Centre for Clinical Brain Sciences, UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK.
Department of Anesthesiology, Yale School of Medicine, New Haven, CT, USA.
Nat Rev Neurol. 2020 Mar;16(3):137-153. doi: 10.1038/s41582-020-0312-z. Epub 2020 Feb 24.
Perivascular spaces include a variety of passageways around arterioles, capillaries and venules in the brain, along which a range of substances can move. Although perivascular spaces were first identified over 150 years ago, they have come to prominence recently owing to advances in knowledge of their roles in clearance of interstitial fluid and waste from the brain, particularly during sleep, and in the pathogenesis of small vessel disease, Alzheimer disease and other neurodegenerative and inflammatory disorders. Experimental advances have facilitated in vivo studies of perivascular space function in intact rodent models during wakefulness and sleep, and MRI in humans has enabled perivascular space morphology to be related to cognitive function, vascular risk factors, vascular and neurodegenerative brain lesions, sleep patterns and cerebral haemodynamics. Many questions about perivascular spaces remain, but what is now clear is that normal perivascular space function is important for maintaining brain health. Here, we review perivascular space anatomy, physiology and pathology, particularly as seen with MRI in humans, and consider translation from models to humans to highlight knowns, unknowns, controversies and clinical relevance.
血管周围间隙包括大脑中小动脉、毛细血管和小静脉周围的各种通道，其中一系列物质可以移动。尽管血管周围间隙在 150 多年前就被首次发现，但由于人们对其在清除脑间质液和废物方面的作用的认识不断深入，特别是在睡眠期间，以及在小血管疾病、阿尔茨海默病和其他神经退行性和炎症性疾病的发病机制中的作用，它们最近变得备受关注。实验进展促进了在清醒和睡眠期间对完整啮齿动物模型中血管周围空间功能的体内研究，而人类 MRI 使血管周围空间形态能够与认知功能、血管风险因素、血管和神经退行性脑损伤、睡眠模式和脑血流动力学相关联。关于血管周围间隙仍有许多问题，但现在清楚的是，正常的血管周围空间功能对于维持大脑健康很重要。在这里，我们回顾血管周围间隙的解剖、生理学和病理学，特别是在人类 MRI 中所见，并考虑从模型到人类的转化，以突出已知、未知、争议和临床相关性。
