Cerebral small vessel disease: Capillary pathways to stroke and cognitive decline

Østergaard, L., Engedal, T. S., Moreton, F., Hansen, M. B., Wardlaw, J. M., Dalkara, T., Markus, H. S. and Muir, K. W. (2016) Cerebral small vessel disease: Capillary pathways to stroke and cognitive decline. Journal of Cerebral Blood Flow and Metabolism, 36(2), pp. 302-325. (doi: 10.1177/0271678X15606723) (PMID:26661176) (PMCID:PMC4759673)

Abstract

Cerebral small vessel disease (SVD) gives rise to one in five strokes worldwide and constitutes a major source of cognitive decline in the elderly. SVD is known to occur in relation to hypertension, diabetes, smoking, radiation therapy and in a range of inherited and genetic disorders, autoimmune disorders, connective tissue disorders, and infections. Until recently, changes in capillary patency and blood viscosity have received little attention in the aetiopathogenesis of SVD and the high risk of subsequent stroke and cognitive decline. Capillary flow patterns were, however, recently shown to limit the extraction efficacy of oxygen in tissue and capillary dysfunction therefore proposed as a source of stroke-like symptoms and neurodegeneration, even in the absence of physical flow-limiting vascular pathology. In this review, we examine whether capillary flow disturbances may be a shared feature of conditions that represent risk factors for SVD. We then discuss aspects of capillary dysfunction that could be prevented or alleviated and therefore might be of general benefit to patients at risk of SVD, stroke or cognitive decline.

• Item Type: Articles
• Additional Information: LØ, TSE and MBH were supported by the Danish National Research Foundation (CFIN), The Danish Ministry of Science, Innovation, and Education (MINDLab) and the VELUX Foundation (ARCADIA). HSM is supported by an NIHR Senior Investigator award and by the Cambridge University Hospitals NIHR Comprehensive Biomedical Research Centre. FM was supported by a Chief Scientist Office of Scotland project grant. JW was supported by the Scottish Funding Council and Chief Scientist Office through the Scottish Imaging Network A Platform for Scientific Excellence (SINAPSE), the Wellcome Trust and the Medical Research Council through the Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Moreton, Dr Fiona and Muir, Professor Keith
• Authors: Østergaard, L., Engedal, T. S., Moreton, F., Hansen, M. B., Wardlaw, J. M., Dalkara, T., Markus, H. S., and Muir, K. W.
• College/School: College of Medical Veterinary and Life Sciences > School of Psychology & Neuroscience
• Journal Name: Journal of Cerebral Blood Flow and Metabolism
• Publisher: Sage Journals
• ISSN: 0271-678X
• ISSN (Online): 1559-7016
• Copyright Holders: Copyright © 2015 The Authors
• First Published: First published in Journal of Cerebral Blood Flow and Metabolism 36(2): 302-325
• Publisher Policy: Reproduced under a Creative Commons License