Journal
ANNUAL REVIEW OF PHYSIOLOGY, VOL 82
Volume 82, Issue -, Pages 275-295Publisher
ANNUAL REVIEWS
DOI: 10.1146/annurev-physiol-021119-034338
Keywords
microcirculation; endothelium; blood-brain barrier; cerebral blood flow; nitric oxide
Categories
Funding
- US National Institutes of Health [NS-096465, NS-108409]
- Fondation Leducq (Transatlantic Network of Excellence)
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Cerebral small vessel disease (SVD) is characterized by changes in the pial and parenchymal microcirculations. SVD produces reductions in cerebral blood flow and impaired blood-brain barrier function, which are leading contributors to age-related reductions in brain health. End-organ effects are diverse, resulting in both cognitive and noncognitive deficits. Underlying phenotypes and mechanisms are multifactorial, with no specific treatments at this time. Despite consequences that are already considerable, the impact of SVD is predicted to increase substantially with the growing aging population. In the face of this health challenge, the basic biology, pathogenesis, and determinants of SVD are poorly defined. This review summarizes recent progress and concepts in this area, highlighting key findings and some major unanswered questions. We focus on phenotypes and mechanisms that underlie microvascular aging, the greatest risk factor for cerebrovascular disease and its subsequent effects.
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