The role of inflammation in cerebral small vessel disease and vascular cognitive impairment, and therapeutic implications.

backgroundIncreasing evidence suggests that inflammation occurs in cerebral small vessel disease (SVD). Inflammation has been hypothesized to play a role in disease pathogenesis and also in progression to vascular cognitive impairment and dementia (VCID), suggesting that targeting inflammation may offer a novel treatment option.

aimsIn this review, we aimed to summarize the evidence that both systemic and central nervous system (CNS) inflammation occur in SVD and VCID, critically examine whether associations are causal, and review the evidence that anti-inflammatory interventions might represent possible treatments. We include coverage of sporadic SVD, cerebral amyloid angiopathy, and genetic small vessel diseases. SUMMARY OF REVIEW: CNS inflammation has been demonstrated in SVD both in post-mortem brains and

conclusionsConsiderable data support the presence of both systemic and CNS inflammation in SVD and VCID. However, whether these associations are causal remains unclear, and more longitudinal and interventional studies are required. A better understanding of the molecular basis of inflammation and immune dysfunction in SVD also allows more precise therapeutic targeting.