Cerebral hemodynamics and vascular risk factors: setting the stage for Alzheimer's disease.

摘要: Considerable information is currently available from neuroimaging, pathological, and population-based prospective studies showing that vascular risk factors are independently associated with an increased of Alzheimer's disease (AD). Many these indicate can predict the clinical development cognitive dysfunction AD onset. This review examines role cerebral hemodynamics vasoactive molecules contribute to regulation perfusion how three common AD, namely, hypertension, diabetes type 2, atherosclerosis, alter blood flow (CBF) generate pressure deficits. It proposed (and presumably other factors) initiate chronic brain hypoperfusion ultimately impair signaling neurons, astrocytes, endothelial cells smooth muscle controlling vessel diameter. Impaired involving pathways in elderly attenuate tone deregulate CBF. Noxious hemodynamic responses partly explained by Poiseuille's Law which states miniscule changes diameter have a dramatic effect on resistance rate flow. Using model, even minor narrowing arteriolar lead major reductions CBF suboptimal delivery high energy nutrients brain, lethal consequences participate function. Regional cell loss sets stage for age-related impairment Keeping homeostasis careful management could be decisive therapeutic target prevention AD.