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Reversible Hypervascularization Drives Cognitive Decline and Blood-Brain Barrier Damage During Aging

MCML Authors

Abstract

Cerebrovascular dysfunction emerges early in neurodegeneration, yet how vascular structure, blood–brain barrier (BBB) failure, and cognition are linked remains undefined. Using VesselPro, a whole-brain pipeline integrating perfusion-resolved 3D imaging with spatial proteomics, we mapped vascular aging across the mouse lifespan. We identify two discrete trajectories: a hypovascular state and a previously unrecognized hyper-vascular, BBB-compromised state, defined relative to a young-adult vascular baseline. The hyper-vascular trajectory, concentrated in the cortex and hippocampus, was associated with marked spatial memory impairment and pervasive BBB leakage. Spatial proteomics revealed a coordinated program involving angiogenic activation, endothelial stress, cytoskeletal remodeling, and inflammatory signaling. Cross-species comparison with human proteomic biomarkers from the UK Biobank showed strong alignment between the mouse hypervascular signature and vascular dementia risk, but minimal concordance with Alzheimer’s disease, defining a vascular-specific dementia endotype. Transient Tie2 activation with AKB-9778 attenuated this trajectory, improving vessel organization, BBB integrity, and memory performance. Our findings show that endothelial instability is a key mechanistic driver of this heterogeneous vascular aging state.

misc TTM+26


Preprint

May. 2026

Authors

M. I. Todorov • K. Todorov-Völgy •  Minde • S. Kapoor • M. Ali • R. Malik • J. C. Paetzold • J. McGinnis • L. Zhang • A. Nottebrock • L. Liu • M. Simons • H. S. Bhatia • M. K. Georgakis • M. Dichgans • F. Hellal • A. Ertürk

Links

DOI

Research Area

 C1 | Medicine

BibTeXKey: TTM+26

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