Abstract:

In recent years, the rapid advancement of neuroimaging techniques and the continuous discovery, validation and exploration of novel biomarkers have significantly increased the detection rate of cerebral small vessel disease (CSVD).Cognitive impairment caused by CSVD is highly prevalent and exerts a substantial negative impact on the quality of life among the Chinese population.Consequently, CSVD and its associated cognitive impairment have emerged as both a major focus and a substantial challenge in scientific research.Current evidence strongly supports that inflammatory mechanisms, particularly vascular inflammatory responses mediated by lipoprotein-associated phospholipase A2 (LP-PLA2), play a critical role in the pathogenesis and progression of CSVD and its cognitive sequelae.For instance, LP-PLA2-driven pathways may contribute to blood-brain barrier disruption, structural and functional damage to vascular endothelium, acceleration of atherosclerosis, and sustained chronic inflammatory states, all of which collectively influence the initiation and progression of CSVD-related cognitive impairment.This review aims to synthesize recent advances in understanding cognitive impairment in CSVD and to elucidate the biological role of LPPLA2 as a representative mediator of specific vascular inflammatory responses in its pathological cascade.

Key words: Cerebral small vessel disease, Cognitive impairment, Lipoprotein-associated phospholipase A2, Inflammatory response