Higher Pulsatility in Cerebral Perforating Arteries in Patients With Small Vessel Disease Related Stroke, a 7T MRI Study

Geurts, Lennart J.; Zwanenburg, Jaco J.M.; Klijn, Catharina J.M.; Luijten, Peter R.; Biessels, Geert Jan

doi:10.1161/strokeaha.118.022516

Cited by 77 publications

(96 citation statements)

References 28 publications

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“…Higher cerebral pulsatility index has been shown to be associated with MRI features of cerebral small vessel disease (131) and cognitive impairment (132). Furthermore, a recent study using intravoxel incoherent motion MRI found that the microvascular properties of the hippocampus are altered in individuals with T2D (130), which may be related to worse cognitive function.…”

Section: Methods For Measuring Pulsatility In the Microvasculaturementioning

confidence: 99%

Measuring the Interaction Between the Macro- and Micro-Vasculature

Climie

Gallo

Picone

et al. 2019

Front. Cardiovasc. Med.

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Structural and functional dysfunction in both the macro- and microvasculature are a feature of essential hypertension. In a healthy cardiovascular system, the elastic properties of the large arteries ensure that pulsations in pressure and flow generated by cyclic left ventricular contraction are dampened, so that less pulsatile pressure and flow are delivered at the microvascular level. However, in response to aging, hypertension, and other disease states, arterial stiffening limits the buffering capacity of the elastic arteries, thus exposing the microvasculature to increased pulsatile stress. This is thought to be particularly pertinent to high flow/low resistance organs such as the brain and kidney, which may be sensitive to excess pressure and flow pulsatility, damaging capillary networks, and resulting in target organ damage. In this review, we describe the clinical relevance of the pulsatile interaction between the macro- and microvasculature and summarize current methods for measuring the transmission of pulsatility between the two sites.

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Section: Methods For Measuring Pulsatility In the Microvasculaturementioning

confidence: 99%

Measuring the Interaction Between the Macro- and Micro-Vasculature

Climie

Gallo

Picone

et al. 2019

Front. Cardiovasc. Med.

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“…An alternative is vasomotion generated by larger, spontaneous, low-frequency contractions and dilations of smooth muscle cells 55,56 , and a role for this motive force is supported by accumulating evidence 54,57 . Additional studies are needed to unravel the contributions of arterial pulsations and vasomotion 58 , and advances in contrast-enhanced MRI could improve visualization of clearance pathways in humans in vivo 59,60 , an important development towards translating experimental observations to the clinical setting.…”

Section: Aβ Clearance Pathwaysmentioning

confidence: 99%

Cerebral amyloid angiopathy and Alzheimer disease — one peptide, two pathways

et al. 2019

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The shared role of amyloid-β (Aβ) deposition in cerebral amyloid angiopathy (CAA) and Alzheimer disease (AD) is arguably the clearest instance of cross-talk between neurodegenerative and cerebrovascular processes. The pathogenic pathways of CAA and AD intersect at the levels of Aβ generation, its circulation within the interstitial fluid and perivascular drainage pathways and its brain clearance, but diverge in their mechanisms of brain injury and disease presentation. Here, we review the evidence for and pathogenic implications of interactions between CAA and AD. Both pathologies seem to be driven by impaired Aβ clearance, creating conditions for a selfreinforcing cycle of increased vascular Aβ, reduced perivascular clearance and further CAA and AD progression. Despite the close relationship between vascular and plaque Aβ deposition, several factors favour one or the other, such as the carboxy-terminal site of the peptide and specific co-deposited proteins. Amyloid-related imaging abnormalities that have been seen in trials of anti-Aβ immunotherapy are another probable intersection between CAA and AD, representing overload of perivascular clearance pathways and the effects of removing Aβ from CAA-positive vessels. The intersections between CAA and AD point to a crucial role for improving vascular function in the treatment of both diseases and indicate the next steps necessary for identifying therapies.

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“…Direct imaging of the small penetrating vessels on MRI remains challenging, especially at routinely used field strengths. Although ultra-high field MRI at 7-T (and above) holds the potential to characterize small vessels both in structure and function (96,97), most neuroimaging manifestations captured by MRI are parenchymal alterations thought to arise from small vessel pathology. A detailed overview of the broad spectrum of SVD-related lesions together with consensus terminology has been provided by the STRIVE (STandards for ReportIng Vascular changes on nEuroimaging) initiative (95).…”

Section: Imagingmentioning

confidence: 99%

Vascular Cognitive Impairment and Dementia

Iadecola

Duering

Hachinski

et al. 2019

Journal of the American College of Cardiology

487

386

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Cognitive impairment associated with aging has emerged as one of the major public health challenges of our time. Although Alzheimer’s disease is the leading cause of clinically diagnosed dementia in Western countries, cognitive impairment of vascular etiology is the second most common cause and may be the predominant one in East Asia. Furthermore, alterations of the large and small cerebral vasculature, including those affecting the microcirculation of the subcortical white matter, are key contributors to the clinical expression of cognitive dysfunction caused by other pathologies, including Alzheimer’s disease. This scientific expert panel provides a critical appraisal of the epidemiology, pathobiology, neuropathology, and neuroimaging of vascular cognitive impairment and dementia, and of current diagnostic and therapeutic approaches. Unresolved issues are also examined to shed light on new basic and clinical research avenues that may lead to mitigating one of the most devastating human conditions.

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Higher Pulsatility in Cerebral Perforating Arteries in Patients With Small Vessel Disease Related Stroke, a 7T MRI Study

Abstract: Supplemental Digital Content is available in the text.

Cited by 77 publications

References 28 publications

Measuring the Interaction Between the Macro- and Micro-Vasculature

Measuring the Interaction Between the Macro- and Micro-Vasculature

Cerebral amyloid angiopathy and Alzheimer disease — one peptide, two pathways

Vascular Cognitive Impairment and Dementia

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