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Vascular Plasticity and Cognition During Normal Aging and Dementia

Axel Montagne, PhD1; Judy Pa, PhD2; Berislav V. Zlokovic, MD, PhD1
[+] Author Affiliations
1Zilkha Neurogenetic Institute, Department of Physiology and Biophysics, Keck School of Medicine, University of Southern California, Los Angeles
2Institute for Neuroimaging and Informatics, Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles
JAMA Neurol. 2015;72(5):495-496. doi:10.1001/jamaneurol.2014.4636.
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This Viewpoint discusses the role the hippocampus may play in dementia.

Functional neurovascular changes reflecting alterations in brain function and cognition and/or originating primarily from abnormalities localized to the cerebrovascular system have been described in many neurological disorders and during normal brain aging. However, the relationship between vascular and neuronal dysfunction, and how they relate to each other and contribute to cognitive impairment and dementia due to Alzheimer disease (AD), vascular cognitive impairment and dementia (VCID), and/or other neurological disorders, still remains controversial.1,2 An obvious place to look for neurovascular and cognitive changes is in the hippocampus, a region involved with learning and memory that is particularly susceptible to changes in oxygen and blood supply and is damaged early in AD.

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Figure.
Modern Neuroimaging Techniques and Insights Into the Vascular and Neural Plasticity of the Hippocampus in Aging and Disease

Imaging vascular and neuronal functions in the living human brain in the hippocampus during normal aging, mild cognitive impairment, dementia due to Alzheimer disease (AD) and related disorders, and vascular cognitive impairment and dementia. Lifestyle can modify the effects of genetic, vascular, and environmental risk factors, which can impact vascular health and neuronal function. ApoE4 indicates apolipoprotein E4 allele; ASL, arterial spin labeling; BBB, blood-brain barrier; BOLD, blood oxygen level–dependent; CA1, cornu ammonis 1; CBV, cerebral blood volume; DCE, dynamic contrast enhanced; DG, dentate gyrus; DTI, diffusion tensor imaging; fMRI, functional magnetic resonance imaging; ModBent, modified Benton Visual Retention Test; MRI, magnetic resonance imaging; and PS1, presenilin 1.

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