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Invited Review: The spectrum of age-related small vessel diseases: potential overlap and interactions of amyloid and nonamyloid vasculopathies

Invited Review: The spectrum of age-related small vessel diseases: potential overlap and interactions of amyloid and nonamyloid vasculopathies
Invited Review: The spectrum of age-related small vessel diseases: potential overlap and interactions of amyloid and nonamyloid vasculopathies

Deep perforator arteriopathy (DPA) and cerebral amyloid angiopathy (CAA) are the commonest known cerebral small vessel diseases (CSVD), which cause ischaemic stroke, intracebral haemorrhage (ICH) and vascular cognitive impairment (VCI). While thus far mainly considered as separate entities, we here propose that DPA and CAA share similarities, overlap and interact, so that ‘pure’ DPA or CAA are extremes along a continuum of age-related small vessel pathologies. We suggest blood-brain barrier (BBB) breakdown, endothelial damage and impaired perivascular β-amyloid (Aβ) drainage are hallmark common mechanisms connecting DPA and CAA. We also suggest a need for new biomarkers (e.g. high-resolution imaging) to deepen understanding of the complex relationships between DPA and CAA.

blood-brain barrier, cerebral amyloid angiopathy, cerebral small vessel diseases, deep perforator arteriopathy, hypertensive arteriopathy, β-amyloid drainage
0305-1846
Schreiber, S.
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Wilisch-Neumann, A.
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Schreiber, F.
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Assmann, A.
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Scheumann, V.
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Perosa, V.
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Jandke, S.
93edb572-ac6a-4696-9a56-e5b464bb40d5
Mawrin, C.
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Carare, R. O.
0478c197-b0c1-4206-acae-54e88c8f21fa
Werring, D. J.
0caabc8a-8597-4f08-9189-e8a6e6a213a6
Schreiber, S.
fe66208f-fd30-4f46-9acc-b7c6268df75b
Wilisch-Neumann, A.
6002e1dc-9ce0-4789-a4e9-4c87189f33a9
Schreiber, F.
bd04e7b2-fb42-468c-a09c-11729bb0cc38
Assmann, A.
629ff673-3688-4d2a-94b0-e6373903a096
Scheumann, V.
7d10942c-4151-47f8-a6e1-3e083c6f506e
Perosa, V.
9ce42abe-58b9-4eb2-8c47-36c9979e868d
Jandke, S.
93edb572-ac6a-4696-9a56-e5b464bb40d5
Mawrin, C.
e570b7ab-95bd-4d99-bc53-43427379771b
Carare, R. O.
0478c197-b0c1-4206-acae-54e88c8f21fa
Werring, D. J.
0caabc8a-8597-4f08-9189-e8a6e6a213a6

Schreiber, S., Wilisch-Neumann, A., Schreiber, F., Assmann, A., Scheumann, V., Perosa, V., Jandke, S., Mawrin, C., Carare, R. O. and Werring, D. J. (2019) Invited Review: The spectrum of age-related small vessel diseases: potential overlap and interactions of amyloid and nonamyloid vasculopathies. Neuropathology and Applied Neurobiology. (doi:10.1111/nan.12576).

Record type: Review

Abstract

Deep perforator arteriopathy (DPA) and cerebral amyloid angiopathy (CAA) are the commonest known cerebral small vessel diseases (CSVD), which cause ischaemic stroke, intracebral haemorrhage (ICH) and vascular cognitive impairment (VCI). While thus far mainly considered as separate entities, we here propose that DPA and CAA share similarities, overlap and interact, so that ‘pure’ DPA or CAA are extremes along a continuum of age-related small vessel pathologies. We suggest blood-brain barrier (BBB) breakdown, endothelial damage and impaired perivascular β-amyloid (Aβ) drainage are hallmark common mechanisms connecting DPA and CAA. We also suggest a need for new biomarkers (e.g. high-resolution imaging) to deepen understanding of the complex relationships between DPA and CAA.

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Schreiber_et_al-2019-Neuropathology_and_Applied_Neurobiology - Version of Record
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Accepted/In Press date: 11 July 2019
e-pub ahead of print date: 6 August 2019
Keywords: blood-brain barrier, cerebral amyloid angiopathy, cerebral small vessel diseases, deep perforator arteriopathy, hypertensive arteriopathy, β-amyloid drainage

Identifiers

Local EPrints ID: 434574
URI: http://eprints.soton.ac.uk/id/eprint/434574
ISSN: 0305-1846
PURE UUID: 7f2cc367-f431-4195-abf0-1654c231585c
ORCID for R. O. Carare: ORCID iD orcid.org/0000-0001-6458-3776

Catalogue record

Date deposited: 02 Oct 2019 16:30
Last modified: 26 Nov 2021 02:42

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Contributors

Author: S. Schreiber
Author: A. Wilisch-Neumann
Author: F. Schreiber
Author: A. Assmann
Author: V. Scheumann
Author: V. Perosa
Author: S. Jandke
Author: C. Mawrin
Author: R. O. Carare ORCID iD
Author: D. J. Werring

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