The neurovascular unit in healthy and injured spinal cord

J Cereb Blood Flow Metab. 2023 Sep;43(9):1437-1455. doi: 10.1177/0271678X231172008. Epub 2023 May 15.

Abstract

The neurovascular unit (NVU) reflects the close temporal and spatial link between neurons and blood vessels. However, the understanding of the NVU in the spinal cord is far from clear and largely based on generalized knowledge obtained from the brain. Herein, we review the present knowledge of the NVU and highlight candidate approaches to investigate the NVU, particularly focusing on the spinal cord. Several unique features maintain the highly regulated microenvironment in the NVU. Autoregulation and neurovascular coupling ensure regional blood flow meets the metabolic demand according to the blood supply or local neural activation. The blood-central nervous system barrier partitions the circulating blood from neural parenchyma and facilitates the selective exchange of substances. Furthermore, we discuss spinal cord injury (SCI) as a common injury from the perspective of NVU dysfunction. Hopefully, this review will help expand the understanding of the NVU in the spinal cord and inspire new insights into SCI.

Keywords: Blood–spinal cord barrier; neurovascular coupling; neurovascular unit; spinal cord; spinal cord injury.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood-Brain Barrier
  • Brain* / blood supply
  • Head
  • Humans
  • Neurons / physiology
  • Spinal Cord Injuries*