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Cerebral perfusion alterations and cerebral amyloid in autosomal dominant Alzheimer disease

Eric McDade1, Albert Kim2, Jeffrey James2

  • 1From the Departments of Neurology (E.M., S.I., O.L., B.S.), Psychiatry (A.K., J.B., W.K.), and Radiology (J.J., D.M., J.P., C.M., W.K.), School of Medicine, and Department of Psychology (L.K.S., D.C.-H.K., P.J.G.), School of Arts and Sciences, University of Pittsburgh, PA; and Medical College of Georgia (A.K.), Augusta. mcdadee@upmc.edu.

Neurology
|July 18, 2014
PubMed
Abstract

Insights

Autosomal dominant Alzheimer disease (ADAD) mutation carriers show reduced cerebral blood flow (CBF) early, particularly in the striatum. This decrease is linked to amyloid buildup and cognitive decline, especially in executive functions.

Area of Science:

  • Neuroimaging
  • Neurology
  • Alzheimer's Disease Research

Background:

  • Cerebral blood flow (CBF) alterations are observed in Alzheimer's dementia, but studies in autosomal dominant Alzheimer disease (ADAD) are limited.
  • ADAD mutation carriers offer a unique model to study early pathological changes before significant symptoms arise, as they typically lack vascular disease.

Purpose of the Study:

  • To evaluate changes in cerebral blood flow (CBF) using arterial spin-labeled MRI in ADAD mutation carriers.
  • To assess the relationship between CBF, cerebral amyloid deposition, and cognitive function in ADAD.
  • To compare CBF in ADAD mutation carriers with age-matched healthy controls.

Main Methods:

  • Utilized 3-tesla pulsed arterial spin-labeled MRI on 14 ADAD mutation carriers and 50 controls.
  • Analyzed voxel-level effects of mutation carrier status on CBF using SPM8, controlling for age and Clinical Dementia Rating (CDR).

Main Results:

  • ADAD mutation carriers exhibited reduced CBF in the bilateral caudate and inferior striatum, even after controlling for age and CDR.
  • Decreased CBF in specific regions correlated with increased cerebral amyloid burden.
  • Reduced CBF was associated with diminished performance in attention and executive functions.

Conclusions:

  • Early alterations in CBF, especially in the anterior striatum, are detectable in asymptomatic and mildly symptomatic ADAD mutation carriers.
  • Amyloid deposition is linked to decreased CBF in both cortical and subcortical areas.
  • Both amyloid accumulation and reduced CBF are associated with declines in executive cognitive function in ADAD.

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