Neurovascular dysfunction and neurodegeneration in dementia and Alzheimer's disease
Open accessAbstract
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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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)
Experimental — accuracy not yet measuredIncreasing 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].”
From Molecular and cellular mechanisms underlying the pathogenesis of Alzheimer’s disease (2020) · cites this paper as [627]
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Glucose transporter plasticity during memory processing
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Control of Vascular Cell Differentiation by Homeobox Transcription Factors
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Phase 1 Safety, Tolerability and Pharmacokinetics of 3K3A-APC in Healthy Adult Volunteers
Lyden, P. D., Levy, H. A., Weymer, S., Pryor, K. E., Kramer, W. G., Griffin, J. H., Davis, T. P., & Zloković, B. V. (2014) · Current Pharmaceutical Design · doi:10.2174/1381612819666131230131454 · Cited by 64 · see citing works
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The Cyclophilin Inhibitor SCY-635 Disrupts Hepatitis C Virus NS5A-Cyclophilin A Complexes
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A genome-wide study reveals rare CNVs exclusive to extreme phenotypes of Alzheimer disease
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Blood–brain barrier breakdown in Alzheimer disease and other neurodegenerative disorders
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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)
- PMC
- PMC4821735
- 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
- bronze
- doi.org
- Licence
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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