25-Hydroxyvitamin D Status Is Associated With Chronic Cerebral Small Vessel Disease

Abstract

Background and Purpose-The aim of this study was to determine the association between 25-hydroxyvitamin D (25(OH) D) and neuroimaging correlates of cerebral small vessel disease. Methods-We identified 759 consecutive patients with acute ischemic stroke or transient ischemic attack. Lacunes, white matter hyperintensity, and cerebral microbleed (CMB) were assessed using MR images.

Vitamin D in Neurological Diseases: A Rationale for a Pathogenic Impact

“…Some studies link the vitamin defect to an increased risk of hypertension, diabetes, congestive heart failure, myocardial infarction and stroke [223]. Moreover, some very recent studies link it to small vessel disease and vascular dementia too [224][225][226]. Vitamin D receptors are hugely expressed by the endothelial cells and their activation induce the promotion towards maturation of immature cells, via VEGF [227].…”

“…All the effects of vitamin D on the vascular system link it to vascular dementia, in many different ways: epidemiological [225], based on vascular pressure control [228], based on biological properties of vitamin D, above described [194,237], or simply considering vitamin D deficiency as a risk-modifiable factor [201,223,230,[238][239]. It seems quite interesting that the three works which link vitamin D defect to small vessel disease-related dementia [224][225][226] stand on two biological axiomatic properties: the antioxidative capacity of vitamin D (therefore a loss of protection against ROS, whenever it lacks), and the control of smooth vessel, which is fundamental for auto-regulation in brain circulation. It is widely known that there is an excess of superoxide by NADPH oxidase in small vessel disease [240].…”

“…Authors hypothesize a common way of alteration, in the peripheral autonomous nervous system, which deteriorates small-bone vessels as well as brain vessels [248]. The first and the third study on the topic [225][226], starting from two different perspectives have some common points. Chung et al (225) demonstrate that vitamin D is inversely associated with lacunes, white matter hyperintensites and deep microbleeding, in profound white matter, not elsewhere, suggesting a high impact on small vessel disease.…”

Low Serum 25(OH)D Levels in Parkinson ’s Disease; a Non Specific Marker of Neurodegeneration?

“…There is strong evidence that vitamin D is involved in neuroprotection through various mechanisms: up-regulation of neurotrophic factors, antioxidative mechanisms, neuronal calcium regulation, nerve growth factor modulation [33][34][35][36][37], regulation of the toxicity of reactive oxygen species [38] and through immunomodulation and vasoprotection [7,10]. However, it is also possible that lower vitamin D levels could be a common factor in diseases that share neuro-inflammatory dysfunction as observed in MS.…”

“…Furthermore, growing evidence highlight the possible role of vitamin D in neuroprotection through neuronal calcium regulation, antioxidative pathway, immunomodulation and detoxification [5,6]. On the other hand, vitamin D deficiency may correlate with neuroinflammatoryautoimmune cascades, cerebrovascular lesions and, most recently, with neurodegenerative diseases [7][8][9][10][11].…”