Cerebral small vessel disease: Recent advances and future directions

International Journal of Stroke, Journal Year: 2022, Volume and Issue: 18(1), P. 4 - 14

Published: Dec. 27, 2022

Cerebral small vessel disease (SVD) causes lacunar stroke and intracerebral hemorrhage, is the most common pathology underlying vascular cognitive impairment. Increasingly, importance of other clinical features SVD being recognized including motor impairment, (vascular) parkinsonism, impaired balance, falls, behavioral symptoms, such as depression, apathy, personality change. Epidemiological data show a high prevalence characteristic magnetic resonance imaging (MRI) white matter hyperintensities infarcts in community studies, recent suggest that it also major health burden low- middle-income countries. In this review, we cover advances diagnosis, imaging, presentations, pathogenesis, treatment. The two pathologies are arteriolosclerosis caused by aging, hypertension, conventional risk factors, cerebral amyloid angiopathy (CAA) deposition β-amyloid. We discuss revised Boston criteria CAA based on MRI features, which have been recently validated. Imaging providing important insights into improved detection tissue damage using diffusion tensor (DTI) leading to its use monitor progression surrogate endpoints trials. Advanced techniques can demonstrate functional or dynamic abnormalities blood vessels, while spatial resolution provided ultrahigh field at 7 T allows individual perforating arteries for first time, measurement flow velocity pulsatility within these arteries. DTI structural network analysis highlighted disruption mediating effect different causing number gait disturbance. Despite public SVD, there few proven treatments. review evidence primary prevention, showing how intensive pressure lowering reduces (WMH) delays onset There treatments secondary but trials currently evaluating novel treatment approaches. Recent implicated molecular processes related endothelial dysfunction, nitric oxide synthesis, blood–brain barrier integrity, maintenance repair extracellular matrix, inflammation. Novel approaches developed targets. Finally, highlight large International collaborative initiatives address research questions established.

Language: Английский

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Molecular biomarkers for vascular cognitive impairment and dementia

Nature Reviews Neurology, Journal Year: 2023, Volume and Issue: 19(12), P. 737 - 753

Published: Nov. 13, 2023

Language: Английский

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Integrative Approaches in Acute Ischemic Stroke: From Symptom Recognition to Future Innovations

Biomedicines, Journal Year: 2023, Volume and Issue: 11(10), P. 2617 - 2617

Published: Sept. 23, 2023

Among the high prevalence of cerebrovascular diseases nowadays, acute ischemic stroke stands out, representing a significant worldwide health issue with important socio-economic implications. Prompt diagnosis and intervention are milestones for management this multifaceted pathology, making understanding various stroke-onset symptoms crucial. A key role in is emphasizing essential multi-disciplinary team, therefore, increasing efficiency recognition treatment. Neuroimaging neuroradiology have evolved dramatically over years, multiple approaches that provide higher morphological aspects as well timely cerebral artery occlusions effective therapy planning. Regarding treatment matter, pharmacological approach, particularly fibrinolytic therapy, has its merits challenges. Endovascular thrombectomy, game-changer management, witnessed advances, technologies like stent retrievers aspiration catheters playing pivotal roles. For select patients, combining endovascular strategies offers evidence-backed benefits. The aim our comprehensive study on to efficiently compare current therapies, recognize novel possibilities from literature, describe state art interdisciplinary approach stroke. As we aspire holistic patient emphasis not just medical but also physical mental health, community engagement. future holds promising innovations, artificial intelligence poised reshape diagnostics treatments. Bridging gap between groundbreaking research clinical practice remains challenge, urging continuous collaboration research.

Language: Английский

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Role of microglia in stroke

Glia, Journal Year: 2024, Volume and Issue: 72(6), P. 1016 - 1053

Published: Jan. 4, 2024

Abstract Microglia play key roles in the post‐ischemic inflammatory response and damaged tissue removal reacting rapidly to disturbances caused by ischemia working restore lost homeostasis. However, modified environment, encompassing ionic imbalances, disruption of crucial neuron–microglia interactions, spreading depolarization, generation danger signals from necrotic neurons, induce morphological phenotypic shifts microglia. This leads them adopt a proinflammatory profile heighten their phagocytic activity. From day three post‐ischemia, macrophages infiltrate core while microglia amass at periphery. Further, inflammation prompts metabolic shift favoring glycolysis, pentose‐phosphate shunt, lipid synthesis. These shifts, combined with intake, drive droplet biogenesis, fuel anabolism, enable proliferation. Proliferating release trophic factors contributing protection repair. some accumulate lipids persistently transform into dysfunctional potentially harmful foam cells. Studies also showed that either display impaired apoptotic cell clearance, or eliminate synapses, viable endothelial Yet, it will be essential elucidate viability engulfed cells, features local extent damage, temporal sequence. Ischemia provides rich variety region‐ injury‐dependent stimuli for microglia, evolving time generating distinct phenotypes including those exhibiting traits others showing pro‐repair features. Accurate profiling phenotypes, alongside more precise understanding associated conditions, is necessary step serve as potential foundation focused interventions human stroke.

