脑老化中血管周围间隙扩大的生理学和临床意义。
Physiology and Clinical Relevance of Enlarged Perivascular Spaces in the Aging Brain.
机构信息
From Vanderbilt Memory and Alzheimer's Center (C.W.B., M.S.S., A.L.J.) and Department of Neurology (C.W.B., M.S.S., A.L.J.), Vanderbilt University Medical Center; Vanderbilt Brain Institute (C.W.B., M.S.S., A.L.J.), Vanderbilt University, Nashville, TN; and Department of Medicine (R.O.C.), University of Southampton, Hampshire, UK.
From Vanderbilt Memory and Alzheimer's Center (C.W.B., M.S.S., A.L.J.) and Department of Neurology (C.W.B., M.S.S., A.L.J.), Vanderbilt University Medical Center; Vanderbilt Brain Institute (C.W.B., M.S.S., A.L.J.), Vanderbilt University, Nashville, TN; and Department of Medicine (R.O.C.), University of Southampton, Hampshire, UK
出版信息
Neurology. 2022 Jan 18;98(3):107-117. doi: 10.1212/WNL.0000000000013077. Epub 2021 Nov 22.
Perivascular spaces (PVS) are fluid-filled compartments that are part of the cerebral blood vessel wall and represent the conduit for fluid transport in and out of the brain. PVS are considered pathologic when sufficiently enlarged to be visible on MRI. Recent studies have demonstrated that enlarged PVS (ePVS) may have clinical consequences related to cognition. Emerging literature points to arterial stiffening and abnormal protein aggregation in vessel walls as 2 possible mechanisms that drive ePVS formation. We describe the clinical consequences, anatomy, fluid dynamics, physiology, risk factors, and in vivo quantification methods of ePVS. Given competing views of PVS physiology, we detail the 2 most prominent theoretical views and review ePVS associations with other common small vessel disease markers. Because ePVS are a marker of small vessel disease and ePVS burden is higher in Alzheimer disease, a comprehensive understanding about ePVS is essential in developing prevention and treatment strategies.
血管周围间隙（PVS）是充满液体的腔室，是脑血管壁的一部分，代表脑内外液体转运的通道。当 PVS 扩大到足以在 MRI 上可见时，被认为是病理性的。最近的研究表明，扩大的 PVS（ePVS）可能与认知相关的临床后果。新兴文献指出，动脉僵硬和血管壁中异常蛋白聚集是导致 ePVS 形成的 2 种可能机制。我们描述了 ePVS 的临床后果、解剖结构、流体动力学、生理学、危险因素和体内定量方法。鉴于对 PVS 生理学的不同观点，我们详细介绍了 2 种最突出的理论观点，并回顾了 ePVS 与其他常见小血管疾病标志物的关联。由于 ePVS 是小血管疾病的标志物，并且 ePVS 负担在阿尔茨海默病中更高，因此全面了解 ePVS 对于制定预防和治疗策略至关重要。
Zotero 插件