Kong Qianqian, Xie Xinxin, Wang Ziyue, Zhang Yi, Zhou Xirui, Wu Lingshan, Yu Zhiyuan, Huang Hao, Luo Xiang
Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan 430030, China.
Brain Sci. 2024 Mar 12;14(3):269. doi: 10.3390/brainsci14030269.
Cerebral small vessel disease (CSVD), which is a group of pathological processes affecting cerebral microvessels, leads to functional loss in the elderly population and mostly presents as cognitive impairment and gait decline. CSVD is diagnosed based on brain imaging biomarkers, but blood biomarkers are of great significance for the early diagnosis and progression prediction of CSVD and have become a research focus because of their noninvasiveness and easy accessibility. Notably, many blood biomarkers have been reported to be associated with CSVD in a relatively large population, particularly serum neurofilament light chain (NfL), which has been regarded as a promising biomarker to track the variation trend in WMH and to predict the further status of white matter hyperintensities (WMH) and lacunar infarcts. And neuro-glio-vascular unit structure and blood-brain barrier function have been proposed as underlying mechanisms of CSVD. The article starts from the neuroimaging markers of CSVD, including recent small subcortical infarcts (RSSI), white matter hyperintensities (WMH), lacunes, cerebral microbleeds (CMB), enlarged perivascular spaces (EPVS), cerebral atrophy, and the combined small vessel disease score, and attempts to systematically review and summarize the research progress regarding the blood biomarkers of CSVD that form the changes in the neuro-glio-vascular unit structure and blood-brain barrier function.
脑小血管病（CSVD）是一组影响脑微血管的病理过程，导致老年人群功能丧失，主要表现为认知障碍和步态衰退。CSVD基于脑成像生物标志物进行诊断，但血液生物标志物对CSVD的早期诊断和病情进展预测具有重要意义，且因其非侵入性和易于获取而成为研究热点。值得注意的是，在相对较大的人群中，许多血液生物标志物已被报道与CSVD相关，尤其是血清神经丝轻链（NfL），它被视为追踪脑白质高信号（WMH）变化趋势以及预测白质高信号和腔隙性梗死进一步发展状况的有前景的生物标志物。神经-胶质-血管单元结构和血脑屏障功能已被提出作为CSVD的潜在机制。本文从CSVD的神经影像学标志物入手，包括近期皮质下小梗死灶（RSSI）、脑白质高信号（WMH）、腔隙、脑微出血（CMB）、血管周围间隙增宽（EPVS）、脑萎缩以及综合小血管病评分，并试图系统回顾和总结关于CSVD血液生物标志物的研究进展，这些标志物构成了神经-胶质-血管单元结构和血脑屏障功能的变化。
