Physiological Regulatory Mechanisms of Neurovascular Coupling and the Role of Its Dysfunction in Neurological Diseases

Neurovascular coupling (NVC) is a fundamental physiological process that regulates cerebral blood flow in response to neuronal activity. This mechanism ensures the efficient delivery of oxygen and glucose to active brain regions while clearing metabolic byproducts, thus maintaining brain homeostasis and supporting optimal neural function. Disruptions in NVC are linked to complex molecular and cellular alterations and contribute significantly to a range of both acute and chronic neurological disorders, including Alzheimer's disease, ischemic stroke, cerebral small vessel disease, migraines, epilepsy, and cognitive deficits associated with diabetes. Gaining a deeper understanding of the pathological mechanisms underlying NVC dysfunction in these conditions is critical for developing novel diagnostic biomarkers and targeted therapeutic strategies. This review aims to provide a comprehensive exploration of the physiological basis of NVC in a healthy brain, alongside the methods used to study it. Additionally, it offers a detailed analysis of the molecular and cellular mechanisms driving NVC dysfunction in major neurological diseases, presenting a theoretical framework and new insights for the development of innovative diagnostic and therapeutic interventions.