[Leuko-araiosis--regional cerebral hemodynamics]

Area of Science:

• Neurology
• Radiology
• Vascular Biology

Context:

• Leuko-araiosis (L-A) is a common finding in neuroimaging, often associated with cognitive decline.
• Understanding the cerebral hemodynamic alterations in L-A is crucial for managing associated neurological deficits.

Purpose:

• To investigate the cerebral hemodynamics in patients with leuko-araisosis (L-A) using SPECT imaging.
• To assess regional cerebral blood flow (rCBF), cerebrovascular reactivity to CO2 and blood pressure, and changes during sleep in L-A patients.

Summary:

• SPECT measurements revealed reduced rCBF in the white matter, frontal, and parietal cortex of L-A patients.
• Cerebrovascular CO2 reactivity was impaired in white matter but preserved in cortical areas.
• Cerebral blood flow autoregulation was impaired in the frontal and parietal cortex.
• During sleep, rCBF reduction was most pronounced in the frontal and parietal cortex, suggesting dys-autoregulation contributed to reduced blood flow.

Impact:

• This study highlights impaired cerebral hemodynamics in L-A, particularly concerning white matter and cortical blood flow regulation.
• Findings suggest that impaired autoregulation and reduced cerebrovascular reactivity play significant roles in the pathophysiology of L-A.
• These insights can inform future therapeutic strategies targeting hemodynamic dysfunction in L-A.