Welcome to Francis Academic Press

International Journal of Frontiers in Medicine, 2023, 5(7); doi: 10.25236/IJFM.2023.050715.

Cerebral microvascular disease and its associated cognitive dysfunction research progress


Peili Xu1, Yongmei Yan2

Corresponding Author:
Yongmei Yan

1Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, 712046, China

2Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, 712000, China


Cerebral small vessel disease is a kind of aging cerebral microvascular disease, accounting for 83.8% of all cerebrovascular diseases, and gradually become an important disease affecting human health. When cerebral small vascular disease is in the early stage, the damage to cognitive function is not obvious, and the onset is often hidden.With the further development of the disease, cognitive and behavioral dysfunction gradually appears, which can eventually cause dementia and seriously decline the quality of life of patients. Early diagnosis and intervention are of great value in controlling the cognitive impairment caused by CSVD and even preventing the occurrence of dementia. The potential benefits of TCM in the treatment of cognitive dysfunction in CSVD, which provides novel insights for the treatment of small cerebral vascular disease-related cognitive impairment. Integrated Traditional Chinese and Western medicine (TCM-WM) treatment is the trend in the development of the complementary benefits of TCM-WM treatment in the future.This article has reviewed the cognitive impairments associated with CSVD in order to provide a reference for clinical diagnosis and prevention of CSVD.


cerebral small vessel disease; cognitive dysfunction; traditional Chinese and western medicine; research progress

Cite This Paper

Peili Xu, Yongmei Yan. Cerebral microvascular disease and its associated cognitive dysfunction research progress. International Journal of Frontiers in Medicine (2023), Vol. 5, Issue 7: 93-100. https://doi.org/10.25236/IJFM.2023.050715.


[1] Wu S, Wu B, Liu M, et al. China Stroke Study Collaboration. Stroke in China: advances and challenges in epidemiology, prevention, and management. Lancet Neurol. 2019 Apr; 18(4): 394-405. 

[2] Thompson CS, Hakim AM. Living beyond our physiological means: small vessel disease of the brain is an expression of a systemic failure in arteriolar function: a unifying hypothesis[J]. Stroke, 2009, 40: e322-e330. 

[3] Panton L. Cerebral small vessel disease: from pathogenesis and clinical characteristicsto therapeutic challenges [J]. Lancet Neurol, 2010, 9 (7): 689-701. 

[4] Neurology Branch of Chinese Medical Association, Cerebrovascular Disease Group of Neurology Branch of Chinese Medical Association. Consensus on diagnosis and treatment of cerebral small vessel disease in China [J]. Chinese Journal of Neurology, 2015, 48 (10): 838-844. 

[5] Wardlaw JM, Smith EE, Biessel GJ, et al. Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration [J]. Lancet Neurol, 2013, 12(8): 822- 838. 

[6] Xuanting Li; Wenli Hu. Research progress in the association among imaging markers of cerebral small vessel disease [J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2021, 15(4): 218-221

[7] Barnes SR, Ng TS, Montagne A, Law M, Zlokovic BV, Jacobs RE. Optimal acquisition and modeling parameters for accurate assessment of low Ktrans blood-brain barrier permeability using dynamic contrast-enhanced MRI. Magn Reson Med. 2016 May; 75(5): 1967-77. 

[8] Hainsworth AH, Fisher MJ. A dysfunctional blood-brain barrier and cerebral small vessel disease. Neurology. 2017 Jan 31; 88(5): 420-421. 

[9] Muñoz Maniega S, Chappell FM, Valdés Hernández MC, Armitage PA, Makin SD, Heye AK, Thrippleton MJ, Sakka E, Shuler K, Dennis MS, Wardlaw JM. Integrity of normal-appearing white matter: Influence of age, visible lesion burden and hypertension in patients with small-vessel disease. J Cereb Blood Flow Metab. 2017 Feb; 37(2): 644-656. 

[10] Zhang CE, Wong SM, van de Haar HJ, Staals J, Jansen JF, Jeukens CR, Hofman PA, van Oostenbrugge RJ, Backes WH. Blood-brain barrier leakage is more widespread in patients with cerebral small vessel disease. Neurology. 2017 Jan 31; 88(5): 426-432. 

