Abstract
Cerebrovascular disease may lead to a wide range of cognitive changes, referred to collectively as vascular cognitive impairment. Stroke increases the risk of cognitive impairment and dementia, and may contribute to the progression of Alzheimer’s disease (AD). Apart from clinical stroke itself, vascular risk factors are associated with the development of cognitive impairment and dementia. Animal models involving a temporary or permanent interruption of blood flow in the common carotid arteries develop nonprogressive cognitive impairment. Oxidative stress during cerebral hypoperfusion in animal models plays a key role in neuronal death and may thus contribute to the development of cognitive impairment in cerebrovascular disease. Genetic and pharmacological interventions to inhibit the major source of reactive oxygen species, nicotinamide adenine dinucleotide phosphate (NADPH) oxidase, are neuroprotective in experimental cerebral ischemia. Recent studies have demonstrated that inhibition of NADPH oxidase activity can mitigate cognitive impairment in rodent models of cerebral hypoperfusion. In this article, we review the evidence linking cognitive impairment and/or AD with NADPH oxidase-dependent oxidative stress, including the renin–angiotensin system.
Similar content being viewed by others
Abbreviations
- Aβ:
-
Amyloid-β
- AD:
-
Alzheimer’s disease
- APP:
-
Amyloid precursor protein
- AT1:
-
Angiotensin II type I
- CCAs:
-
Common carotid arteries
- PCAs:
-
Posterior communicating arteries
- ROS:
-
Reactive oxygen species
- VCI:
-
Vascular cognitive impairment
References
Ansari MA, Scheff SW (2011) NADPH-oxidase activation and cognition in Alzheimer disease progression. Free Radic Biol Med 51(1):171–178
Attems J, Quass M, Jellinger KA, Lintner F (2007) Topographical distribution of cerebral amyloid angiopathy and its effect on cognitive decline are influenced by Alzheimer disease pathology. J Neurol Sci 257(1–2):49–55
Beckman JS, Beckman TW, Chen J, Marshall PA, Freeman BA (1990) Apparent hydroxyl radical production by peroxynitrite: implications for endothelial injury from nitric oxide and superoxide. Proc Nat Acad Sci 87(4):1620–1624
Bennett S, Grant MM, Aldred S (2009) Oxidative stress in vascular dementia and Alzheimer’s disease: a common pathology. J Alzheimers Dis 17(2):245–257
Bezprozvanny I, Mattson M (2008) Neuronal calcium mishandling and the pathogenesis of Alzheimer’s disease. Trends Neurosci 31(9):454–463
Casado Á, Encarnación López-Fernández M, Concepción Casado M, de La Torre R (2008) Lipid peroxidation and antioxidant enzyme activities in vascular and Alzheimer dementias. Neurochem Res 33(3):450–458
Chan PH (1996) Role of oxidants in ischemic brain damage. Stroke 27(6):1124–1129
Chan PH (2001) Reactive oxygen radicals in signaling and damage in the ischemic brain. J Cereb Blood Flow Metab 21(1):2–14
Chen H, Song YS, Chan PH (2009) Inhibition of NADPH oxidase is neuroprotective after ischemia–reperfusion. J Cereb Blood Flow Metab 29(7):1262–1272
Chen H, Kim GS, Okami N, Narasimhan P, Chan PH (2011) NADPH oxidase is involved in post-ischemic brain inflammation. Neurobiol Dis 42(3):341–348
Chui HC, Zarow C, Mack WJ, Ellis WG, Zheng L, Jagust WJ, Mungas D, Reed BR, Kramer JH, DeCarli CC, Weiner MW, Vinters HV (2006) Cognitive impact of subcortical vascular and Alzheimer’s disease pathology. Ann Neurol 60(6):677–687
Dai W, Lopez OL, Carmichael OT, Becker JT, Kuller LH, Gach HM (2008) Abnormal regional cerebral blood flow in cognitively normal elderly subjects with hypertension. Stroke 39(2):349–354
de la Torre JC (2002) Alzheimer disease as a vascular disorder. Stroke 33(4):1152–1162
