Blood-Brain Barrier Dysfunction and the Potential Mechanisms in Chronic Cerebral Hypoperfusion Induced Cognitive Impairment

WenQing Xu; Qingke Bai; Qiang Dong; Min Guo; Mei Cui

doi:10.3389/fncel.2022.870674

Blood-Brain Barrier Dysfunction and the Potential Mechanisms in Chronic Cerebral Hypoperfusion Induced Cognitive Impairment

Front Cell Neurosci. 2022 Jun 16:16:870674. doi: 10.3389/fncel.2022.870674. eCollection 2022.

Authors

WenQing Xu¹, Qingke Bai², Qiang Dong³, Min Guo¹, Mei Cui¹

Affiliations

¹ Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
² Department of Neurology, Pudong People's Hospital, Shanghai, China.
³ State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.

Abstract

Chronic cerebral hypoperfusion (CCH) is a major cause of vascular cognitive impairment and dementia (VCID). Although the underlying mechanisms have not been fully elucidated, the emerging data suggest that blood-brain barrier (BBB) dysfunction is one of the pivotal pathological changes in CCH. BBB dysfunction appears early in CCH, contributing to the deterioration of white matter and the development of cognitive impairment. In this review, we summarize the latest experimental and clinical evidence implicating BBB disruption as a major cause of VCID. We discuss the mechanisms of BBB dysfunction in CCH, focusing on the cell interactions within the BBB, as well as the potential role of APOE genotype. In summary, we provide novel insights into the pathophysiological mechanisms underlying BBB dysfunction and the potential clinical benefits of therapeutic interventions targeting BBB in CCH.

Keywords: blood–brain barrier; chronic cerebral hypoperfusion; normal appearing white matter; vascular cognitive impairment and dementia; white matter hyperintensity.

Publication types

Review