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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...

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Autores principales: van Lanen, Rick HGJ, Melchers, Stan, Hoogland, Govert, Schijns, Olaf EMG, van Zandvoort, Marc AMJ, Haeren, Roel HL, Rijkers, Kim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
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.
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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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