Microvascular perfusion based on arterial spin labeled perfusion MRI as a measure of vascular risk in Alzheimer's disease
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Published on: May 30, 2011
Quan Zhang1, Randall B Stafford, Ze Wang
1Center for Functional Neuroimaging, University of Pennsylvania, Philadelphia, PA, USA Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China.
Abstract:
There is growing recognition of an interaction between cerebrovascular disease and Alzheimer's disease, but the mechanisms of this interaction remain poorly understood. While macroscopic stroke can clearly produce cognitive deficits and accelerate Alzheimer's disease, the prevalence and implications of microvascular disease in Alzheimer's disease pathogenesis has been harder to define. At present, white matter (WM) lesions, primarily defined as hyperintensities seen on T2-weighted magnetic resonance imaging (MRI), provide the best biomarker of cerebrovascular disease at the microvascular level. However, T2 hyperintensities in WM can also be caused by other mechanisms such as inflammation. Arterial spin labeled (ASL) perfusion MRI provides a noninvasive approach for quantifying cerebral blood flow (CBF). We explored CBF measurements with ASL in AD patients, mild cognitive impairment patients, and an age-matched control group to determine if CBF in gray matter or WM could be correlated with WM lesions, or to stratify patients by microvascular disease severity. In a retrospective sample, we were able to obtain credible measures of WM CBF using ASL MRI and observed trends suggesting that WM CBF may provide a useful biomarker of microvascular disease. Future prospective studies in larger cohorts with optimized ASL MRI protocols will be needed to validate these observations.
Insights
Cerebrovascular disease and Alzheimer's disease interact, but mechanisms are unclear. Arterial spin labeled perfusion MRI shows potential for measuring white matter blood flow, possibly indicating microvascular disease severity in Alzheimer's patients.
Area of Science:
- Neuroimaging
- Cerebrovascular Health
- Neurodegenerative Diseases
Background:
- The interplay between cerebrovascular disease and Alzheimer's disease (AD) is recognized, yet underlying mechanisms require elucidation.
- While large strokes impact cognition and accelerate AD, the role of microvascular disease in AD pathogenesis is less defined.
- White matter (WM) lesions on MRI are current biomarkers for microvascular disease, but can also stem from inflammation.
Purpose of the Study:
- To investigate cerebral blood flow (CBF) using Arterial Spin Labeled (ASL) perfusion MRI in Alzheimer's disease (AD) and mild cognitive impairment (MCI) patients.
- To determine if WM CBF correlates with WM lesions or can stratify patients by microvascular disease severity.
- To explore ASL MRI as a tool for assessing microvascular contributions to cognitive decline.
Main Methods:
- Retrospective analysis of ASL perfusion MRI data.
- Quantification of cerebral blood flow (CBF) in gray matter and white matter (WM).
- Comparison of CBF measurements across AD patients, MCI patients, and age-matched controls.
Main Results:
- Credible measures of WM CBF were obtained using ASL MRI in the retrospective sample.
- Trends indicated that WM CBF may serve as a valuable biomarker for microvascular disease.
- Further research is needed to confirm these preliminary findings.
Conclusions:
- ASL perfusion MRI shows promise for quantifying WM CBF and assessing microvascular disease in the context of cognitive impairment.
- WM CBF measurements could potentially stratify patients based on cerebrovascular disease severity.
- Prospective studies with larger cohorts and optimized ASL protocols are necessary for validation.
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