The pathobiology of vascular dementia.

The pathobiology of vascular dementia.
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DOI:
10.1016/j.neuron.2013.10.008
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发表时间:
2013-11-20
期刊:
影响因子:
16.2
通讯作者:
Iadecola C
Iadecola C
中科院分区:
医学1区
文献类型:
--
作者:
Iadecola C

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血管性认知障碍定义了认知的改变,范围从轻微的缺陷到全面的痴呆,可归因于脑血管原因。混合性血管性和神经退行性痴呆通常与阿尔茨海默病共存,已成为与年龄相关的认知障碍的主要原因。疾病机制的核心是脑血管在大脑健康中发挥的关键作用,不仅用于输送氧气和营养物质,而且还用于将神经元和神经胶质的健康与脑血管细胞的健康密不可分地联系起来的营养信号。本文将探讨血管损伤如何破坏这些重要的稳态相互作用,集中在半球白色的问题,在血管损伤的风险增加的地区,血管因素和阿尔茨海默氏病之间的相互作用。最后,将检查预防和治疗前景,强调中年血管危险因素控制在预防老年痴呆症中的重要性。
Vascular cognitive impairment defines alterations in cognition, ranging from subtle deficits to full-blown dementia, attributable to cerebrovascular causes. Often coexisting with Alzheimer’s disease, mixed vascular and neurodegenerative dementia has emerged as the leading cause of age-related cognitive impairment. Central to the disease mechanism is the crucial role that cerebral blood vessels play in brain health, not only for the delivery of oxygen and nutrients, but also for the trophic signaling that links inextricably the well being of neurons and glia to that of cerebrovascular cells. This review will examine how vascular damage disrupts these vital homeostatic interactions, focusing on the hemispheric white matter, a region at heightened risk for vascular damage, and on the interplay between vascular factors and Alzheimer’s disease. Finally, preventative and therapeutic prospects will be examined, highlighting the importance of midlife vascular risk factor control in the prevention of late-life dementia.
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