Pumps, aqueducts, and drought management: vascular physiology in vascular cognitive impairment

Area of Science:

• Neurology
• Vascular Medicine
• Cognitive Science

Background:

• Vascular cognitive impairment (VCI) is traditionally linked to infarcts and structural brain changes.
• Emerging evidence suggests hemodynamic dysfunction, like hypoperfusion, may independently cause cognitive impairment.
• This review focuses on the role of impaired cerebral blood flow in VCI.

Purpose of the Study:

• To review evidence linking hemodynamic impairment to cognitive dysfunction.
• To explore the contribution of altered cerebral blood flow in large vessel disease, cardiac failure, and microvascular disease to VCI.
• To assess the potential of hemodynamic therapies for VCI.

Main Methods:

• Literature review of studies on vascular cognitive impairment and hemodynamics.
• Analysis of evidence connecting large vessel disease, cardiac failure, and microvascular disease to cerebral blood flow.
• Synthesis of findings on the relationship between hemodynamic dysfunction and cognitive decline.

Main Results:

• Evidence supports hemodynamic dysfunction as a significant contributor to VCI.
• Impaired cerebral blood flow is implicated across various vascular pathologies including large vessel disease, cardiac failure, and microvascular disease.
• Altered cerebral blood flow regulation and hypoperfusion are key factors.

Conclusions:

• Hemodynamic impairment is a crucial, potentially independent, mediator of VCI.
• Targeting hemodynamic dysfunction offers a promising therapeutic avenue for cognitive impairment.
• Future treatments may focus on restoring vascular physiology to improve cognitive function.