Cerebral small vessel disease: The impact of glymphopathy and sleep disorders.

IF 4.5 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Journal of Cerebral Blood Flow and Metabolism Pub Date : 2025-05-05 DOI:10.1177/0271678X251333933

Zaw Myo Hein, Che Mohd Nasril Che Mohd Nassir, Muhammad Danial Che Ramli, Usman Jaffer, Muhammad Zulfadli Mehat, Muzaimi Mustapha, Hafizah Abdul Hamid

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Abstract

The glymphatic system, a vital brain perivascular network for waste clearance, hinges on the functionality of the aquaporin 4 (AQP4) water channel. Alarmingly, AQP4 single nucleotide polymorphisms (SNPs) are linked to impaired glymphatic clearance, or glymphopathy, which contributes to sleep disturbances and various age-related neurodegenerative diseases. Despite the critical role of glymphopathy and sleep disturbances in cerebral small vessel disease (CSVD) - a silent precursor to age-related neurodegenerative disorders - their interplay remains underexplored. CSVD is a major cause of stroke and dementia, yet its pathogenesis is not fully understood. Emerging evidence implicates glymphopathy and sleep disorders as pivotal factors in age-related CSVD, exacerbating the condition by hindering waste removal and compromising blood-brain barrier (BBB) integrity. Advanced imaging techniques promise to enhance diagnosis and monitoring, while lifestyle modifications and personalised medicine present promising treatment avenues. This narrative review underscores the need for a multidisciplinary approach to understanding glymphopathy and sleep disorders in CSVD. By exploring their roles, emphasising the necessity for longitudinal studies, and discussing potential therapeutic interventions, this paper aims to pave the way for new research and therapeutic directions in CSVD management.

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脑血管疾病：淋巴病变与睡眠障碍的影响。

淋巴系统是一个重要的脑血管周围网络，用于废物清除，取决于水通道蛋白4 （AQP4）水通道的功能。令人担忧的是，AQP4单核苷酸多态性（snp）与淋巴清除受损或淋巴病变有关，这有助于睡眠障碍和各种与年龄相关的神经退行性疾病。尽管淋巴病变和睡眠障碍在脑血管病（CSVD）中起着关键作用（CSVD是与年龄相关的神经退行性疾病的无声前兆），但它们之间的相互作用仍未得到充分探讨。心血管疾病是中风和痴呆的主要原因，但其发病机制尚不完全清楚。新出现的证据表明，淋巴病变和睡眠障碍是年龄相关性CSVD的关键因素，它们通过阻碍废物清除和损害血脑屏障（BBB）完整性来加剧病情。先进的成像技术有望加强诊断和监测，而改变生活方式和个性化医疗则提供了有希望的治疗途径。这篇叙述性综述强调需要多学科方法来理解CSVD的淋巴病变和睡眠障碍。本文旨在通过探讨它们的作用，强调纵向研究的必要性，并讨论潜在的治疗干预措施，为CSVD管理的新研究和治疗方向铺平道路。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cerebral Blood Flow and Metabolism 医学-内分泌学与代谢

CiteScore

12.00

自引率

4.80%

发文量

300

审稿时长

3 months

期刊介绍： JCBFM is the official journal of the International Society for Cerebral Blood Flow & Metabolism, which is committed to publishing high quality, independently peer-reviewed research and review material. JCBFM stands at the interface between basic and clinical neurovascular research, and features timely and relevant research highlighting experimental, theoretical, and clinical aspects of brain circulation, metabolism and imaging. The journal is relevant to any physician or scientist with an interest in brain function, cerebrovascular disease, cerebral vascular regulation and brain metabolism, including neurologists, neurochemists, physiologists, pharmacologists, anesthesiologists, neuroradiologists, neurosurgeons, neuropathologists and neuroscientists.