How Does Cerebrovascular Dysfunction Lead to Cognitive Deficits?
Aging, AD, and hypertension are often associated with focal (lacunes) or diffuse (laukoaraiosis) white matter abnormalities, which can have a profound impact on the severity of dementia.9 The periventricular white matter and the white matter of the basal ganglia and centrum semiovale are particularly susceptible to damage by reduced cerebral perfusion. These regions are located at the border between different arterial territories and are prone to hypoperfusion.9,26 Moreover, in AD, aging, and hypertension, these brain regions exhibit marked capillary loss and an increase in microvascular tortuosity, changes that increase resistance to flow and reduce tissue perfusion.9 Therefore, subcortical white matter regions are highly vulnerable to injurious stimuli. These structural and functional cerebrovascular alterations are likely to have major impact also in brain regions primarily involved in cognition, such as the neocortex and the hippocampus. Reduced blood flow at rest and during activa
