Age-related small vessel disease: A potential contributor to neurodegeneration in multiple sclerosis

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disorder of the central nervous system wherein, after an initial phase of transient neurological defects, slow neurological deterioration due to progressive neuronal loss ensues. Age is a major determinant of MS progression onset and di...

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Main Authors: Geraldes, R, Esiri, M, DeLuca, G, Palace, J
Format: Journal article
Language:English
Published: Wiley 2016
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author Geraldes, R
Esiri, M
DeLuca, G
Palace, J
author_facet Geraldes, R
Esiri, M
DeLuca, G
Palace, J
author_sort Geraldes, R
collection OXFORD
description Multiple sclerosis (MS) is a chronic inflammatory demyelinating disorder of the central nervous system wherein, after an initial phase of transient neurological defects, slow neurological deterioration due to progressive neuronal loss ensues. Age is a major determinant of MS progression onset and disability. Over the past years, several mechanisms have been proposed to explain the key drivers of neurodegeneration and disability accumulation in MS. However, the effect of commonly encountered age-related cerebral vessel disease, namely small vessel disease (SVD), has been largely neglected and constitutes the aim of this review. SVD shares some features with MS, i.e. white matter demyelination and brain atrophy, and has been shown to contribute to the neuronal damage seen in vascular cognitive impairment. Several lines of evidence suggest that an interaction between MS and SVD may influence MS-related neurodegeneration. SVD may contribute to hypoperfusion, reduced vascular reactivity and tissue hypoxia, features seen in MS. Venule and endothelium abnormalities have been documented in MS but the role of arterioles and of other neurovascular unit structures, such as the pericyte, have not been explored. Vascular risk factors (VRF) have recently been associated with faster progression in MS though the mechanisms are unclear since very few studies have addressed the impact of VRF and SVD on MS imaging and pathology outcomes. Therapeutic agents targeting the microvasculature and the neurovascular unit may impact both SVD and MS and may benefit patients with dual pathology. This article is protected by copyright. All rights reserved.
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spelling oxford-uuid:ed9bf91a-6355-4003-b8e8-24a88e3bf93e2022-03-27T11:26:30ZAge-related small vessel disease: A potential contributor to neurodegeneration in multiple sclerosisJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:ed9bf91a-6355-4003-b8e8-24a88e3bf93eEnglishSymplectic Elements at OxfordWiley2016Geraldes, REsiri, MDeLuca, GPalace, JMultiple sclerosis (MS) is a chronic inflammatory demyelinating disorder of the central nervous system wherein, after an initial phase of transient neurological defects, slow neurological deterioration due to progressive neuronal loss ensues. Age is a major determinant of MS progression onset and disability. Over the past years, several mechanisms have been proposed to explain the key drivers of neurodegeneration and disability accumulation in MS. However, the effect of commonly encountered age-related cerebral vessel disease, namely small vessel disease (SVD), has been largely neglected and constitutes the aim of this review. SVD shares some features with MS, i.e. white matter demyelination and brain atrophy, and has been shown to contribute to the neuronal damage seen in vascular cognitive impairment. Several lines of evidence suggest that an interaction between MS and SVD may influence MS-related neurodegeneration. SVD may contribute to hypoperfusion, reduced vascular reactivity and tissue hypoxia, features seen in MS. Venule and endothelium abnormalities have been documented in MS but the role of arterioles and of other neurovascular unit structures, such as the pericyte, have not been explored. Vascular risk factors (VRF) have recently been associated with faster progression in MS though the mechanisms are unclear since very few studies have addressed the impact of VRF and SVD on MS imaging and pathology outcomes. Therapeutic agents targeting the microvasculature and the neurovascular unit may impact both SVD and MS and may benefit patients with dual pathology. This article is protected by copyright. All rights reserved.
spellingShingle Geraldes, R
Esiri, M
DeLuca, G
Palace, J
Age-related small vessel disease: A potential contributor to neurodegeneration in multiple sclerosis
title Age-related small vessel disease: A potential contributor to neurodegeneration in multiple sclerosis
title_full Age-related small vessel disease: A potential contributor to neurodegeneration in multiple sclerosis
title_fullStr Age-related small vessel disease: A potential contributor to neurodegeneration in multiple sclerosis
title_full_unstemmed Age-related small vessel disease: A potential contributor to neurodegeneration in multiple sclerosis
title_short Age-related small vessel disease: A potential contributor to neurodegeneration in multiple sclerosis
title_sort age related small vessel disease a potential contributor to neurodegeneration in multiple sclerosis
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