Blood-Brain Barrier Dysfunction and the Potential Mechanisms in Chronic Cerebral Hypoperfusion Induced Cognitive

WenQing Xu1, Qingke Bai2, Qiang Dong3

  • 1Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.

Insights

Chronic cerebral hypoperfusion (CCH) causes vascular cognitive impairment and dementia (VCID) by disrupting the blood-brain barrier (BBB). Targeting BBB dysfunction offers potential therapeutic benefits for cognitive decline.

Area of Science:

  • Neuroscience
  • Cerebrovascular Medicine
  • Pathology

Background:

  • Chronic cerebral hypoperfusion (CCH) is a significant contributor to vascular cognitive impairment and dementia (VCID).
  • Blood-brain barrier (BBB) dysfunction is increasingly recognized as a key pathological feature in CCH.
  • Early BBB breakdown in CCH correlates with white matter deterioration and cognitive deficits.

Purpose of the Study:

  • To review current experimental and clinical evidence linking BBB disruption to VCID.
  • To elucidate the mechanisms underlying BBB dysfunction in CCH.
  • To explore the potential role of APOE genotype in BBB pathology and therapeutic strategies.

Main Methods:

  • Literature review of experimental and clinical studies on CCH and VCID.
  • Analysis of mechanisms involving cell interactions at the BBB.
  • Discussion of the influence of genetic factors, such as APOE genotype.

Main Results:

  • BBB dysfunction is a critical early event in CCH, preceding or coinciding with cognitive impairment.
  • Mechanisms involve complex cellular interactions within the BBB and are influenced by factors like APOE genotype.
  • Evidence supports BBB disruption as a major driver of VCID.

Conclusions:

  • BBB dysfunction is a pivotal pathological mechanism in CCH-induced VCID.
  • Understanding these mechanisms offers insights into potential therapeutic targets.
  • Interventions aimed at restoring BBB integrity may hold promise for treating cognitive impairment in CCH.