Neurovascular coupling and cerebral perfusion in aging, cerebral microangiopathy and Alzheimer’s diseases

Abstract

Integrity of neurovascular unit (NVU) and interaction of its components is the basis for brain function. Exceptional role of NVU for providing metabolism of all cerebral processes substantiates obligate participation in pathophysiology of wide range of neurological disorders. Established similarity of structural changes in NVU at early stages of aging and hypertensive cerebral microangiopathy (CMA) suggests common pathogenic mechanisms of its damage and, in view of reversibility of early changes in neurovascular coupling (NVC), allows considering several forms of CMA as variants of early accelerated vascular wall aging. Understanding small vessel damage as a significant risk factor for Alzheimer’s disease and mixed dementias has encouraged revision of the current concept of the development of cognitive decline. A universal role of early NVC impairments in the development of various dementias has been shown. Further studies should improve our understanding of mechanisms of NVC impairment, role of classical and newly specified risk factors in their development and perspectives for preventive strategies. Apparently, success can be achieved through collaboration of neuroscience researchers, which allows translation of advantages of fundamental studies into clinical practice