[11] Low A, Mak E, Rowe JB, Markus HS, O'Brien JT. Inflammation and cerebral small vessel disease: A systematic review. Ageing Res Rev. 2019 Aug; 53: 100916. 

[12] Wiseman SJ, Doubal FN, Chappell FM, Valdés-Hernández MC, Wang X, Rumley A, Lowe GD, Dennis MS, Wardlaw JM. Plasma Biomarkers of Inflammation, Endothelial Function and Hemostasis in Cerebral Small Vessel Disease. Cerebrovasc Dis. 2015; 40(3-4): 157-64. 

[13] Gu Yucheng, Xu Yun. Biomarkers of cerebral small vessel disease [J]. International Journal of Cerebrovascular Diseases, 2017, 25(3): 251-257. 

[14] Zhang Qiongyu, Dong Xiaoyu, Cheng Jianfei, etc. Analysis of Related Factors of Three Common Cerebrovascular Diseases [J]. Journal of Clinical Research, 2017, 34(3): 435-438. 

[15] Lohner V, Brookes RL, Hollocks MJ, et al. Apathy, but not depression, is associated with executive dysfunction in cerebral small vessel disease [J]. PLoS One, 2017, 12(5): e0176943. 

[16] Prins ND, Scheltens P. White matter hyperintensities, cognitive impairment and dementia: an update [J]. Nat Rev Neurol, 2015, 11(3): 157-165. 

[17] Makin SD, Turpin S, Dennis MS, et al. Cognitive impairment after lacunar stroke: systematic review and meta-analysis of incidence, prevalence and comparison with other stroke subtypes [J]. Neurol Neurosurg Psychiatry, 2013, 84(8): 893-900. 

[18] Spiers HJ, Maguire EA, Burgess N. Hippocampal amnesia [J]. Neurocase, 2001, 7(5): 357-382. 

[19] Biesbroek JM, Weaver NA, Hilal S, et al. Impact of strategically located white matter hyperintensities on cognition in memory clinicpatients with small vessel disease [J]. PLoS One, 2016, 11(11): e0166261. 

[20] Pantoni L, Basile AM, Romanelli M, et al. Abulia and cognitive impairment in two patients with capsular genuinfarct [J]. Acta Neurol Scand, 2001, 104(3): 185-190. 

[21] Parfenow V A, Ostroumova O D, Ostroumova T M, et al. Vascular cognitive impairment: pathophysio-logical mechanisms, insights into structural basis, and perspectives in specific treatments[J]. Neuropsychiatr Dis Treat, 2019, 15: 1381-1402. 

[22] Huang Yan, You Yong. Adavances in Small Vessel Disease and Cognitive Impairment [J]. Chinese Journal of Arterosclerosis, 2014, 0(2): 204-208. 

[23] Yang Na, Wang Jian. Cerebral microvascular disease and cognitive dysfunction [J]. Modern medicine and health, 2012, 28 (12): 1855-1857. 

[24] Roman GC, Kalaria RN. Vascular determinants of cholinergic deficits in Alzheimer disease and vascular dementia [J]. Neurobiol Aging, 2006, 27(12): 1769-1785. 

[25] Hairu R, Close JCT, Lord SR, et al. The association between white matter hyperintensity volume and cognitive/physical decline in older people with dementia: a one-year longitudinal study [J]. Aging Ment Health, 2021: 1-8. 

[26] Sivakumar L, Riaz P, Kate M, et al. White matter hyperintensity volume predicts persistent cognitive impairment in transient ischemic attack and minor stroke [J]. Stroke, 2017, 12(3): 264-272. 

[27] Filley CM. White Matter, Behavioral Neurology, and the Influence of Corticocentrism. Cogn Behav Neurol. 2022 Jun 1; 35(2): 147-152. 

[28] DE Groot JC, DE Leeuw FE, Oudkerk M, et al. Cerebral white matter lesions and subjective cognitive dysfunction: the Rotterdam scan study [J]. Ann Neurol, 2000, 47(2): 145-151. 

[29] Ye Hong, Li Fei, Pan Zhixin, et al. Imaging classification of cerebral small vessel disease and vascular cognitive impairment and related risk factors [J]. Guangdong Medical Science, 2016, 37 (11): 1687-1690. 

