Neuroprotection Research Laboratory, Departments of Radiology and Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA.
Department of Neurology, Mie University Graduate School of Medicine, Tsu, Japan.
J Cereb Blood Flow Metab. 2023 Nov;43(2_suppl):18-36. doi: 10.1177/0271678X231154597. Epub 2023 Mar 8.
Vascular cognitive impairment (VCI) refers to all forms of cognitive disorder related to cerebrovascular diseases, including vascular mild cognitive impairment, post-stroke dementia, multi-infarct dementia, subcortical ischemic vascular dementia (SIVD), and mixed dementia. Among the causes of VCI, more attention has been paid to SIVD because the causative cerebral small vessel pathologies are frequently observed in elderly people and because the gradual progression of cognitive decline often mimics Alzheimer's disease. In most cases, small vessel diseases are accompanied by cerebral hypoperfusion. In mice, prolonged cerebral hypoperfusion is induced by bilateral carotid artery stenosis (BCAS) with surgically implanted metal micro-coils. This cerebral hypoperfusion BCAS model was proposed as a SIVD mouse model in 2004, and the spreading use of this mouse SIVD model has provided novel data regarding cognitive dysfunction and histological/genetic changes by cerebral hypoperfusion. Oxidative stress, microvascular injury, excitotoxicity, blood-brain barrier dysfunction, and secondary inflammation may be the main mechanisms of brain damage due to prolonged cerebral hypoperfusion, and some potential therapeutic targets for SIVD have been proposed by using transgenic mice or clinically used drugs in BCAS studies. This review article overviews findings from the studies that used this hypoperfused-SIVD mouse model, which were published between 2004 and 2021.
血管性认知障碍(VCI)是指所有与脑血管疾病相关的认知障碍形式,包括血管性轻度认知障碍、卒中后痴呆、多发梗死性痴呆、皮质下缺血性血管性痴呆(SIVD)和混合性痴呆。在 VCI 的病因中,SIVD 受到了更多的关注,因为导致认知能力下降的脑小血管病理在老年人中经常观察到,而且认知能力的逐渐下降常类似于阿尔茨海默病。在大多数情况下,小血管疾病伴有脑灌注不足。在小鼠中,通过双侧颈总动脉狭窄(BCAS)并用手术植入的金属微线圈来诱导长时间的脑灌注不足。这种脑灌注不足的 BCAS 模型于 2004 年被提出作为 SIVD 小鼠模型,这种小鼠 SIVD 模型的广泛应用提供了关于认知功能障碍和由于脑灌注不足引起的组织学/遗传变化的新数据。氧化应激、微血管损伤、兴奋性毒性、血脑屏障功能障碍和继发性炎症可能是由于长时间脑灌注不足导致脑损伤的主要机制,并且在 BCAS 研究中使用转基因小鼠或临床使用的药物提出了一些 SIVD 的潜在治疗靶点。本文综述了 2004 年至 2021 年间发表的使用这种低灌注 SIVD 小鼠模型的研究结果。