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Cerebral small vessel disease: A glymphopathy?
Helene Benveniste1, Maiken Nedergaard2
1Department of Anesthesiology, Yale School of Medicine, New Haven, CT, USA.
Current Opinion in Neurobiology
|August 18, 2021
Summary
Small vessel disease (SVD), a cause of dementia, may stem from impaired brain fluid transport via the glymphatic system. This failure can lead to fluid buildup and damage in the aging brain.
Area of Science:
- Neurology
- Neuroscience
- Pathology
Background:
- Small vessel disease (SVD) is a primary contributor to dementia in aging populations.
- Key indicators of SVD include enlarged perivascular spaces and white matter hyperintensities, signaling fluid accumulation or damage.
Purpose of the Study:
- To propose that impaired glymphatic system function is a critical factor in the initiation and progression of SVD.
- To explore the role of cerebrospinal fluid transport and brain fluid homeostasis in SVD pathogenesis.
Main Methods:
- Review of existing glymphatic system research, particularly studies involving rodent models.
- Analysis of how hypertension and diabetes impact glymphatic function and SVD development.
Main Results:
- Perivascular spaces serve as critical pathways for cerebrospinal fluid influx.
- Stagnation in glymphatic transport disrupts brain fluid balance, potentially causing edema and demyelination.
Conclusions:
- Failure of the glymphatic system is implicated in the development of SVD and subsequent dementia.
- Understanding glymphatic dysfunction offers new avenues for investigating SVD pathogenesis, especially in conditions like hypertension and diabetes.
