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Blood-based biomarkers of cerebral small vessel disease
Liu-Yun Wu1, Yuek Ling Chai1, Irwin K Cheah2
1Memory Aging and Cognition Centre, National University Health System, Singapore; Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Insights
Age-associated cerebral small vessel disease (CSVD) is a heterogeneous condition impacting aging populations. Understanding its underlying mechanisms is crucial for developing accessible blood-based biomarkers for early detection and risk stratification.
Area of Science:
- Neurology
- Vascular Biology
- Biomarker Discovery
Background:
- Age-associated cerebral small vessel disease (CSVD) is a heterogeneous condition leading to chronic cerebrovascular dysfunction, stroke, and vascular cognitive impairment.
- Neuroimaging detects CSVD but is resource-intensive; thus, blood-based biomarkers are sought for accessible screening.
- Understanding CSVD pathogenesis is vital for identifying clinically useful biomarkers.
Purpose of the Study:
- To provide an overview of CSVD pathogenesis.
- To review clinical studies of key biomolecules involved in CSVD.
- To outline future directions for CSVD biomarker discovery and validation.
Main Methods:
- Review of pathophysiological processes in CSVD pathogenesis, including endothelial injury, neuroinflammation, oxidative stress, and cardiovascular dysfunction.
- Comprehensive review of clinical studies on biomolecules implicated in CSVD.
- Analysis of current trends and future prospects in CSVD biomarker research.
Main Results:
- CSVD pathogenesis involves endothelial dysfunction, neuroinflammation, oxidative stress, perivascular damage, and cardiovascular issues.
- Numerous biomolecules are implicated in these processes, with ongoing research into their diagnostic and prognostic value.
- Neuroimaging, while advanced, remains a barrier to widespread CSVD screening.
Conclusions:
- Developing accessible blood-based biomarkers for CSVD is a priority for early detection and risk stratification.
- Further research into CSVD pathogenesis and associated biomolecules is needed for clinical validation.
- Future efforts should focus on translating biomarker research into practical clinical tools for managing age-associated cerebrovascular disease.
Abstract:
Age-associated cerebral small vessel disease (CSVD) represents a clinically heterogenous condition, arising from diverse microvascular mechanisms. These lead to chronic cerebrovascular dysfunction and carry a substantial risk of subsequent stroke and vascular cognitive impairment in aging populations. Owing to advances in neuroimaging, in vivo visualization of cerebral vasculature abnormities and detection of CSVD, including lacunes, microinfarcts, microbleeds and white matter lesions, is now possible, but remains a resource-, skills- and time-intensive approach. As a result, there has been a recent proliferation of blood-based biomarker studies for CSVD aimed at developing accessible screening tools for early detection and risk stratification. However, a good understanding of the pathophysiological processes underpinning CSVD is needed to identify and assess clinically useful biomarkers. Here, we provide an overview of processes associated with CSVD pathogenesis, including endothelial injury and dysfunction, neuroinflammation, oxidative stress, perivascular neuronal damage as well as cardiovascular dysfunction. Then, we review clinical studies of the key biomolecules involved in the aforementioned processes. Lastly, we outline future trends and directions for CSVD biomarker discovery and clinical validation.
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