Cited by 559Barrier Structure and Function StudiesAlzheimer's disease research and treatmentsNeurological Disease Mechanisms and Treatments

Neurovascular dysfunction and neurodegeneration in dementia and Alzheimer's disease

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Nelson, Amy R., Sweeney, Melanie D., Sagare, Abhay P., Zlokovic, Berislav V.·2016·Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease

Abstract

Vascular insults can initiate a cascade of molecular events leading to neurodegeneration, cognitive impairment, and dementia. Here, we review the cellular and molecular mechanisms in cerebral blood vessels and the pathophysiological events leading to cerebral blood flow dysregulation and disruption of the neurovascular unit and the blood-brain barrier, which all may contribute to the onset and progression of dementia and Alzheimer's disease (AD). Particularly, we examine the link between neurovascular dysfunction and neurodegeneration including the effects of AD genetic risk factors on cerebrovascular functions and clearance of Alzheimer's amyloid-β peptide toxin, and the impact of vascular risk factors, environment, and lifestyle on cerebral blood vessels, which in turn may affect synaptic, neuronal, and cognitive functions. Finally, we examine potential experimental treatments for dementia and AD based on the neurovascular model, and discuss some critical questions to be addressed by future studies. This article is part of a Special Issue entitled: Vascular Contributions to Cognitive Impairment and Dementia edited by M. Paul Murphy, Roderick A. Corriveau and Donna M. Wilcock.

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Crossref · 10.1016/j.bbadis.2015.12.016

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  • AD risk factors such as aging, hypertension, diabetes, and apolipoprotein E4 genotype lead to cerebrovascular damage, inducing blood-brain barrier damage and brain perfusion reduction.

    “Hit one, the AD risk factors such as aging, hypertension, diabetes, and apolipoprotein E4 (ApoE4) genotype lead to cerebrovascular damage, inducing blood‐brain barrier (BBB) damage and brain perfusion reduction.[ 4 , 6 ]”

    From Multifunctional Nanostructure RAP‐RL Rescues Alzheimer's Cognitive Deficits through Remodeling the Neurovascular Unit (2021) · cites this paper as [6]

    Sections 2.2 and 3.2 link APOE4 and aging to BBB breakdown; section 4.1 reports that hypertension reduces cerebral blood flow and, in animal models, impairs the BBB. Section 4.2 reports vascular alterations and increased BBB permeability in type 2 diabetes. The paper also describes reduced cerebral blood flow in people at risk of AD (section 3.1), but does not establish that each listed risk factor causes both BBB damage and reduced brain perfusion as the sentence implies. Page numbers are unavailable in our copy. (LLM, conf=0.84)

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  • Increasing evidence supports that early cerebrovascular dysfunction contributes to AD pathophysiology and cognitive impairment.

    “In addition to the classic hallmark pathology, A 𝛃 plaques, hyperphosphorylated tau neurofibrillary tangles, and neuron loss, increasing evidence supports that early cerebrovascular dysfunction contributes to AD pathophysiology and cognitive impairment (29, 285, 418, 421, 429, 569, 571, 593, 682, 693).”

    From Blood-Brain Barrier: From Physiology to Disease and Back (2019) · cites this paper as [429]

  • Growing evidence indicates that BBB damage and early cerebrovascular disease increase risk of dementia and age-related disorders such as AD.

    “Growing evidence indicates that BBB damage and early cerebrovascular disease increase risk of dementia and age-related disorders such as AD [625–627].”

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Authors
Nelson, A. R., Sweeney, M. D., Sagare, A. P., & Zlokovic, B. V.
Affiliations
University of Southern California (US)
Venue
Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease
Publisher
Elsevier BV
Published
2016-05
Volume
1862
Issue
5
Pages
887-900
ISSN
0925-4439 (ISSN-L)
OpenAlex
W2198664180
Cited by
559
References
249
Citations by year
2026: 35 · 2025: 52 · 2024: 46 · 2023: 61 · 2022: 73 · 2021: 69 · 2020: 69 · 2019: 60 · 2018: 40 · 2017: 34 · 2016: 20
FWCI
2.50
Type
journal article
Language
en
Open access
Locations
  • Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (R01AG023084, R01NS090904, R01NS034467, R01AG039452)
  • Cure for Alzheimer's Fund (006002-00001)
Topics
  • Life Sciences › Neuroscience › Neurology › Barrier Structure and Function Studies
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
  • Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
Keywords
neurovascular dysfunction, neurodegeneration, dementia, Alzheimer's disease, neurovascular unit, blood-brain barrier, amyloid-beta clearance, genetic risk factors, vascular risk factors, synaptic function, cognitive impairment, experimental treatment
MeSH terms
Neurovascular Coupling, Alzheimer Disease, Animals, Blood-Brain Barrier, Brain, Cerebrovascular Circulation, Dementia, Humans, Risk Factors

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