摘要
脑小血管病是导致血管性痴呆最常见的疾病之一,其病因类型众多,高血压是其最常见的危险因素,常导致神经血管胶质单元受损而致病。CSVD导致认知功能障碍主要与大脑白质纤维破坏所致大脑网络连接出现中断和继发性皮质萎缩变薄有关,但近年来随着胶质淋巴系统发现,β淀粉样蛋白清除功能障碍导致其过度沉积有关而造成认知功能障碍,为其补充了新机制。胶质淋巴系统在夜间睡眠时清除功能达到巅峰,存在昼夜节律。关于CSVD与昼夜节律的相关性研究,目前已知CSVD患者普遍存在睡眠障碍的问题,是昼夜节律紊乱的具体表现之一,而且很容易被忽视,可导致胶质淋巴系统清除β淀粉样蛋白功能下降,加重患者的认知功能障碍。但对于胶质淋巴系统的昼夜节律紊乱与CSVD认知功能障碍的相关性尚缺乏深入的机制研究。本文对既往已经开展的睡眠节律紊乱、胶质淋巴系统功能障碍及其对CSVD认知功能障碍影响的相关研究进行综述。
Cerebral small vessel disease(CSVD)is a common cause of vascular dementia and has various etiolo-gies,among which hypertension is the most common risk factor and can induce the disease by damaging the neurovascular glial unit.The process of CSVD leading to cognitive impairment is mainly associated with the disruption of cerebral net-work connections due to the destruction of cerebral white matter fibers,as well as secondary cortical atrophy and thinning;however,with the discovery of the glymphatic system in recent years,cognitive impairment associated withβ-amyloid clearance dysfunction has been considered a new mechanism.The clearance function of the glymphatic system reaches the peak during sleep due to circadian rhythm.Previous studies on the association between CSVD and circadian rhythm have shown that CSVD patients often experience sleep disorders,which is a specific manifestation of circadian rhythm disor-ders.Such disorders are often neglected,which can lead to a reduction in the function of the glymphatic system inβ-amy-loid clearance,thereby aggravating cognitive impairment in patients.However,there is still a lack of in-depth studies on the association between the circadian rhythm disorders of the glymphatic system and cognitive impairment in CSVD.This article reviews the studies on sleep rhythm disorders,dysfunction of the glymphatic system,and their influence on cogni-tive impairment in CSVD.
作者
肖炽(综述)
范玉华(审校)
XIAO Chi;FAN Yuhua(Department of Neurology,The First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China)
出处
《中风与神经疾病杂志》
CAS
2024年第3期246-250,F0003,共6页
Journal of Apoplexy and Nervous Diseases
基金
国家自然科学基金面上项目(82071294)
广东省自然科学基金(2023A1515011013)。
