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Microvascular changes associated with epilepsy: A narrative review
The blood-brain barrier (BBB) is dysfunctional in temporal lobe epilepsy (TLE). In this regard, microvascular changes are likely present. The aim of this review is to provide an overview of the current knowledge on microvascular changes in epilepsy, and includes clinical and preclinical evidence of...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8504411/ https://www.ncbi.nlm.nih.gov/pubmed/33866850 http://dx.doi.org/10.1177/0271678X211010388 |
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author | van Lanen, Rick HGJ Melchers, Stan Hoogland, Govert Schijns, Olaf EMG van Zandvoort, Marc AMJ Haeren, Roel HL Rijkers, Kim |
author_facet | van Lanen, Rick HGJ Melchers, Stan Hoogland, Govert Schijns, Olaf EMG van Zandvoort, Marc AMJ Haeren, Roel HL Rijkers, Kim |
author_sort | van Lanen, Rick HGJ |
collection | PubMed |
description | The blood-brain barrier (BBB) is dysfunctional in temporal lobe epilepsy (TLE). In this regard, microvascular changes are likely present. The aim of this review is to provide an overview of the current knowledge on microvascular changes in epilepsy, and includes clinical and preclinical evidence of seizure induced angiogenesis, barriergenesis and microcirculatory alterations. Anatomical studies show increased microvascular density in the hippocampus, amygdala, and neocortex accompanied by BBB leakage in various rodent epilepsy models. In human TLE, a decrease in afferent vessels, morphologically abnormal vessels, and an increase in endothelial basement membranes have been observed. Both clinical and experimental evidence suggests that basement membrane changes, such as string vessels and protrusions, indicate and visualize a misbalance between endothelial cell proliferation and barriergenesis. Vascular endothelial growth factor (VEGF) appears to play a crucial role. Following an altered vascular anatomy, its physiological functioning is affected as expressed by neurovascular decoupling that subsequently leads to hypoperfusion, disrupted parenchymal homeostasis and potentially to seizures”. Thus, epilepsy might be a condition characterized by disturbed cerebral microvasculature in which VEGF plays a pivotal role. Additional physiological data from patients is however required to validate findings from models and histological studies on patient biopsies. |
format | Online Article Text |
id | pubmed-8504411 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-85044112021-10-12 Microvascular changes associated with epilepsy: A narrative review van Lanen, Rick HGJ Melchers, Stan Hoogland, Govert Schijns, Olaf EMG van Zandvoort, Marc AMJ Haeren, Roel HL Rijkers, Kim J Cereb Blood Flow Metab Review Articles The blood-brain barrier (BBB) is dysfunctional in temporal lobe epilepsy (TLE). In this regard, microvascular changes are likely present. The aim of this review is to provide an overview of the current knowledge on microvascular changes in epilepsy, and includes clinical and preclinical evidence of seizure induced angiogenesis, barriergenesis and microcirculatory alterations. Anatomical studies show increased microvascular density in the hippocampus, amygdala, and neocortex accompanied by BBB leakage in various rodent epilepsy models. In human TLE, a decrease in afferent vessels, morphologically abnormal vessels, and an increase in endothelial basement membranes have been observed. Both clinical and experimental evidence suggests that basement membrane changes, such as string vessels and protrusions, indicate and visualize a misbalance between endothelial cell proliferation and barriergenesis. Vascular endothelial growth factor (VEGF) appears to play a crucial role. Following an altered vascular anatomy, its physiological functioning is affected as expressed by neurovascular decoupling that subsequently leads to hypoperfusion, disrupted parenchymal homeostasis and potentially to seizures”. Thus, epilepsy might be a condition characterized by disturbed cerebral microvasculature in which VEGF plays a pivotal role. Additional physiological data from patients is however required to validate findings from models and histological studies on patient biopsies. SAGE Publications 2021-04-17 2021-10 /pmc/articles/PMC8504411/ /pubmed/33866850 http://dx.doi.org/10.1177/0271678X211010388 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Review Articles van Lanen, Rick HGJ Melchers, Stan Hoogland, Govert Schijns, Olaf EMG van Zandvoort, Marc AMJ Haeren, Roel HL Rijkers, Kim Microvascular changes associated with epilepsy: A narrative review |
title | Microvascular changes associated with epilepsy: A narrative review |
title_full | Microvascular changes associated with epilepsy: A narrative review |
title_fullStr | Microvascular changes associated with epilepsy: A narrative review |
title_full_unstemmed | Microvascular changes associated with epilepsy: A narrative review |
title_short | Microvascular changes associated with epilepsy: A narrative review |
title_sort | microvascular changes associated with epilepsy: a narrative review |
topic | Review Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8504411/ https://www.ncbi.nlm.nih.gov/pubmed/33866850 http://dx.doi.org/10.1177/0271678X211010388 |
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