Journal
JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM
Volume 36, Issue 1, Pages 40-54Publisher
SAGE PUBLICATIONS INC
DOI: 10.1038/jcbfm.2015.88
Keywords
Amyloid angiopathy; brain imaging; dementia; focal ischemia; vascular cognitive impairment
Categories
Funding
- National Institutes of Health [R01 AG26484, R01 NS070834]
- American Heart Association [14POST20010031]
- NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE [P50NS051343, R01NS070834] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE ON AGING [R01AG026484] Funding Source: NIH RePORTER
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Cerebral amyloid angiopathy (CAA) is a common form of cerebral small vessel disease and an important risk factor for intracerebral hemorrhage and cognitive impairment. While the majority of research has focused on the hemorrhagic manifestation of CAA, its ischemic manifestations appear to have substantial clinical relevance as well. Findings from imaging and pathologic studies indicate that ischemic lesions are common in CAA, including white-matter hyperintensities, microinfarcts, and microstructural tissue abnormalities as detected with diffusion tensor imaging. Furthermore, imaging markers of ischemic disease show a robust association with cognition, independent of age, hemorrhagic lesions, and traditional vascular risk factors. Widespread ischemic tissue injury may affect cognition by disrupting white-matter connectivity, thereby hampering communication between brain regions. Challenges are to identify imaging markers that are able to capture widespread microvascular lesion burden invivo and to further unravel the etiology of ischemic tissue injury by linking structural magnetic resonance imaging (MRI) abnormalities to their underlying pathophysiology and histopathology. A better understanding of the underlying mechanisms of ischemic brain injury in CAA will be a key step toward new interventions to improve long-term cognitive outcomes for patients with CAA.
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