Modelling microstrokes

Microstrokes cause local disruptions in blood flow in the brain that may can become more severe over time.

Microscope image of brain cells called astrocytes (yellow) in the brain of a mouse, wrapping their end feet around a blood vessel (purple). Image credit: Ladina Hösli (CC BY-NC-ND 2.0)

A blockage in one of the tiny blood vessels or capillaries of the brain causes a ‘microstroke’. Microstrokes do not cause the same level of damage as a major stroke, which is caused by a blockage in a larger blood vessel that completely cuts off oxygen to a part of the brain for a period. But microstrokes do increase the risk of developing conditions like dementia – including Alzheimer’s disease – later in life.

People with these neurodegenerative conditions have fewer capillaries in their brains. The capillaries make up a mesh-like network of millions of vessels that supply most of the energy and oxygen to the brain. Repeated microstrokes may contribute to progressive loss of capillaries over time. Reduced numbers of capillaries may increase memory loss and other brain difficulties.

To better understand how microstrokes affect blood flow in the brain, Schmid et al. created a computer model to simulate blood flow in capillaries in the mouse brain. Then, they modeled what happens to the blood flow when one capillary is blocked. The experiments showed that the configuration of the blocked capillary determines how much blood flow in neighboring capillaries changes. Blockages in capillaries with two vessels feeding in and two vessels feeding out caused the greatest blood flow disturbances. But these 2-in-2-out vessels only make up about 8% of all brain capillaries. Blockages in capillaries with different configurations with respect to feeding vessels had less effect.

The experiments suggest that most microstrokes have limited effects on blood flow on the scale of the entire brain because of redundancies in the capillary network in the brain. However, the ability of the capillary network to adapt and reroute blood flow in response to small blockages may decrease with aging. Over time, ministrokes in a single capillary may set off a chain reaction of disturbed blood flow and more blockages. This may decrease energy and oxygen supplies explaining age- and disease-related brain decline. Better understanding the effects of microstrokes on blood flow may help scientists develop new ways to prevent such declines.