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Koueik, Joyce; Wesley, Umadevi V.; Dempsey, Robert J.
Neurochemistry international, March 2023, 2023-03-00, 20230301, Letnik: 164Journal Article
Cerebrovascular disease (CVD) is the second most common cause of cognitive impairment and dementia in aged population. CVD presents in a myriad number of clinical ways based on the functional location of pathology. While primary clinical emphasis has been placed on motor, speech and visual deficits, vascular cognitive decline is a vastly under recognized and devastating condition afflicting millions of Americans. CVD, a disease of the blood vessels that supply blood to brain involves an integration between small and large vessels. Cerebral large vessel diseases (LVD) are associated with atherosclerosis, artery-to-artery embolism, intracardiac embolism and a large vessel stroke leading to substantial functional disability. Cerebral small vessel disease (SVD) is critically involved in stroke, brain hemorrhages, cognitive decline and functional loss in elderly patients. An evolving understanding of cellular and molecular mechanisms emphasizes that inflammatory vascular changes contribute to systemic pathologic conditions of the central nervous systems (CNS), with specific clinical presentations including, cognitive decline. Advances in an understanding of pathophysiology of disease processes and therapeutic interventions may help improve outcomes. This review will focus on large and small vessels diseases and their relationship to vascular cognitive decline, atherosclerosis, stroke, and inflammatory neurodegeneration. We will also emphasize the molecular and cellular mechanisms, as well as genetic and epigenetic factors associated with LVD and SVD. •Large vessel and small vessel diseases (LVD and SVDs) coordinately impact cerebro-vascular diseases (CVD).•Vascular and brain hyper-inflammation play a key role in the LVD and SVD.•Cytokines, angiogenic factors, proteases, and adipokines impact these diseases.•Understanding the cellular and molecular mechanisms, is likely to advance therapeutic strategies for a wide range of CVDs.
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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