扩大的血管周围间隙发生机制及其与认知功能障碍的关系

The pathological mechanisms of enlarged perivascular space and its relationship with cognitive impairment

血管周围间隙(perivascular spaces,PVS)是大脑中小动脉、毛细血管和小静脉周围充满液体的间隙,是脑脊液和代谢产物的引流系统。磁共振成像(magnetic resonance imaging,MRI)上可见的扩大的血管周围间隙(enlarged perivascular spaces,EPVS),可能反应了脑血管周围脑脊液和代谢产物的清除功能障碍。既往研究表明,高血压性动脉硬化和脑淀粉样血管病变可能是驱动不同部位EPVS形成的主要机制。另外,不同部位的EPVS可能与不同类型的认知功能障碍相关。为加强广大研究者对EPVS的进一步理解和重视,本文将不同部位EPVS的发生机制及其与认知功能障碍的关系予以综述。

Perivascular spaces(PVS)are fluid-filled cavities that surround small arterioles,capillaries,and venules in the brain,which is a drainage system for cerebrospinal and brain metabolic products.The enlarged perivascular spaces(EPVS)are visible on magnetic resonance imaging scans,which may reflect impaired clearance of cerebrospinal fluid and metabolic products.Previous studies have suggested that hypertensive arteriopathy and cerebral amyloid angiopathy may drive the formation of EPVS in different brain areas.In addition,the association of EPVS with cognitive impairment may vary with brain regions.Therefore,this review focuses on the pathological mechanisms and cognitive outcomes of EPVS in different brain areas to strengthen researchers’further understanding and pay more attention to EPVS.