Cerebral blood vessel changes in old people

Brain arteriolosclerosis (B-ASC), characterized by pathologic arteriolar wall thickening, is a common finding at autopsy in aged persons and is associated with cognitive impairment. Hypertension and diabetes are widely recognized as risk factors for B-ASC. Recent research indicates other and more complex risk factors and pathogenetic mechanisms. Here we describe aspects of the unique architecture of brain arterioles, histomorphologic features of B-ASC, relevant neuroimaging findings, epidemiology and association with aging, established genetic risk factors, and the co-occurrence of B-ASC with other neuropathologic conditions such as A a a b c-predominant age-related TDP-43 encephalopathy (LATE).There may also be complex physiologic interactions between metabolic syndrome (e.g. hypertension and inflammation) and brain arteriolar pathology. Although there is no universally applied diagnostic methodology, several classification schemes and neuroimaging techniques are used to diagnose and categorize cerebral small vessel disease pathologies that include B-ASC, microinfarcts, microbleeds, lacunar infarcts, and cerebral amyloid angiopathy (CAA). In clinical-pathologic studies that include consideration of comorbid diseases, B-ASC is independently associated with impairments in global cognition, episodic memory, working memory, and perceptual speed, and has been linked to autonomic dysfunction and motor symptoms including parkinsonism. We conclude by discussing critical knowledge gaps related to B-ASC and suggest that there are probably subcategories of B-ASC that differ in pathogenesis. Observed in over 80% of autopsied individuals beyond 80 years of age, B-ASC is a complex and under-studied contributor to neurologic disability.

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“…The aged brain may contain a broad spectrum of arteriolar pathologic changes [38,81,111,159,197,210] (Fig. 4).…”

Section: Neuropathologic Workup: Diagnostic and Research Approachesmentioning

confidence: 99%

Brain arteriolosclerosis

et al. 2020

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“…5 Examination of autopsied brains of South American Indians living at high altitudes and permanently exposed to hypoxia has revealed increases in microvessel density. 6 Furthermore, the different time courses of ischemia caused variability in the number of surviving microvessels, and this prompted us to undertake a quantitative study on the morphology of blood vessels and vascular density. The findings were correlated with patient survival time after stroke.…”

mentioning

confidence: 99%

Role of angiogenesis in patients with cerebral ischemic stroke.

Krupiński

Kałuza

Kumar

et al. 1994

Stroke

773

555

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Background and Purpose Stroke is one of the most common causes of mortality and morbidity in the Western world. It results from the occlusion of a cerebral artery followed by severe disturbances in blood supply through microvessels to brain tissue. Despite an extensive literature its pathophysiology is poorly understood, and this has severely impeded the logical development of therapy.Methods Brains were obtained from 10 patients aged 46 to 85 years with survival times of 5 to 92 days after their stroke. Infarcted areas and representative control tissues from the contralateral uninvolved brain hemisphere were collected. Microvessel density was measured microscopically. A total of 6520 microvessels were scored in 10 801 areas. The level of activation of the endothelial cells was studied by immunohistochemistry using three monoclonal antibodies, viz, E-9, raised against activated endothelial cells; IG11, recognizing vascular cell adhesion molecule-1; and anti-proliferating cell nuclear antigen. Angiogenic activity in tissue extracts was examined using an in vivo chicken chorioallantoic membrane assay.Results There was a statistically significant increase in the number of microvessels (Wilcoxon log-rank test;Ps.01) in 9 of

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“…The mammalian brain is known to exhibit gross morphological evidence of microvascular degeneration in senescence. These alterations of the cerebral microvessel have been noted in both human (Ravens, 1978) and rodent (Bar, 1978;Casey and Feldman, 1985) brain and include microvascular fibrosis (Knox et al, 1980;de Jong et al, 1992), vascular convolutions (Cervos-Navarro et al, 1987), thickening of the basement membrane (Heinsen and Heinsen, 1983), and amyloid-like degeneration of the microvessel wall (Wisniewski et al, 1970). The changes in microvessel membrane phosphoglyceride and fatty acid composition reported here may represent, at least in part, a biochemical correlate to this altered vascular morphology.…”

Section: Discussionmentioning

confidence: 99%

Altered Composition of Cerebral Microvessel Membrane Phosphoglycerides from Senescent Mouse

Williams

Rapoport

1993

Journal of Neurochemistry

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Phosphoglyceride and fatty acid composition was determined in the cellular membranes of isolated cerebral microvessels and brain parenchymal cells (neurons and glia) taken from 10-, 20-, and 27-30-month-old C57BL6/NNIA mice. Lipids were extracted from each fraction and the fatty acid profiles of ethanolamine, choline, serine, and inositol phosphoglycerides analyzed by gas chromatography. The results suggest that membrane phosphoglycerides from cerebral microvessels are significantly more affected by the aging process than are those of the brain parenchyma. Relative percentage for fatty acids in cerebral microvessels indicate an overall decline in membrane unsaturation with a concomitant elevation in the level of saturation. The decline in unsaturation is reflected primarily in the loss of precursor fatty acids for arachidonic (18:2n-6 and 20:3n-6) and docosahexaenoic (20:5n-3 and 22:5n-3) acids. Levels of arachidonic (20:4n-6) and docosahexaenoic (22:6n-3) acids in each phosphoglyceride remained unchanged with age; however, mol% for ethanolamine plasmalogen, a major source of these fatty acids, was significantly reduced in 27-30-month-old mice. Conversely, mol% for choline phosphoglyceride increased with age. The age-related changes in fatty acid profile for microvessel membrane phosphoglycerides are reflected by increased saturation/unsaturation ratios and decreased unsaturation indices. These parameters were not affected by aging in parenchymal membranes.

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Cerebral blood vessel changes in old people

Cited by 23 publications

References 7 publications

Brain arteriolosclerosis

Brain arteriolosclerosis

Role of angiogenesis in patients with cerebral ischemic stroke.

Altered Composition of Cerebral Microvessel Membrane Phosphoglycerides from Senescent Mouse

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