Abstract
Efficient blood supply to the brain is of paramount importance to its normal functioning and improper blood flow can result in potentially devastating neurological consequences. Cerebral blood flow in response to neural activity is intrinsically regulated by a complex interplay between various cell types within the brain in a relationship termed neurovascular coupling. The breakdown of neurovascular coupling is evident across a wide variety of both neurological and psychiatric disorders including Alzheimer’s disease. Atherosclerosis is a chronic syndrome affecting the integrity and function of major blood vessels including those that supply the brain, and it is therefore hypothesised that atherosclerosis impairs cerebral blood flow and neurovascular coupling leading to cerebrovascular dysfunction. This review will discuss the mechanisms of neurovascular coupling in health and disease and how atherosclerosis can potentially cause cerebrovascular dysfunction that may lead to cognitive decline as well as stroke. Understanding the mechanisms of neurovascular coupling in health and disease may enable us to develop potential therapies to prevent the breakdown of neurovascular coupling in the treatment of vascular brain diseases including vascular dementia, Alzheimer’s disease and stroke.
Highlights
The human brain accounts for just 2% of total body weight, yet receives between 15 and 20% of total cardiac output [1]
This review will focus on the neurophysiology of neurovascular coupling, how it is impaired in certain neurological conditions, how to study it and will discuss how cardiovascular disease may affect the regulation of cerebral blood flow (CBF) and neurovascular coupling
Lipohyalinosis is a brain-specific vessel disease characterised by vascular wall disruption and occurs as a result of systemic atherosclerosis, especially due to extensive inflammation occurring through the accumulation of reactive-oxygen species (ROS), in addition to gliosis involving astrocytes, oligodendrocyte precursor cells and microglia which themselves in their reactive state produce ROS [80]
Summary
The human brain accounts for just 2% of total body weight, yet receives between 15 and 20% of total cardiac output [1]. The NVU facilitates cerebral blood flow (CBF) changes in response to the metabolic activity of neurons in a relationship termed neurovascular coupling [3].
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