Microvascular changes associated with epilepsy: A narrative review

R.H.G.J. van Lanen*, S. Melchers, G. Hoogland, O.E.M.G. Schijns, M.A.J. van Zandvoort, R.H.L. Haeren, K. Rijkers

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

4 Citations (Web of Science)

Abstract

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.
Original languageEnglish
Article numberARTN 0271678X211010388
Pages (from-to)2492-2509
Number of pages18
JournalJournal of Cerebral Blood Flow and Metabolism
Volume41
Issue number10
Early online date17 Apr 2021
DOIs
Publication statusPublished - Oct 2021

Keywords

  • Angiogenesis
  • epilepsy
  • microvascular density
  • temporal lobe epilepsy
  • vascular endothelial growth factor
  • BLOOD-BRAIN-BARRIER
  • ENDOTHELIAL GROWTH-FACTOR
  • HYPOXIA-INDUCIBLE FACTOR-1-ALPHA
  • STATUS EPILEPTICUS
  • HIPPOCAMPAL SCLEROSIS
  • VASCULAR CHANGES
  • PILOCARPINE MODEL
  • FACTOR VEGF
  • ANGIOGENESIS
  • EXPRESSION

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