de Leeuw FE, de Groot JC, Oudkerk M, Witteman JCM, Hofman A, van Gijn J, Breteler MMB (2002) Hypertension and cerebral white matter lesions in a prospective cohort study. Brain 125(4):765–772
De Silva TM, Broughton BRS, Drummond GR, Sobey CG, Miller AA (2009) Gender influences cerebral vascular responses to angiotensin II through Nox2-derived reactive oxygen species. Stroke 40(4):1091–1097
Devan BD, White NM (1999) Parallel information processing in the dorsal striatum: relation to hippocampal function. J Neurosci 19(7):2789–2798
Diekmann D, Abo A, Johnston C, Segal A, Hall A (1994) Interaction of Rac with p67phox and regulation of phagocytic NADPH oxidase activity. Science 265(5171):531–533
Dong Y-F, Kataoka K, Toyama K, Sueta D, Koibuchi N, Yamamoto E, Yata K, Tomimoto H, Ogawa H, Kim-Mitsuyama S (2011) Attenuation of brain damage and cognitive impairment by direct renin inhibition in mice with chronic cerebral hypoperfusion. Hypertension 58(4):635–642
Drummond GR, Selemidis S, Griendling KK, Sobey CG (2011) Combating oxidative stress in vascular disease: NADPH oxidases as therapeutic targets. Nat Rev Drug Discov 10(6):453–471
Duan W, Gui L, Zhou Z, Liu Y, Tian H, Chen J-F, Zheng J (2009) Adenosine A2A receptor deficiency exacerbates white matter lesions and cognitive deficits induced by chronic cerebral hypoperfusion in mice. J Neurol Sci 285(1–2):39–45
Gorelick PB, Scuteri A, Black SE, DeCarli C, Greenberg SM, Iadecola C, Launer LJ, Laurent S, Lopez OL, Nyenhuis D, Petersen RC, Schneider JA, Tzourio C, Arnett DK, Bennett DA, Chui HC, Higashida RT, Lindquist R, Nilsson PM, Roman GC, Sellke FW, Seshadri S (2011) Vascular contributions to cognitive impairment and dementia. Stroke 42(9):2672–2713
Greenberg SM, Gurol ME, Rosand J, Smith EE (2004) Amyloid angiopathy-related vascular cognitive impairment. Stroke 35(11 suppl 1):2616–2619
Hachinski V (1992) Preventable senility: a call for action against the vascular dementias. Lancet 340(8820):645–648
Higashi M, Shimokawa H, Hattori T, Hiroki J, Mukai Y, Morikawa K, Ichiki T, Takahashi S, Takeshita A (2003) Long-term inhibition of rho-kinase suppresses angiotensin II-induced cardiovascular hypertrophy in rats in vivo. Circ Res 93(8):767–775
Horiuchi M, Mogi M (2011) Role of angiotensin II receptor subtype activation in cognitive function and ischaemic brain damage. Brit J Pharmacol 163(6):1122–1130
Huang L, He Z, Guo L, Wang H (2008) Improvement of cognitive deficit and neuronal damage in rats with chronic cerebral ischemia via relative long-term inhibition of rho-kinase. Cell Mol Neurobiol 28(5):757–768
Iadecola C (2010) The overlap between neurodegenerative and vascular factors in the pathogenesis of dementia. Acta Neuropathol 120(3):287–296
Iadecola C, Anrather J (2011) The immunology of stroke: from mechanisms to translation. Nat Med 17(7):796–808
Iadecola C, Zhang F, Niwa K, Eckman C, Turner SK, Fischer E, Younkin S, Borchelt DR, Hsiao KK, Carlson GA (1999) SOD1 rescues cerebral endothelial dysfunction in mice overexpressing amyloid precursor protein. Nat Neurosci 2(2):157–161
Ihara Y, Hayabara T, Sasaki K, Fujisawa Y, Kawada R, Yamamoto T, Nakashima Y, Yoshimune S, Kawai M, Kibata M, Kuroda S (1997) Free radicals and superoxide dismutase in blood of patients with Alzheimer’s disease and vascular dementia. J Neurol Sci 153(1):76–81
Jackman K, Miller A, De Silva T, Crack P, Drummond G, Sobey C (2009a) Reduction of cerebral infarct volume by apocynin requires pretreatment and is absent in Nox2-deficient mice. Br J Pharmacol 156(4):680–688
