{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:33:44Z","timestamp":1740126824995,"version":"3.37.3"},"reference-count":52,"publisher":"Georg Thieme Verlag KG","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Fortschr Neurol Psychiatr"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Die sporadische zerebrale Mikroangiopathie umfasst altersabh\u00e4ngige\n                    Ver\u00e4nderungen der kleinen Hirngef\u00e4\u00dfe, die durch das\n                    Vorliegen vaskul\u00e4rer Risikofaktoren beschleunigt werden. Die\n                    mikrovaskul\u00e4ren Wandver\u00e4nderungen entwickeln sich eher langsam,\n                    mit m\u00f6glichem Beginn bereits in der mittleren Lebensphase \u2013\n                    \u00fcber Dekaden \u2013 und zeigen einen stadienhaften Verlauf. Dieser\n                    wird durch eine Aktivierung von Zellen der neurovaskul\u00e4ren Einheit, wie\n                    Endothel und Perizyten, induziert und setzt sich dann \u00fcber eine\n                    Blut-Hirn-Schranken-St\u00f6rung, den Umbau der extrazellul\u00e4ren\n                    Matrix und Neuroinflammation zu den Sp\u00e4tstadien aus Blutungen,\n                    synaptischer und neuronaler Dysfunktion fort. Begleitend kommt es bereits\n                    fr\u00fch zu St\u00f6rungen der perivaskul\u00e4ren Drainage von\n                    neurotoxischen Substanzen und deren Akkumulation im Hirngewebe. Die Diagnose der\n                    Mikroangiopathie erfolgt allgemein im Wesentlichen anhand der \u201cStandards\n                    for Reporting Vascular Changes on Neuroimaging 2\u201d in der\n                    Magnetresonanztomographie, und die der zerebralen Amyloidangiopathie im\n                    Speziellen anhand der neuen Boston-Version-2.0 Kriterien. Klinisch kann die\n                    Mikroangiopathie asymptomatisch verlaufen oder sich in einem sehr heterogenen\n                    ph\u00e4notypischen Spektrum manifestieren. Kognitive Defizite und\n                    Schlaganfallsymptome sind hier, je nach Kohorte, sicher die h\u00e4ufigsten\n                    Pr\u00e4sentationen. In der Therapie und Beratung betroffener Patienten steht\n                    die Kontrolle vaskul\u00e4rer Risikofaktoren sowie die Empfehlung\n                    k\u00f6rperlicher und kognitiver Aktivit\u00e4t zusammen mit einer guten\n                    Schlafhygiene, die die perivaskul\u00e4re Drainage f\u00f6rdert, im\n                    Vordergrund. Herausfordernd bleiben individuelle Konstellationen der\n                    Isch\u00e4miepr\u00e4vention durch Antikoagulantien bei gleichzeitig hohem\n                    Hirnblutungsrisiko, v.\u2009a. bei Vorliegen einer kortikalen superfizialen\n                    Siderose. Die sehr dynamischen wissenschaftlichen und translationalen\n                    Entwicklungen im Feld der zerebralen Mikroangiopathie zielen auf die Etablierung\n                    von Bildgebungs- und anderen Biomarkern, z.\u2009B. in Blut und Liquor, ab,\n                    die bereits die fr\u00fchen Krankheitsstadien erfassen, bevor es zur\n                    Hirnparenchymsch\u00e4digung und klinischen Symptomen kommt. Entsprechend\n                    fokussiert werden sich neue Therapieans\u00e4tze auch dezidiert auf die\n                    Stabilisierung der neurovaskul\u00e4ren Einheit und eine Verbesserung der\n                    Drainagefunktion konzentrieren. Die Mikrovaskulatur und deren\n                    Ver\u00e4nderungen spielen auch f\u00fcr das Verst\u00e4ndnis anderer\n                    neurologischer Erkrankungen aus dem Feld der prim\u00e4ren Neuroimmunologie\n                    und Neurodegeneration eine zentrale Rolle. Einige, bisher als separate,\n                    neurologische Entit\u00e4ten betrachtete Erkrankungen k\u00f6nnten\n                    zuk\u00fcnftig folglich zunehmend als Spektrum \u00e4hnlicher\n                    pathophysiologischer Prozesse verstanden werden. Das legt perspektivisch den\n                    Grundstein f\u00fcr die Entwicklung und Anwendung \u00fcberlappender\n                    Therapiekonzepte.<\/jats:p>","DOI":"10.1055\/a-2190-8957","type":"journal-article","created":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T23:30:45Z","timestamp":1702337445000},"page":"494-502","source":"Crossref","is-referenced-by-count":1,"title":["Zerebrale Mikroangiopathie: Fortschritte im Verst\u00e4ndnis der\n                    Pathophysiologie"],"prefix":"10.1055","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9103-7276","authenticated-orcid":false,"given":"Solveig","family":"Henneicke","sequence":"additional","affiliation":[{"name":"Neurologie, Otto-von-Guericke-Universit\u00e4t Magdeburg\n                    Medizinische Fakult\u00e4t, Magdeburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sven G\u00fcnther","family":"Meuth","sequence":"additional","affiliation":[{"name":"Neurologie, Heinrich-Heine-Universit\u00e4t D\u00fcsseldorf,\n                    D\u00fcsseldorf, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefanie","family":"Schreiber","sequence":"additional","affiliation":[{"name":"Neurologie, Otto-von-Guericke-Universit\u00e4t Magdeburg\n                    Medizinische Fakult\u00e4t, Magdeburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,12,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1146","DOI":"10.1212\/WNL.0000000000007654","article-title":"CNS small vessel disease: A clinical review","volume":"92","author":"R J Cannistraro","year":"2019","journal-title":"Neurology"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1111\/nan.12576","article-title":"Invited Review: The spectrum of age-related small vessel diseases: potential\n                    overlap and interactions of amyloid and nonamyloid 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