Language: Английский

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A Decade of Dedication: Pioneering Perspectives on Neurological Diseases and Mental Illnesses

Biomedicines, Journal Year: 2024, Volume and Issue: 12(5), P. 1083 - 1083

Published: May 13, 2024

Welcome to

Language: Английский

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Incidence of post-stroke cognitive impairment in patients with first-ever ischemic stroke: a multicenter cross-sectional study in China

The Lancet Regional Health - Western Pacific, Journal Year: 2023, Volume and Issue: 33, P. 100687 - 100687

Published: Jan. 14, 2023

Post-stroke cognitive impairment (PSCI) is a common sequela after stroke. China has large population of stroke survivors, but large-scale survey on the incidence and risk factors for PSCI not been undertaken. We aimed to calculate vascular symptoms among first-ever survivors in through multicenter cross-sectional study.From May 1, 2019 November 30, 2019, patients with clinical diagnosis ischemic were recruited from 563 hospitalized-based center networks 30 provinces China. Cognitive was measured by 5-min National Institute Neurological Disease Stroke-Canadian Stroke Network (NINDS-CSN) at 3-6 months indexed Stepwise multivariate regression stratified analysis performed assess association between demographic variables.A total 24,055 enrolled, an average age 70.25 ± 9.88 years. The as per NINDS-CSN 78.7%. Age ≥75 years old (OR: 1.887, 95%CI: 1.391-2.559), western regional residence 1.620, 1.411-1.860) lower education level associated increased risk. Hypertension might be related non-PSCI 0.832, 0.779-0.888). For under 45 old, unemployment independent factor 6.097, 1.385-26.830). who residents southern region 1.490, 1.185-1.873) non-manual workers 2.122, 1.188-3.792), diabetes PSCI.PSCI Chinese stroke, many are occurrence PSCI.The Beijing Hospitals Authority Youth Program (No. QMS20200801); Natural Science Foundation 81801142); Key Project Technology Development Railway Corporation K2019Z005); Capital Health Research Special 2020-2-2014); Innovation 2030-Major 2021ZD0201806).

Language: Английский

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Repetitive transcranial magnetic stimulation combined with cognitive training for cognitive function and activities of daily living in patients with post-stroke cognitive impairment: A systematic review and meta-analysis

Ageing Research Reviews, Journal Year: 2023, Volume and Issue: 87, P. 101919 - 101919

Published: April 1, 2023

Language: Английский

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Prolonged myelin deficits contribute to neuron loss and functional impairments after ischaemic stroke

Brain, Journal Year: 2024, Volume and Issue: 147(4), P. 1294 - 1311

Published: Jan. 30, 2024

Abstract Ischaemic stroke causes neuron loss and long-term functional deficits. Unfortunately, effective approaches to preserving neurons promoting recovery remain unavailable. Oligodendrocytes, the myelinating cells in CNS, are susceptible oxygen nutrition deprivation undergo degeneration after ischaemic stroke. Technically, new oligodendrocytes myelin can be generated by differentiation of oligodendrocyte precursor (OPCs). However, dynamics their significance poorly understood. Here, we report numerous denuded axons accompanied decreased density sections from lesions human brain, suggesting that correlates with deficits these lesions. To investigate longitudinal changes stroke, labelled traced pre-existing newly-formed myelin, respectively, using cell-specific genetic approaches. Our results indicated massive death 2 weeks transient middle cerebral artery occlusion (tMCAO) mouse model. In contrast, regeneration remained insufficient 4 8 post-stroke. Notably, neuronal impairments worsened aged brains, generation was diminished. analyse causal relationship between remyelination survival, manipulated myelinogenesis conditional deletion Olig2 (a positive regulator) or muscarinic receptor 1 (M1R, a negative OPCs. Deleting inhibited remyelination, reducing survival tMCAO. Conversely, enhancing M1R knockout treatment pro-myelination drug clemastine tMCAO preserved white matter integrity accelerating recovery. Together, our findings demonstrate is promising strategy preserve promote

Language: Английский

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Psychedelics for acquired brain injury: a review of molecular mechanisms and therapeutic potential

Molecular Psychiatry, Journal Year: 2024, Volume and Issue: 29(3), P. 671 - 685

Published: Jan. 4, 2024

Language: Английский

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Multimorbidity, healthy lifestyle, and the risk of cognitive impairment in Chinese older adults: a longitudinal cohort study

BMC Public Health, Journal Year: 2024, Volume and Issue: 24(1)

Published: Jan. 2, 2024

Evidence on the association between multimorbidity and cognitive impairment in Chinese older population is limited. In addition, whether a healthy lifestyle can protect function multimorbid remains unknown.

Language: Английский

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