Jackman KA, Miller AA, Drummond GR, Sobey CG (2009b) Importance of NOX1 for angiotensin II-induced cerebrovascular superoxide production and cortical infarct volume following ischemic stroke. Brain Res 1286:215–220
Jiwa NS, Garrard P, Hainsworth AH (2010) Experimental models of vascular dementia and vascular cognitive impairment: a systematic review. J Neurochem 115(4):814–828
Johnson KA, Albert MS (2000) Perfusion abnormalities in prodromal AD. Neurobiol Aging 21(2):289–292
Kahles T, Luedike P, Endres M, Galla H-J, Steinmetz H, Busse R, Neumann-Haefelin T, Brandes RP (2007) NADPH oxidase plays a central role in blood–brain barrier damage in experimental stroke. Stroke 38(11):3000–3006
Kahles T, Kohnen A, Heumueller S, Rappert A, Bechmann I, Liebner S, Wittko IM, Neumann-Haefelin T, Steinmetz H, Schroeder K, Brandes RP (2010) NADPH oxidase Nox1 contributes to ischemic injury in experimental stroke in mice. Neurobiol Dis 40(1):185–192
Kleinschnitz C, Grund H, Wingler K, Armitage ME, Jones E, Mittal M, Barit D, Schwarz T, Geis C, Kraft P, Barthel K, Schuhmann MK, Herrmann AM, Meuth SG, Stoll G, Meurer S, Schrewe A, Becker L, Gailus-Durner V, Fuchs H, Klopstock T, de Angelis MH, Jandeleit-Dahm K, Shah AM, Weissmann N, Schmidt HHHW (2010) Post-stroke inhibition of induced NADPH oxidase type 4 prevents oxidative stress and neurodegeneration. PLoS Biol 8(9):e1000479
Liu C, Wu J, Gu J, Xiong Z, Wang F, Wang J, Wang W, Chen J (2007) Baicalein improves cognitive deficits induced by chronic cerebral hypoperfusion in rats. Pharmacol Biochem Behav 86(3):423–430
Lu F, Nakamura T, Toyoshima T, Liu Y, Hirooka K, Kawai N, Okabe N, Shiraga F, Tamiya T, Miyamoto O, Keep RF, Itano T (2012) Edaravone, a free radical scavenger, attenuates behavioral deficits following transient forebrain ischemia by inhibiting oxidative damage in gerbils. Neurosci Lett 506(1):28–32
Meyer JS, Xu G, Thornby J, Chowdhury MH, Quach M (2002) Is mild cognitive impairment prodromal for vascular dementia like Alzheimer’s disease? Stroke 33(8):1981–1985
Miki K, Ishibashi S, Sun L, Xu H, Ohashi W, Kuroiwa T, Mizusawa H (2009) Intensity of chronic cerebral hypoperfusion determines white/gray matter injury and cognitive/motor dysfunction in mice. J Neurosci Res 87(5):1270–1281
Moskowitz MA, Lo EH, Iadecola C (2010) The science of stroke: mechanisms in search of treatments. Neuron 67(2):181–198
Nelson PT, Schmitt FA, Lin Y, Abner EL, Jicha GA, Patel E, Thomason PC, Neltner JH, Smith CD, Santacruz KS, Sonnen JA, Poon LW, Gearing M, Green RC, Woodard JL, Van Eldik LJ, Kryscio RJ (2011) Hippocampal sclerosis in advanced age: clinical and pathological features. Brain 134(5):1506–1518
Nishio K, Ihara M, Yamasaki N, Kalaria RN, Maki T, Fujita Y, Ito H, Oishi N, Fukuyama H, Miyakawa T, Takahashi R, Tomimoto H (2010) A mouse model characterizing features of vascular dementia with hippocampal atrophy. Stroke 41(6):1278–1284
Packard MG, McGaugh JL (1996) Inactivation of hippocampus or caudate nucleus with lidocaine differentially affects expression of place and response learning. Neurobiol Learn Mem 65(1):65–72
Pakrasi S, O’Brien JT (2005) Emission tomography in dementia. Nucl Med Comm 26(3):189–196
Park L, Anrather J, Forster C, Kazama K, Carlson GA, Iadecola C (2004) A[beta]-induced vascular oxidative stress and attenuation of functional hyperemia in mouse somatosensory cortex. J Cereb Blood Flow Metab 24(3):334–342
Park L, Anrather J, Zhou P, Frys K, Pitstick R, Younkin S, Carlson GA, Iadecola C (2005) NADPH oxidase-derived reactive oxygen species mediate the cerebrovascular dysfunction induced by the amyloid beta peptide. J Neurosci 25(7):1769–1777
