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In this regard, microvascular changes are likely present. The aim of this review is to provide an overview of the current knowledge on microvascular changes in epilepsy, and includes clinical and preclinical evidence of seizure induced angiogenesis, barriergenesis and microcirculatory alterations. Anatomical studies show increased microvascular density in the hippocampus, amygdala, and neocortex accompanied by BBB leakage in various rodent epilepsy models. In human TLE, a decrease in afferent vessels, morphologically abnormal vessels, and an increase in endothelial basement membranes have been observed. Both clinical and experimental evidence suggests that basement membrane changes, such as string vessels and protrusions, indicate and visualize a misbalance between endothelial cell proliferation and barriergenesis. Vascular endothelial growth factor (VEGF) appears to play a crucial role. Following an altered vascular anatomy, its physiological functioning is affected as expressed by neurovascular decoupling that subsequently leads to hypoperfusion, disrupted parenchymal homeostasis and potentially to seizures\u201d. Thus, epilepsy might be a condition characterized by disturbed cerebral microvasculature in which VEGF plays a pivotal role. Additional physiological data from patients is however required to validate findings from models and histological studies on patient biopsies.<\/jats:p>","DOI":"10.1177\/0271678x211010388","type":"journal-article","created":{"date-parts":[[2021,4,17]],"date-time":"2021-04-17T12:12:46Z","timestamp":1618661566000},"page":"2492-2509","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":46,"title":["Microvascular changes associated with epilepsy: A narrative review"],"prefix":"10.1177","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6557-9127","authenticated-orcid":false,"given":"Rick HGJ","family":"van Lanen","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Maastricht University Medical Center, Maastricht, the Netherlands"},{"name":"School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stan","family":"Melchers","sequence":"additional","affiliation":[{"name":"Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Govert","family":"Hoogland","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Maastricht University Medical Center, Maastricht, the Netherlands"},{"name":"School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands"},{"name":"Academic Center for Epileptology, Maastricht University Medical Center, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olaf EMG","family":"Schijns","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Maastricht University Medical Center, Maastricht, the Netherlands"},{"name":"School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands"},{"name":"Academic Center for Epileptology, Maastricht University Medical Center, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc AMJ van","family":"Zandvoort","sequence":"additional","affiliation":[{"name":"School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands"},{"name":"Department of Molecular Cell Biology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands"},{"name":"School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roel HL","family":"Haeren","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Maastricht University Medical Center, Maastricht, the Netherlands"},{"name":"Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Rijkers","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Maastricht University Medical Center, Maastricht, the Netherlands"},{"name":"School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands"},{"name":"Academic Center for Epileptology, Maastricht University Medical Center, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,4,17]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13709"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60456-6"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-017-8441-z"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.phrs.2016.03.003"},{"key":"e_1_3_4_6_2","unstructured":"Engel J. 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