Vascular changes in Iowa-type hereditary cerebral amyloid angiopathy.
Vascular dysfunction due to cerebral amyloid angiopathy (CAA) may contribute to cognitive impairment. The Iowa D694N amyloid precursor protein mutation, a recently identified cause of hereditary CAA with dementia, offers an opportunity to explore the anatomic basis of CAA-related vascular dysfunction. Examination by immunolabeling and confocal microscopy demonstrated extensive loss of smooth muscle cells in affected segments as well as a perivascular inflammatory reaction of astrocytes and microglia. On 3-D reconstruction, vessels appeared tortuous with twiglike projections that may represent areas of vascular degeneration. The observed changes in the Iowa brain suggest pathophysiologic mechanisms for vascular dysfunction in CAA and possible approaches to treatment of CAA-related cognitive impairment.
Shin
Youngah
Y
Department of Neurology, Alzheimer Research Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Cho
Hyun Soon
HS
Rebeck
G William
GW
Greenberg
Steven M
SM
D028243:Cerebral Amyloid Angiopathy, Familial / Q000473:pathology*; D006801:Humans; D007484:Iowa; D008833:Microcirculation / Q000473:pathology / Q000648:ultrastructure; D009131:Muscle, Smooth, Vascular / Q000473:pathology*; D013702:Temporal Lobe / Q000098:blood supply* / Q000473:pathology