Cited by 238Intracerebral and Subarachnoid Hemorrhage ResearchAlzheimer's disease research and treatmentsCerebrovascular and genetic disorders

Sporadic cerebral amyloid angiopathy: pathology, clinical implications, and possible pathomechanisms

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Attems, Johannes·2005·Acta Neuropathologica

Abstract

Cerebral amyloid angiopathy (CAA) was observed for the first time nearly 100 years ago and systematically described in 1938. It is a common finding in elderly individuals, defined by beta-amyloid peptide (Abeta) depositions in cerebral blood vessels, and associated with Alzheimer's disease (AD). A variety of genetic mutations cause hereditary forms of CAA; in this review, however, only the sporadic variant of CAA is considered. In CAA, Abeta depositions primarily occur in the abluminal portion of the tunica media, and with increasing severity all layers of the blood vessel wall are infiltrated and an additional spread of Abeta into the surrounding neuropil may be seen (i.e., dyshoric changes). CAA is most pronounced in the occipital lobe and its distribution is usually patchy. The relationship between CAA and AD is poorly understood; however, low positive correlations between the severity of both CAA and AD pathology have been observed. CAA is a frequent cause of (warfarin-associated) intracerebral hemorrhage, and the diagnosis of probable CAA-related hemorrhage can be made during life with high accuracy. Both APOE-epsilon4 and APOE-epsilon2 are risk factors for CAA, while only APOE-epsilon2 increases the risk for hemorrhage in CAA. Although the role of CAA as an independent risk factor for cognitive decline is unclear, severe CAA is likely to lower the threshold for clinically overt dementia in neurodegenerative diseases. As for the origin of Abeta in CAA, it may be both produced by smooth muscle cells (vessel wall) and derived from neurons in the course of perivascular drainage.

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Crossref · 10.1007/s00401-005-1074-9

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Research works printed but not linked: 7

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Authors
Attems, J.
Affiliations
Otto Wagner Hospital (AT)
Corresponding author
Attems, Johannes
Venue
Acta Neuropathologica
Published
2005-09-17
Volume
110
Issue
4
Pages
345-359
ISSN
  • 0001-6322 (ISSN-L)
  • 1432-0533
OpenAlex
W1979221664
Cited by
238
References
154
Citations by year
2026: 7 · 2025: 9 · 2024: 13 · 2023: 9 · 2022: 9 · 2021: 5 · 2020: 24 · 2019: 14 · 2018: 9 · 2017: 10 · 2016: 12 · 2015: 11 · 2014: 16 · 2013: 14 · 2012: 6
FWCI
7.65
Type
journal article
Language
en
Open access
Locations
  • Acta Neuropathologica (publishedVersion)
  • PubMed (publishedVersion)
  • Newcastle University ePrints (Newcastle Univesity)
Funders
Chinese Academy of Agricultural Sciences
Topics
  • Health Sciences › Medicine › Neurology › Intracerebral and Subarachnoid Hemorrhage Research
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
  • Health Sciences › Medicine › Neurology › Cerebrovascular and genetic disorders
Keywords
sporadic cerebral amyloid angiopathy, amyloid-beta deposition, Alzheimer's disease, intracerebral hemorrhage, warfarin, APOE ε4, APOE ε2, cognitive decline, dementia, smooth muscle cells, occipital lobe, pathogenesis
MeSH terms
Apolipoproteins E, Humans, Neurons, Risk Factors, Amyloid beta-Peptides, Cerebral Amyloid Angiopathy, Myocytes, Smooth Muscle, History, 19th Century, History, 20th Century

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