as diabetes and genetic vulnerability, plays an important role in the origin of white matter changes. The pathological vascular wall process leads to lumen constriction, impaired ability to change lumen diameter according to metabolic needs and possible ischemic-hypoxic tissue damage in the vulnerable vascular architectural terminal areas of the long penetrating arteries. The arteriolosclerotic blood vessels are associated with inflammation and remodelling of the extracellular matrix. Enzymes connected to this process have also been found to be involved in demyelination and blood brain barrier opening but also in the repair process of angiogenesis and neurogenesis. Biochemical changes reflecting these processes might be early indicators of small vessel disease and hence increase the knowledge about the disease characteristic mechanisms. Moreover, monitoring disease modifying treatment effects can be an important application for small vessel disease specific biochemical markers. (c) 2012 Elsevier B.V. All rights reserved.