诊断学理论与实践 ›› 2022, Vol. 21 ›› Issue (05): 644-649.doi: 10.16150/j.1671-2870.2022.05.018

• 综述 • 上一篇    下一篇

脑小血管疾病合并中枢神经系统退行性疾病机制的研究进展

武冬冬, 陈玉辉(), 刘芳, 刘银红(), 蒋景文   

  1. 北京医院保健医疗部神经内科 国家老年医学中心 中国医学科学院老年医学研究院,北京 100730
  • 收稿日期:2021-10-20 出版日期:2022-10-25 发布日期:2023-01-29
  • 通讯作者: 陈玉辉,刘银红 E-mail:cmucyh@163.com;liuyh302@126.com
  • 基金资助:
    北京医院121工程项目(BJ-2019-200)

Study progress on cerebral small vessel disease complicated with neurodegenerative disorders in central nervous system

WU Dongdong, CHEN Yuhui(), LIU Fang, LIU Yinhong(), JIANG Jingwen   

  1. Department of Medical Care, Department of Neurology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
  • Received:2021-10-20 Online:2022-10-25 Published:2023-01-29
  • Contact: CHEN Yuhui,LIU Yinhong E-mail:cmucyh@163.com;liuyh302@126.com

摘要:

脑小血管疾病(cerebral small vessel disease,CSVD)和中枢神经系统退行性疾病(如阿尔茨海默病、帕金森病和额颞叶变性等)的发病具有共同的分子基础和神经生物学机制,包括缺氧、血管内皮功能障碍、脑血管舒缩反应性受损和血脑屏障功能紊乱和胶质淋巴途径损伤等。中枢神经退行性疾病与CSVD合并发生时,患者常会呈现出与原有中枢神经退行性疾病不同的临床表型、疾病进程和结局。CSVD与神经退行性疾病(阿尔茨海默病、帕金森病及额颞叶变性)的病理及临床表现相关,脑脊液生物标志物对CSVD合并神经退行性疾病诊断具有一定价值。分子影像学标志物脑网络在全面研究CSVD与神经退行性疾病间关系中具有一定应用前景。聚焦于血管-神经-炎症模型的新治疗方法可能在未来中枢神经系统退行性疾病治疗中具有一定前景。

关键词: 脑小血管病, 阿尔茨海默病, 帕金森病, 生物标志物, 脑网络

Abstract:

There is a common molecular basis and neurobiological mechanism in the pathogenesis of cerebral small vessel disease (CSVD) and degenerative diseases in central nervous system (such as Alzheimer′s disease, Parkinson′s disease and frontotemporal degeneration), including hypoxia, vascular endothelial dysfunction, impairment of cerebrovascular vasomotor response, dysfunction of blood-brain barrier and impairment of glial lymphatic pathway. The CSVD patients complicated with the neurodegenerative diseases often show different clinical phenotypes, disease process and outcome from neurodegenerative diseases. The cerebrospinal fluid biomarkers show certain value in the diagnosis of CSVD complicated with neurodegenerative diseases. The brain network has a certain application prospect in comprehensive study of the relationship between CSVD and neurodegenerative diseases. In the future, the treatment of neurodegenerative diseases focusing on vascular neuroinflammatory model will show broad prospects.

Key words: Cerebral small vessel disease, Alzheimer′s disease, Parkinson′s disease, Biomarker, Brain network

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