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Mild cognitive impairment and alzheimer disease: patterns of altered cerebral blood flow at MR imaging

Weiying Dai1, Oscar L Lopez, Owen T Carmichael

  • 1Department of Radiology, Harvard Medical School, Boston, Mass, USA.

Radiology
|January 24, 2009
PubMed
Abstract

Insights

Regional cerebral blood flow (rCBF) changes, including decreases and increases, are observed in mild cognitive impairment (MCI) and Alzheimer disease (AD). These dynamic rCBF alterations reflect underlying brain pathology and potential compensatory mechanisms.

Area of Science:

  • Neuroimaging
  • Neurology
  • Medical Imaging

Background:

  • Alzheimer disease (AD) and mild cognitive impairment (MCI) are neurodegenerative conditions characterized by progressive cognitive decline.
  • Understanding the early pathophysiological changes in the brain is crucial for timely diagnosis and intervention.
  • Regional cerebral blood flow (rCBF) is a sensitive indicator of brain metabolic activity and vascular health.

Purpose of the Study:

  • To investigate alterations in rCBF in individuals with incident MCI and AD.
  • To utilize continuous arterial spin-labeling (CASL) magnetic resonance (MR) imaging for precise rCBF measurement.
  • To compare rCBF patterns between control subjects, MCI patients, and AD patients.

Main Methods:

  • CASL MR imaging was performed on 38 control subjects, 29 MCI patients, and 37 AD patients.
  • Voxel-level rCBF was analyzed using analysis of variance to identify significant group differences.
  • Multiple regression models accounted for age, sex, and hypertension to correlate rCBF with MCI and AD status.

Main Results:

  • MCI and AD patients exhibited reduced rCBF in the posterior cingulate gyrus and medial precuneus compared to controls.
  • MCI patients showed increased rCBF in the hippocampus, amygdala, and parts of the basal ganglia.
  • AD patients demonstrated decreased rCBF in the inferior parietal, lateral frontal, superior temporal, and orbitofrontal cortices, with increased rCBF in the anterior cingulate gyrus.

Conclusions:

  • The progression from normal cognition to AD involves dynamic brain processes, evidenced by both decreased and increased rCBF.
  • Elevated rCBF in certain brain regions may indicate a compensatory cellular and vascular response in early AD.
  • rCBF patterns measured by CASL MR imaging can help differentiate between normal cognition, MCI, and AD.

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