Park L, Anrather J, Girouard H, Zhou P, Iadecola C (2007) Nox2-derived reactive oxygen species mediate neurovascular dysregulation in the aging mouse brain. J Cereb Blood Flow Metab 27(12):1908–1918
Park L, Zhou P, Pitstick R, Capone C, Anrather J, Norris EH, Younkin L, Younkin S, Carlson G, McEwen BS, Iadecola C (2008) Nox2-derived radicals contribute to neurovascular and behavioral dysfunction in mice overexpressing the amyloid precursor protein. Proc Nat Acad Sci 105(4):1347–1352
Phan TG, Donnan GA, Srikanth V, Chen J, Reutens DC (2009) Heterogeneity in infarct patterns and clinical outcomes following internal carotid artery occlusion. Arch Neurol 66(12):1523–1528
Raz L, Zhang Q, Zhou C, Han D, Gulati P, Yang L, Yang F, Wang R, Brann D (2010) Role of Rac1 GTPase in NADPH oxidase activation and cognitive impairment following cerebral ischemia in the rat. PLoS One 5(9):e12606
Rockwood K, Wentzel C, Hachinski V, Hogan D, MacKnight C, McDowell I (2000) Prevalence and outcomes of vascular cognitive impairment. Vascular cognitive impairment investigators of the Canadian study of health and aging. Neurology 54(2):447–451
Schuff N, Matsumoto S, Kmiecik J, Studholme C, Du A, Ezekiel F, Miller BL, Kramer JH, Jagust WJ, Chui HC, Weiner MW (2009) Cerebral blood flow in ischemic vascular dementia and Alzheimer’s disease, measured by arterial spin-labeling magnetic resonance imaging. Alzheimers Dement 5(6):454–462
Shen J, Bai X-Y, Qin Y, Jin W-W, Zhou J-Y, Zhou J-P, Yan Y-G, Wang Q, Bruce IC, Chen J-H, Xia Q (2011) Interrupted reperfusion reduces the activation of NADPH oxidase after cerebral I/R injury. Free Rad Biol Med 50(12):1780–1786
Shibata M, Ohtani R, Ihara M, Tomimoto H (2004) White matter lesions and glial activation in a novel mouse model of chronic cerebral hypoperfusion. Stroke 35(11):2598–2603
Shibata M, Yamasaki N, Miyakawa T, Kalaria RN, Fujita Y, Ohtani R, Ihara M, Takahashi R, Tomimoto H (2007) Selective impairment of working memory in a mouse model of chronic cerebral hypoperfusion. Stroke 38(10):2826–2832
Shieh D, Liu L, Lin C (2000) Antioxidant and free radical scavenging effects of baicalein, baicalin and wogonin. Anticancer Res 20(5A):2861–2865
Srikanth V, Anderson J, Donnan G, Saling M, Didus E, Alpitsis R, Dewey H, Macdonell R, Thrift A (2004) Progressive dementia after first-ever stroke: a community-based follow-up study. Neurology 63(5):785–792
Srikanth VK, Quinn SJ, Donnan GA, Saling MM, Thrift AG (2006) Long-term cognitive transitions, rates of cognitive change, and predictors of incident dementia in a population-based first-ever stroke cohort. Stroke 37(10):2479–2483
Stephan B, Matthews F, Khaw K, Dufouil C, Brayne C (2009) Beyond mild cognitive impairment: vascular cognitive impairment, no dementia (VCIND). Alzheimers Res Ther 1(1):4
Sugawara T, Chan PH (2003) Reactive oxygen radicals and pathogenesis of neuronal death after cerebral ischemia. Antiox Redox Signal 5(5):597–607
Terashima T, Namura S, Hoshimaru M, Uemura Y, Kikuchi H, Hashimoto N (1998) Consistent injury in the striatum of C57BL/6 mice after transient bilateral common carotid artery occlusion. Neurosurgery 43(4):900–907
Wang Q, Xu J, Rottinghaus GE, Simonyi A, Lubahn D, Sun GY, Sun AY (2002) Resveratrol protects against global cerebral ischemic injury in gerbils. Brain Res 958(2):439–447
Wang Q, Tompkins KD, Simonyi A, Korthuis RJ, Sun AY, Sun GY (2006) Apocynin protects against global cerebral ischemia–reperfusion-induced oxidative stress and injury in the gerbil hippocampus. Brain Res 1090(1):182–189