[30] Doubal FN, Maclullich AM, Ferguson KJ, etal. Enlarged perivascular spaces on MRI are a feature of cerebra small vessel disease [J] Stroke, 2010, 41(3): 450-454. 

[31] Arba F, Quinn TJ, Hankey GJ, et al. Enlarged perivascular spaces and cognitive impairment after stroke and transient ischemic attack[J]. Int J Stroke, 2018, 13(1) : 47-56. 

[32] Huang Shan, Zhang Min, Huang Kuan, et al. Analysis of the relationship between enlarged perivascular space and patients with mild cognitive impairment [J]. Chinese Journal of Cerebrovascular Diseases, 2020, 17(12): 726-733. 

[33] Li Xiangyu, Teng Zhenjie, Li Xiaosha, et al. The relationship between cognitive function and the enlargement of peripheral vascular space in patients with acute ischemic stroke [J]. Chinese Journal of Behavioral Medicine and Brain Science, 2020, 29(8): 736-740. 

[34] Ding J, Sigur-Dsson S, Jónsson P V, et al. Large perivascular spaces visible on magnetic resonance imaging, cerebral small vessel disease progression, and risk of dementia: the age, gene/environment susceptibility-Reyk-javik study[J]. JAMA Neurol, 2017, 74(9): 1105-1112

[35] Jiménez-Balado J, Riba-Llena I, Garde E, et al. Prevalence of hippocampal enlarged perivascular spaces in a sample of patients withhypertension and their relation with vascular risk factors and cognitive function [J]. Neurology Neurosurg Psychiatry, 2018, 89(6): 651-656. 

[36] Hansen T P, Cain J, Thomas O, et al. Dilated perivas-cular spaces in the basal ganglia are a biomarker of small-vessel disease in a very elderly population with dementia[J]. AJNR Am J Neuroradiol, 2015, 36(5): 893-898. 

[37] Vanveluw SJ, Biessels GJ, Klijn CJ, etal. Heterogeneoush is to pathology of cortical microbleeds in cerebral amyloid angiopathy [J]. Neurology, 2016, 86(12): 867-871. 

[38] Werring DJ, Cerebral microbleeds: Pathophy siology to clinical practice [M]. Cambridge: Cambridge university press, 2015: 79-125. 

[39] Van Nieuwenhuizen KM, Hendrikse J, Klijn CJM. New microbleed after blood-brain barrier leakage in intracerebral haemorrhage [J]. BMJ Case Rep. 2017 Apr 27. 

[40] Yang J, Lyu Y, Ma Y, et al. Relationship between cerebral microbleeds location and cognitive impairment in patients with ischemic cerebrovascular disease[J]. Neuro Report, 2018, 29(14): 1209- 1213. 

[41] Regg NM, Kim AE, Curol ME, etal. Incidental cerebral microbleeds and cerebralblood flow in elder individuals [J] JAMA Neurology, 2015, 72(9): 1021-1028. 

[42] Xueyuan L. A meta-analysis of association between cerebral microbleeds and cognitive impairment [J]. Medical Science Monitor, 2014, 20: 2189-2198. 

[43] Ding J, Sigursson S, Jónsson PV, etal. Space and location of cerebral microbleeds, cognitive decline and dementia in the community [J]. Neurology, 2017, 88(22): 2089-2097. 

[44] Li X, Shen M, Jin Y, et al. The effect of cerebral small vessel disease on the subtypes of mild cognitive impairment [J]. Front Psychiatry, 2021, 12: 685965. 

[45] Su N, Liang X, Zhai FF, et al. The consequence of cerebral small vessel disease: linking brain atrophy to motor impairment in the elderly [J]. Hum Brain Mapp, 2018, 39(11): 4452-4461. 

[46] Tuladhar AM, Reid AT, Shumskaya E, et al. Relationship between white matter hyperintensities, cortical thickness, and cognition [J]. Stroke, 2015, 46(2): 425-432. 

[47] Duering M, Righart R, Csanadi E, et al, Incident subcortical infarcts induce focal thinning in connected cortical regions [J]. Neurology, 2012, 79(20): 2025-2028.