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Microvascular changes associated with epilepsy: A narrative review

Journal of Cerebral Blood Flow & Metabolism, 2021-10, Vol.41 (10), p.2492-2509 [Peer Reviewed Journal]

The Author(s) 2021 ;The Author(s) 2021 2021 International Society for Cerebral Blood Flow and Metabolism ;ISSN: 0271-678X ;EISSN: 1559-7016 ;DOI: 10.1177/0271678X211010388 ;PMID: 33866850

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  • Title:
    Microvascular changes associated with epilepsy: A narrative review
  • Author: van Lanen, Rick HGJ ; Melchers, Stan ; Hoogland, Govert ; Schijns, Olaf EMG ; Zandvoort, Marc AMJ van ; Haeren, Roel HL ; Rijkers, Kim
  • Subjects: Review
  • Is Part Of: Journal of Cerebral Blood Flow & Metabolism, 2021-10, Vol.41 (10), p.2492-2509
  • 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.
  • Publisher: London, England: SAGE Publications
  • Language: English
  • Identifier: ISSN: 0271-678X
    EISSN: 1559-7016
    DOI: 10.1177/0271678X211010388
    PMID: 33866850
  • Source: Sage Journals GOLD Open Access 2024
    Geneva Foundation Free Medical Journals at publisher websites
    PubMed Central
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