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0:00
Thank you for
watching this talk on
vascular reactivity in
cerebral amyloid angiopathy.
My name is Eric Smith,
I'm a Professor of Neurology
at the University of Calgary,
and the Kathy Taylor Chair
in Vascular Dementia.
0:15
In this talk, I will discuss
the effects of cerebral
amyloid angiopathy
or CAA on the vessel wall.
Review animal studies of
cerebrovascular reactivity,
abbreviated CVR, in CAA.
Then, I'll move on to
discuss the results of
human studies and the clinical
correlates of loss of CVR
and finally, address the
question of whether CVR
can be restored and with
what clinical benefits.
0:39
CAA is a small vessel disease
marked by the deposition of
beta-amyloid in the media and
adventitia of small arteries
in the cerebral cortex
and leptomeninges.
This deposition leads
to the thickening of
the vessel wall as
shown in the H&E stain.
There's also the
replacement of elements of
the vessel wall,
including loss of
smooth muscle cells as
they are replaced by
beta-amyloid as demonstrated
in the panel in the middle,
which shows the
characteristic apple-green
birefringence when
viewing the vessel.
Stained with congo red
under polarized light
and this reflects the
replacement of much of
the vessel wall by abeta
shown in the immunostain
in the vessel
demonstrating a
small arterial that
is heavily affected by CAA.
1:27
These panels
demonstrate the effect
of vascular amyloid
deposition on
loss of smooth muscle cells in
data collected from
triple transgenic mouse,
where the Swedish, Dutch,
and Iowa amyloid
precursor protein
or APP mutations
have been induced.
This animal exhibits
extreme vascular deposition
of beta-amyloid at an early age,
as shown in the
panel on the right.
Where the bright areas
indicate areas where there is
vascular deposition
of the beta-amyloid
demonstrated by thio-S.
The Panel on the left,
the remaining
smooth muscle cells
appear as the bright bands.
You can appreciate
those areas of
more severe amyloid
depositions are
marked by fewer
smooth muscle cells,
while the areas where there
is relative sparing of
amyloid deposition
have a larger number
of remaining smooth
muscle cells.
Because the smooth
muscle cells are
the contractile element
within the arterials,
one would expect that
lots of these cells
would be resulting
in a loss of CVR.
I'll then move on
to animal studies
