Perivascular spaces in the brain: anatomy, physiology and pathology.,Nature Reviews Neurology

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Perivascular spaces in the brain: anatomy, physiology and pathology.
Nature Reviews Neurology ( IF 28.2 ) Pub Date : 2020-02-24 , DOI: 10.1038/s41582-020-0312-z
Joanna M Wardlaw ₁ , Helene Benveniste ₂ , Maiken Nedergaard _{3,

4} , Berislav V Zlokovic _{5,

6} , Humberto Mestre ₄ , Hedok Lee ₂ , Fergus N Doubal ₁ , Rosalind Brown ₁ , Joel Ramirez _{7,

8,

9} , Bradley J MacIntosh _{8,

10} , Allen Tannenbaum ₁₁ , Lucia Ballerini ₁ , Ravi L Rungta ₁₂ , Davide Boido ₁₂ , Melanie Sweeney _{5,

6} , Axel Montagne _{5,

6} , Serge Charpak ₁₂ , Anne Joutel ₁₃ , Kenneth J Smith ₁₄ , Sandra E Black _{7,

8,

9} ,

Affiliation

Centre for Clinical Brain Sciences, UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK.
Department of Anesthesiology, Yale School of Medicine, New Haven, CT, USA.
Section for Translational Neuroscience, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Division of Glial Disease and Therapeutics, Center for Translational Neuromedicine, University of Rochester Medical Center, Rochester, NY, USA.
Department of Physiology and Neuroscience, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
LC Campbell Cognitive Neurology Research Unit, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.
Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.
Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Department of Applied Mathematics and Statistics and Department of Computer Science, Stony Brook University, Stony Brook, NY, USA.
INSERM U1128, Laboratory of Neurophysiology and New Microscopies, Université Paris Descartes, Paris, France.
Institute of Psychiatry and Neurosciences of Paris, Paris University, Paris, France.
Department of Neuroinflammation, UCL Queen Square Institute of Neurology, London, UK.

Perivascular spaces include a variety of passageways around arterioles, capillaries and venules in the brain, along which a range of substances can move. Although perivascular spaces were first identified over 150 years ago, they have come to prominence recently owing to advances in knowledge of their roles in clearance of interstitial fluid and waste from the brain, particularly during sleep, and in the pathogenesis of small vessel disease, Alzheimer disease and other neurodegenerative and inflammatory disorders. Experimental advances have facilitated in vivo studies of perivascular space function in intact rodent models during wakefulness and sleep, and MRI in humans has enabled perivascular space morphology to be related to cognitive function, vascular risk factors, vascular and neurodegenerative brain lesions, sleep patterns and cerebral haemodynamics. Many questions about perivascular spaces remain, but what is now clear is that normal perivascular space function is important for maintaining brain health. Here, we review perivascular space anatomy, physiology and pathology, particularly as seen with MRI in humans, and consider translation from models to humans to highlight knowns, unknowns, controversies and clinical relevance.

中文翻译：

大脑中的血管周围空间：解剖学、生理学和病理学。

血管周围空间包括大脑中小动脉、毛细血管和小静脉周围的各种通道，一系列物质可以沿着这些通道移动。尽管血管周围空间在 150 多年前首次被发现，但由于人们对它们在清除脑间质液和废物中的作用（特别是在睡眠期间）以及在小血管疾病阿尔茨海默病的发病机制中的作用认识的进步，它们最近变得突出疾病和其他神经退行性和炎症性疾病。实验进展促进了在清醒和睡眠期间完整啮齿动物模型中血管周围空间功能的体内研究，人类的 MRI 使血管周围空间形态与认知功能、血管危险因素、血管和神经退行性脑损伤相关，睡眠模式和脑血流动力学。关于血管周围空间的许多问题仍然存在，但现在很清楚的是，正常的血管周围空间功能对于维持大脑健康很重要。在这里，我们回顾了血管周围空间的解剖学、生理学和病理学，特别是在人类 MRI 中所见，并考虑从模型到人类的转换，以突出已知、未知、争议和临床相关性。

更新日期：2020-02-24

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