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Erschienen in:

24.10.2020 | Review

Brain arteriolosclerosis

verfasst von: Brittney L. Blevins, Harry V. Vinters, Seth Love, Donna M. Wilcock, Lea T. Grinberg, Julie A. Schneider, Rajesh N. Kalaria, Yuriko Katsumata, Brian T. Gold, Danny J. J. Wang, Samantha J. Ma, Lincoln M. P. Shade, David W. Fardo, Anika M. S. Hartz, Gregory A. Jicha, Karin B. Nelson, Shino D. Magaki, Frederick A. Schmitt, Merilee A. Teylan, Eseosa T. Ighodaro, Panhavuth Phe, Erin L. Abner, Matthew D. Cykowski, Linda J. Van Eldik, Peter T. Nelson

Erschienen in: Acta Neuropathologica | Ausgabe 1/2021

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Abstract

Brain arteriolosclerosis (B-ASC), characterized by pathologic arteriolar wall thickening, is a common finding at autopsy in aged persons and is associated with cognitive impairment. Hypertension and diabetes are widely recognized as risk factors for B-ASC. Recent research indicates other and more complex risk factors and pathogenetic mechanisms. Here, we describe aspects of the unique architecture of brain arterioles, histomorphologic features of B-ASC, relevant neuroimaging findings, epidemiology and association with aging, established genetic risk factors, and the co-occurrence of B-ASC with other neuropathologic conditions such as Alzheimer’s disease and limbic-predominant age-related TDP-43 encephalopathy (LATE). There may also be complex physiologic interactions between metabolic syndrome (e.g., hypertension and inflammation) and brain arteriolar pathology. Although there is no universally applied diagnostic methodology, several classification schemes and neuroimaging techniques are used to diagnose and categorize cerebral small vessel disease pathologies that include B-ASC, microinfarcts, microbleeds, lacunar infarcts, and cerebral amyloid angiopathy (CAA). In clinical-pathologic studies that factored in comorbid diseases, B-ASC was independently associated with impairments of global cognition, episodic memory, working memory, and perceptual speed, and has been linked to autonomic dysfunction and motor symptoms including parkinsonism. We conclude by discussing critical knowledge gaps related to B-ASC and suggest that there are probably subcategories of B-ASC that differ in pathogenesis. Observed in over 80% of autopsied individuals beyond 80 years of age, B-ASC is a complex and under-studied contributor to neurologic disability.

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Titel: Brain arteriolosclerosis
verfasst von: Brittney L. Blevins
Harry V. Vinters
Seth Love
Donna M. Wilcock
Lea T. Grinberg
Julie A. Schneider
Rajesh N. Kalaria
Yuriko Katsumata
Brian T. Gold
Danny J. J. Wang
Samantha J. Ma
Lincoln M. P. Shade
David W. Fardo
Anika M. S. Hartz
Gregory A. Jicha
Karin B. Nelson
Shino D. Magaki
Frederick A. Schmitt
Merilee A. Teylan
Eseosa T. Ighodaro
Panhavuth Phe
Erin L. Abner
Matthew D. Cykowski
Linda J. Van Eldik
Peter T. Nelson
Publikationsdatum: 24.10.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Acta Neuropathologica / Ausgabe 1/2021
Print ISSN: 0001-6322
Elektronische ISSN: 1432-0533
DOI: https://doi.org/10.1007/s00401-020-02235-6

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