CEREBRAL PERFUSION IN CHRONIC BRAIN ISCHEMIA: CONTEMPORARY CONCEPTS OF PATHOGENESIS, NEUROIMAGING BIOMARKERS, AND VASCULAR COGNITIVE IMPAIRMENT
Keywords:
chronic cerebral ischemia, cerebral perfusion, vascular cognitive impairment, neuroimaging, ASL-MRI, microangiopathy, hypoperfusionAbstract
Chronic cerebral ischemia remains one of the leading problems in modern neurology due to the high prevalence of cerebrovascular pathology and associated cognitive impairment. In recent years, special attention has been paid to cerebral perfusion disorders as a key mechanism in the pathogenesis of chronic cerebral ischemia. Modern neuroimaging techniques allow assessment of cerebral blood flow, microcirculatory disturbances, and structural brain damage. The article reviews current concepts of cerebral hypoperfusion, endothelial dysfunction, neuroinflammation, and microangiopathy in the development of vascular cognitive impairment. The diagnostic value of MR perfusion imaging, arterial spin labeling MRI, CT perfusion, and other neuroimaging biomarkers is discussed.
References
Левин О.С. Ишемия головного мозга: патогенез и современные методы диагностики. — Москва: ГЭОТАР-Медиа, 2021. — 368 с.
Яхно Н.Н., Захаров В.В., Локшина А.Б. Сосудистые когнитивные расстройства // Неврологический журнал. — 2021. — Т. 26, №2.— С. 4–12.
Wardlaw J.M., Smith C., Dichgans M. Small vessel disease mechanisms and clinical implications // Lancet Neurology. — 2019. — Vol. 18.— P. 684–696.
Iadecola C. The pathobiology of vascular dementia // Neuron. — 2013. — Vol. 80. — P. 844–866.
Liu Q., Zhang X. Neuroimaging in vascular cognitive impairment // Frontiers in Aging Neuroscience. — 2023. — Vol. 15. — P. 1073039.
Huang D., Guan X. Advances in arterial spin labeling MRI // Journal of Cerebral Blood Flow & Metabolism. — 2023. — Vol. 43. — P. 173–184.
Гусев Е.И., Скворцова В.И. Современные представления о хронической ишемии мозга // Consilium Medicum. — 2022. — Т.24, №3.— С. 45–51.
Faraco G., Iadecola C. Hypertension and endothelial dysfunction // Circulation Research. — 2020. — Vol. 126. — P. 102–121.
Rathore S., Tong B. Cerebral microbleeds and cognitive decline // Journal of Neurology. — 2024. — Vol. 271. — P. 4550–4561.
Sweeney M.D., Kisler K. The role of the neurovascular unit // Nature Neuroscience. — 2019. — Vol. 22. — P. 1318–1331.
Montagne A., Nation D.A. Blood-brain barrier dysfunction in aging // Neuron. — 2020. — Vol. 107. — P. 34–52.
Toda N., Ayajiki K. Cerebral blood flow regulation by nitric oxide // Pharmacological Reviews. — 2009. — Vol. 61. — P. 62–97.
O’Sullivan M. Leukoaraiosis and disconnection syndrome // Stroke. — 2008. — Vol. 39. — P. 211–214.
Ferreira R., Bastos-Leite A.J. ASL-MRI in neurocognitive disorders // Neuroradiology. — 2024. — Vol. 66. — P. 1065–1081.
Suchońska B., Moryś J. Perfusion MRI in cerebrovascular disease // Neuroradiology. — 2024. — Vol. 66. — P. 305–315.
Catchlove S.J., Pipingas A. Cerebrovascular reactivity and cognition // BMC Neuroscience. — 2018. — Vol. 19. — P. 21.
Zeng X., Li Y. Artificial intelligence in neuroimaging // NeuroImage. — 2025. — Vol. 301. — P. 120921.
Skrobot O.A., Black S.E. Progress toward standardized diagnosis of vascular cognitive impairment // International Journal of Stroke. — 2018. — Vol. 13. — P. 46–63.
Attems J., Jellinger K.A. Mixed dementia // Acta Neuropathologica. — 2014. — Vol. 127. — P. 361–378.
de la Torre J.C. Cerebral hypoperfusion and Alzheimer disease // Journal of Alzheimer’s Disease. — 2018. — Vol. 62. — P. 1325–1337.
Smith E.E., Markus H.S. New treatment approaches in cerebral small vessel disease // Stroke. — 2020. — Vol. 51. — P. 38–46.
