Cerebral small vessel disease(CSVD)is a common cause of vascular dementia and has various etiolo-gies,among which hypertension is the most common risk factor and can induce the disease by damaging the neurovascular glial unit.The process of CSVD leading to cognitive impairment is mainly associated with the disruption of cerebral net-work connections due to the destruction of cerebral white matter fibers,as well as secondary cortical atrophy and thinning;however,with the discovery of the glymphatic system in recent years,cognitive impairment associated with β-amyloid clearance dysfunction has been considered a new mechanism.The clearance function of the glymphatic system reaches the peak during sleep due to circadian rhythm.Previous studies on the association between CSVD and circadian rhythm have shown that CSVD patients often experience sleep disorders,which is a specific manifestation of circadian rhythm disor-ders.Such disorders are often neglected,which can lead to a reduction in the function of the glymphatic system in β-amy-loid clearance,thereby aggravating cognitive impairment in patients.However,there is still a lack of in-depth studies on the association between the circadian rhythm disorders of the glymphatic system and cognitive impairment in CSVD.This article reviews the studies on sleep rhythm disorders,dysfunction of the glymphatic system,and their influence on cogni-tive impairment in CSVD.
Cerebral small vessel diseaseGlymphatic systemAquapor-4BMAL1Circadian rhythmCognitive impairment
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