The Role of Venous Abnormalities in Neurological Disease

Haacke, E. Mark; Beggs, Clive; Habib, Charbel

doi:10.2174/157488712800100305

Cited by 26 publications

(24 citation statements)

References 127 publications

(200 reference statements)

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“…Several reviews [2] have evaluated clinical and structural factors in venous contributions to neurologic diseases. In addition to the inflammatory-based view of the pathogenesis of these demyelinating diseases, the past few years has witnessed the emergence of a controversial view about MS. Could neurological disease processes such as MS be triggered or intensified in part through venous vascular disturbances?…”

Section: Introductionmentioning

confidence: 99%

Venous endothelial injury in central nervous system diseases

Alexander

Prouty

Tsunoda

et al. 2013

BMC Med

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The role of the venous system in the pathogenesis of inflammatory neurological/neurodegenerative diseases remains largely unknown and underinvestigated. Aside from cerebral venous infarcts, thromboembolic events, and cerebrovascular bleeding, several inflammatory central nervous system (CNS) diseases, such as multiple sclerosis (MS), acute disseminated encephalomyelitis (ADEM), and optic neuritis, appear to be associated with venous vascular dysfunction, and the neuropathologic hallmark of these diseases is a perivenous, rather than arterial, lesion. Such findings raise fundamental questions about the nature of these diseases, such as the reasons why their pathognomonic lesions do not develop around the arteries and what exactly are the roles of cerebral venous inflammation in their pathogenesis. Apart from this inflammatory-based view, a new hypothesis with more focus on the hemodynamic features of the cerebral and extracerebral venous system suggests that MS pathophysiology might be associated with the venous system that drains the CNS. Such a hypothesis, if proven correct, opens new therapeutic windows in MS and other neuroinflammatory diseases. Here, we present a comprehensive review of the pathophysiology of MS, ADEM, pseudotumor cerebri, and optic neuritis, with an emphasis on the roles of venous vascular system programming and dysfunction in their pathogenesis. We consider the fundamental differences between arterial and venous endothelium, their dissimilar responses to inflammation, and the potential theoretical contributions of venous insufficiency in the pathogenesis of neurovascular diseases.

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Section: Introductionmentioning

confidence: 99%

Venous endothelial injury in central nervous system diseases

Alexander

Prouty

Tsunoda

et al. 2013

BMC Med

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“…It is therefore not known the extent to which left and right sidedness in JVR influences brain atrophy and further work will be required to evaluate this. Furthermore, there are other venous abnormalities associated with aging and other neurological disorders which we were not able to assess [9,27,40]. Nevertheless, our findings are novel and suggest that cerebral venous drainage impairment may influence the neuropsychology of AD.…”

Section: Discussionmentioning

confidence: 71%

Jugular venous reflux and brain parenchyma volumes in elderly patients with mild cognitive impairment and Alzheimer’s disease

et al. 2013

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BackgroundTo determine whether or not jugular venous reflux (JVR) is associated with structural brain parenchyma changes in individuals with mild cognitive impairment (MCI) and Alzheimer’s disease (AD).Methods16 AD patients (mean (SD): 81.9 (5.8) years), 33 MCI patients (mean (SD): 81.4 (6.1) years) and 18 healthy elderly controls (mean (SD): 81.5 (3.4) years) underwent duplex ultrasonography and magnetic resonance imaging scans to quantify structural brain parenchyma changes. Normalized whole brain (WB), gray matter (GM) and white matter (WM) volumes were collected, together with CSF volume.ResultsJVR was strongly associated with increased normalized WB (p = 0.014) and GM (p = 0.002) volumes across all three subject groups. There was a trend towards increased WB and GM volumes, which was accompanied by decreased CSF volume, in the JVR-positive subjects in both the MCI and AD groups. When the MCI and AD subjects were aggregated together significant increases were observed in both normalized WB (p = 0.009) and GM (p = 0.003) volumes for the JVR-positive group. No corresponding increases were observed for the JVR-positive subjects in the control group. Through receiver operating characteristic analysis of the brain volumetric data it was possible to discriminate between the JVR-positive and negative AD subjects with reasonable accuracy (sensitivity = 71.4%; specificity = 88.9%; p = 0.007).ConclusionsJVR is associated with intracranial structural changes in MCI and AD patients, which result in increased WB and GM volumes. The neuropathology of this unexpected and counterintuitive finding requires further investigation, but may suggest that JVR retrogradely transmits venous hypertension into the brain and leads to brain tissues swelling due to vasogenic edema.

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“…It is appropriate to point out that such pathologies, along with MS and others not included here, may be amenable to theoretical study through the use of mathematical models for the human circulation and use of common features such as fluid and solid mechanics, to better understand their underlying mechanisms and to design possible cures. The account of this section is by no means, exhaustive, see [59] and [8] for related information.…”

Section: Other Venous-related Neurological Diseasesmentioning

confidence: 99%

Brain venous haemodynamics, neurological diseases and mathematical modelling. A review

Toro

2016

Applied Mathematics and Computation

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The Role of Venous Abnormalities in Neurological Disease

Cited by 26 publications

References 127 publications

Venous endothelial injury in central nervous system diseases

Venous endothelial injury in central nervous system diseases

Jugular venous reflux and brain parenchyma volumes in elderly patients with mild cognitive impairment and Alzheimer’s disease

Brain venous haemodynamics, neurological diseases and mathematical modelling. A review

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