Top Things to Know: The Neurovasculome: Roles in brain health and cognitive impairment
Published: April 03, 2023
Prepared by Anne Leonard MPH, BSN, RN – National Senior Director
- Dementia is one of the world’s largest public health problems. In the United States, more than 500,000 persons are diagnosed with dementia each year. Moer than 1.3% of the U.S. population is currently living with dementia.
- The costs for providing care for persons with dementia is enormous, exceeding those for cardiovascular disease or cancer.
- Advances in neurovascular biology have revealed an intricate relationship between brain cells, meninges, and the hematic and lymphatic vasculature (the neurovasculome), which is showing to be highly relevant to the maintenance of cognitive function.
- The term neurovasculome in this statement refers to the entire extra- (aortic arch to base of the skull) and intra-cranial vasculature and associated cells pertaining to skull, brain, and meninges (arteries, capillaries, veins, and lymphatics). The neurovascular unit (NVU) refers to the specific neurovascular associations occurring at each segment of the neurovasculome. The neurovasculome is constituted by multiple NVUs that vary by cell type composition depending on the specific vascular segment.
- Improved cardiovascular health has been shown to correlate with improved brain health and reduced incidence of dementia later in life. With this, the relationship between the neurovasculature and brain health has been identified.
- The neurovasculome, comprised of extra-cranial, intra-cranial, and meningeal vessels, as well as lymphatics and associated cells, subserves critical homeostatic functions vital for brain health.
- These include not only delivering oxygen and nutrients through blood flow, but also regulating immune trafficking, as well as clearance of pathogenic proteins through perivascular spaces and dural lymphatics.
- Singe-cell omics technologies have unveiled an unprecedented molecular heterogeneity in the cellular components of the neurovasculome and have identified novel reciprocal interactions with brain cells.
- Evidence suggests a previously unappreciated diversity of the pathogenic mechanisms by which disruption of the neurovasculome contributes to cognitive dysfunction in neurovascular and neurodegenerative diseases, providing new opportunities for prevention, recognition and treatment of these conditions.
- This scientific statements shows us that the advances in the study of the neurovasculome sheds light on the symbiotic relationship between the brain and its vessels, and promise to provide new diagnostic and therapeutic approaches for brain disorders associated with cognitive dysfunction.
Citation
Iadecola C, Smith EE, Anrather J, Gu C, Mishra A, Misra S, Perez-Pinzon MA, Shih AY, Sorond FA, van Veluw SJ, Wellington CL; on behalf of the American
Heart Association Stroke Council; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular Radiology and Intervention; Council on Hypertension; and Council on Lifestyle and Cardiometabolic Health. The neurovasculome: key roles in brain health and cognitive impairment: a scientific statement from the American Heart Association/American Stroke Association [published online ahead of print April 3, 2023]. Stroke. doi: 10.1161/STR.0000000000000431