Neurovascular coupling dysfunction in encephalopathy: pathophysiological advances and clinical implications

Neurovascular coupling (NVC) is a sophisticated and vital physiological mechanism that ensures the brain’s intricate balance and optimal performance. It refers to the precise coordination between the brain’s neural activity and the local cerebral blood flow (CBF), which is essential for meeting the...

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Main Authors: Lvbing Sheng, Xiaoyu Zheng, Zhao Ding, Jianxun Liu, Wenting Song
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1522485/full
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author Lvbing Sheng
Xiaoyu Zheng
Zhao Ding
Jianxun Liu
Wenting Song
author_facet Lvbing Sheng
Xiaoyu Zheng
Zhao Ding
Jianxun Liu
Wenting Song
author_sort Lvbing Sheng
collection DOAJ
description Neurovascular coupling (NVC) is a sophisticated and vital physiological mechanism that ensures the brain’s intricate balance and optimal performance. It refers to the precise coordination between the brain’s neural activity and the local cerebral blood flow (CBF), which is essential for meeting the metabolic demands of active neurons. This coupling allows for the efficient delivery of oxygen and nutrients to brain regions experiencing increased activity and facilitates the removal of metabolic waste products. In encephalopathy, a collective term for a wide range of conditions that impair brain function, NVC dysfunction has been identified as a key factor contributing to the progression of these disorders and the emergence of clinical symptoms. This comprehensive review aims to explore the complex pathophysiological mechanisms that lead to NVC dysfunction in several encephalopathic conditions. These include but are not limited to Alzheimer’s disease (AD), Parkinson’s disease (PD), cerebral small vessel disease (CSVD), stroke, migraine, traumatic brain injury (TBI) and epilepsy. Across the spectrum of encephalopathies discussed in this review, a unifying molecular target emerges: endothelin-1 (ET-1) and its receptors. ET-1, a potent vasoconstrictor produced by endothelial cells and astrocytes, is intricately linked to NVC dysfunction in these conditions. A thorough understanding of the role of NVC in encephalopathic disorders can inform the development of diagnostic tools and therapeutic strategies. For instance, identifying early markers of NVC dysfunction could facilitate early intervention and potentially slow disease progression. Moreover, targeting the restoration of NVC could become a novel therapeutic approach to mitigate symptoms and improve patient outcomes. This review also proposes new directions for future research, encouraging the exploration of NVC’s complex interactions and its potential as a therapeutic target in the management of encephalopathic conditions.
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spelling doaj-art-16101c94cb374f098e9fa27e7ad1de0a2025-08-20T02:26:28ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-05-011610.3389/fneur.2025.15224851522485Neurovascular coupling dysfunction in encephalopathy: pathophysiological advances and clinical implicationsLvbing ShengXiaoyu ZhengZhao DingJianxun LiuWenting SongNeurovascular coupling (NVC) is a sophisticated and vital physiological mechanism that ensures the brain’s intricate balance and optimal performance. It refers to the precise coordination between the brain’s neural activity and the local cerebral blood flow (CBF), which is essential for meeting the metabolic demands of active neurons. This coupling allows for the efficient delivery of oxygen and nutrients to brain regions experiencing increased activity and facilitates the removal of metabolic waste products. In encephalopathy, a collective term for a wide range of conditions that impair brain function, NVC dysfunction has been identified as a key factor contributing to the progression of these disorders and the emergence of clinical symptoms. This comprehensive review aims to explore the complex pathophysiological mechanisms that lead to NVC dysfunction in several encephalopathic conditions. These include but are not limited to Alzheimer’s disease (AD), Parkinson’s disease (PD), cerebral small vessel disease (CSVD), stroke, migraine, traumatic brain injury (TBI) and epilepsy. Across the spectrum of encephalopathies discussed in this review, a unifying molecular target emerges: endothelin-1 (ET-1) and its receptors. ET-1, a potent vasoconstrictor produced by endothelial cells and astrocytes, is intricately linked to NVC dysfunction in these conditions. A thorough understanding of the role of NVC in encephalopathic disorders can inform the development of diagnostic tools and therapeutic strategies. For instance, identifying early markers of NVC dysfunction could facilitate early intervention and potentially slow disease progression. Moreover, targeting the restoration of NVC could become a novel therapeutic approach to mitigate symptoms and improve patient outcomes. This review also proposes new directions for future research, encouraging the exploration of NVC’s complex interactions and its potential as a therapeutic target in the management of encephalopathic conditions.https://www.frontiersin.org/articles/10.3389/fneur.2025.1522485/fullneurovascular unitneurovascular couplingendothelin-1encephalopathypathophysiological advancesclinical implications
spellingShingle Lvbing Sheng
Xiaoyu Zheng
Zhao Ding
Jianxun Liu
Wenting Song
Neurovascular coupling dysfunction in encephalopathy: pathophysiological advances and clinical implications
Frontiers in Neurology
neurovascular unit
neurovascular coupling
endothelin-1
encephalopathy
pathophysiological advances
clinical implications
title Neurovascular coupling dysfunction in encephalopathy: pathophysiological advances and clinical implications
title_full Neurovascular coupling dysfunction in encephalopathy: pathophysiological advances and clinical implications
title_fullStr Neurovascular coupling dysfunction in encephalopathy: pathophysiological advances and clinical implications
title_full_unstemmed Neurovascular coupling dysfunction in encephalopathy: pathophysiological advances and clinical implications
title_short Neurovascular coupling dysfunction in encephalopathy: pathophysiological advances and clinical implications
title_sort neurovascular coupling dysfunction in encephalopathy pathophysiological advances and clinical implications
topic neurovascular unit
neurovascular coupling
endothelin-1
encephalopathy
pathophysiological advances
clinical implications
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1522485/full
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