Washida K, Ihara M, Nishio K, Fujita Y, Maki T, Yamada M, Takahashi J, Wu X, Kihara T, Ito H, Tomimoto H, Takahashi R (2010) Nonhypotensive dose of telmisartan attenuates cognitive impairment partially due to peroxisome proliferator-activated teceptor-{gamma} activation in mice with chronic cerebral hypoperfusion. Stroke 41(8):1798–1806
Wei G, Kibler KK, Koehler RC, Maruyama T, Narumiya S, Dor S (2008) Prostacyclin receptor deletion aggravates hippocampal neuronal loss after bilateral common carotid artery occlusion in mouse. Neuroscience 156(4):1111–1117
Wilkinson B, Landreth G (2006) The microglial NADPH oxidase complex as a source of oxidative stress in Alzheimer’s disease. J Neuroinflamm 3:30
Wilkinson BL, Cramer PE, Varvel NH, Reed-Geaghan E, Jiang Q, Szabo A, Herrup K, Lamb BT, Landreth GE (2012) Ibuprofen attenuates oxidative damage through NOX2 inhibition in Alzheimer’s disease. Neurobiol Aging 33(1):197.e121–197.e132
Xu Y, Zhang J-J, Xiong L, Zhang L, Sun D, Liu H (2010) Green tea polyphenols inhibit cognitive impairment induced by chronic cerebral hypoperfusion via modulating oxidative stress. J Nutri Biochem 21(8):741–748
Yamada M, Ihara M, Okamoto Y, Maki T, Washida K, Kitamura A, Hase Y, Ito H, Takao K, Miyakawa T, Kalaria R, Tomimoto H, Takahashi R (2011) The influence of chronic cerebral hypoperfusion on cognitive function and amyloid β metabolism in APP overexpressing mice. PLoS One 6:1
Yamamoto Y, Shioda N, Han F, Moriguchi S, Nakajima A, Yokosuka A, Mimaki Y, Sashida Y, Yamakuni T, Ohizumi Y, Fukunaga K (2009) Nobiletin improves brain ischemia-induced learning and memory deficits through stimulation of CaMKII and CREB phosphorylation. Brain Res 1295:218–229
Yang G, Kitagawa K, Ohtsuki T, Kuwabara K, Mabuchi T, Yagita Y, Takazawa K, Tanaka S, Yanagihara T, Hori M, Matsumoto M (2000) Regional difference of neuronal vulnerability in the murine hippocampus after transient forebrain ischemia. Brain Res 870(1–2):195–198
Yanpallewar SU, Hota D, Rai S, Kumar M, Acharya SB (2004) Nimodipine attenuates biochemical, behavioral and histopathological alterations induced by acute transient and long-term bilateral common carotid occlusion in rats. Pharmacol Res 49(2):143–150
Yonekura I, Kawahara N, Nakatomi H, Furuya K, Kirino T (2004) A model of global cerebral ischemia in C57 BL/6 Mice. J Cereb Blood Flow Metab 24(2):151–158
Yoshioka H, Niizuma K, Katsu M, Okami N, Sakata H, Kim GS, Narasimhan P, Chan PH (2011a) NADPH oxidase mediates striatal neuronal injury after transient global cerebral ischemia. J Cereb Blood Flow Metab 31(3):868–880
Yoshioka H, Niizuma K, Katsu M, Sakata H, Okami N, Chan P (2011b) Consistent injury to medium spiny neurons and white matter in the mouse striatum after prolonged transient global cerebral ischemia. J Neurotrauma 28(4):649–660
Zhang Q-G, Wang R, Han D, Dong Y, Brann DW (2009) Role of Rac1 GTPase in JNK signaling and delayed neuronal cell death following global cerebral ischemia. Brain Res 1265:138–147
Zhang H, Yuan L, Zhao R, Tonng L, Ma R, Dong H, Xiong L (2010) Isoflurane preconditioning induces neuroprotection by attenuating ubiquitin-conjugated protein aggregation in a mouse model of transient global cerebral ischemia. Anesth Analg 111(2):506–514
Zhen G, Dor S (2007) Optimized protocol to reduce variable outcomes for the bilateral common carotid artery occlusion model in mice. J Neurosci Methods 166(1):73–80
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kim, H.A., Miller, A.A., Drummond, G.R. et al. Vascular cognitive impairment and Alzheimer’s disease: role of cerebral hypoperfusion and oxidative stress. Naunyn-Schmiedeberg's Arch Pharmacol 385, 953–959 (2012). https://doi.org/10.1007/s00210-012-0790-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00210-012-0790-7