Abstract
To be able to live a good, independent life cognitive functions need to be intact.
Dementia, stroke and neuropsychiatric disorders are the major disorders underlying
disability. Stroke is usually a consequence of an underlying vessel wall disease that
has lasted for a longer period. This vessel wall disease is commonly silent or without
prominent symptoms. Damage to the small penetrating arterioles of the brain, arteriolosclerosis,
induced by aging and hypertension, as well as other factors such as diabetes and genetic
vulnerability, plays an important role in the origin of white matter changes. The
pathological vascular wall process leads to lumen constriction, impaired ability to
change lumen diameter according to metabolic needs and possible ischemic–hypoxic tissue
damage in the vulnerable vascular architectural terminal areas of the long penetrating
arteries. The arteriolosclerotic blood vessels are associated with inflammation and
remodelling of the extracellular matrix. Enzymes connected to this process have also
been found to be involved in demyelination and blood brain barrier opening but also
in the repair process of angiogenesis and neurogenesis. Biochemical changes reflecting
these processes might be early indicators of small vessel disease and hence increase
the knowledge about the disease characteristic mechanisms. Moreover, monitoring disease
modifying treatment effects can be an important application for small vessel disease
specific biochemical markers.
Keywords
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Article info
Publication history
Published online: August 23, 2012
Accepted:
July 30,
2012
Received in revised form:
July 29,
2012
Received:
January 23,
2012
Identification
Copyright
© 2012 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
