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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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Global brain hypoperfusion and oxygenation in amnestic mild cognitive impairment

Jie Liu1, Yong-Sheng Zhu2, Muhammad Ayaz Khan2

  • 1Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|July 23, 2013
PubMed
Abstract

Insights

Patients with amnestic mild cognitive impairment (aMCI) show reduced cerebral blood flow and oxygen metabolism. These hemodynamic changes suggest early Alzheimer's disease progression, detectable with non-invasive methods.

Area of Science:

  • Neuroscience
  • Medical Imaging
  • Cerebrovascular Physiology

Background:

  • Amnestic mild cognitive impairment (aMCI) is a prodromal stage of Alzheimer's disease.
  • Understanding early cerebral hemodynamic changes in aMCI is crucial for timely intervention.

Purpose of the Study:

  • To investigate global brain hypoperfusion and oxygen hypometabolism in patients with aMCI.
  • To assess if neurovascular decoupling occurs in the early stages of cognitive decline.

Main Methods:

  • Utilized color-coded duplex ultrasonography (CDUS), near-infrared spectroscopy (NIRS), and MRI for measurements.
  • Quantified total cerebral blood flow (TCBF), cerebral metabolic rate of oxygen (CMRO2), and brain tissue volume (TBV).
  • Calculated normalized TCBF (nTCBF) and cerebrovascular resistance (CVR).

Main Results:

  • aMCI patients exhibited a 9% reduction in nTCBF and an 11% decrease in CMRO2 compared to controls.
  • Cerebrovascular resistance (CVR) increased by 13% in aMCI subjects.
  • Correlation between nTCBF and CMRO2 was present in controls but absent in aMCI, indicating neurovascular decoupling.

Conclusions:

  • Global brain hypoperfusion and oxygen hypometabolism are present in aMCI.
  • Neurovascular decoupling in aMCI suggests early hemodynamic changes in Alzheimer's disease.
  • CDUS and NIRS offer low-cost, bedside assessment of these early prodromal changes.
Keywords:
Cerebral blood flowCerebral metabolic rate of oxygenMRIMild cognitive impairmentNear-infrared spectroscopyUltrasonography

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