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Multidelay multiparametric arterial spin labeling perfusion MRI and mild cognitive impairment in early stage
Xueling Suo1, Du Lei1,2, Lan Cheng3
1Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Abstract:
Mild cognitive impairment (MCI), a well-defined nonmotor manifestation of Parkinson's disease (PD), greatly impairs functioning and quality of life. However, the contribution of cerebral perfusion, quantified by arterial spin labeling (ASL), to MCI in PD remains poorly understood. The selection of an optimal delay time is difficult for single-delay ASL, a problem which is avoided by multidelay ASL. This study uses a multidelay multiparametric ASL to investigate cerebral perfusion including cerebral blood flow (CBF) and arterial transit time (ATT) in early stage PD patients exhibiting MCI using a voxel-based brain analysis. Magnetic resonance imaging data were acquired on a 3.0 T system at rest in 39 early stage PD patients either with MCI (PD-MCI, N = 22) or with normal cognition (PD-N, N = 17), and 36 age- and gender-matched healthy controls (HCs). CBF and ATT were compared among the three groups with SPM using analysis of variance followed by post hoc analyses to define regional differences and examine their relationship to clinical data. PD-MCI showed prolonged ATT in right thalamus compared to both PD-N and HC, and in right supramarginal gyrus compared to HC. PD-N showed shorter ATT in left superior frontal cortex compared to HC. Prolonged ATT in right thalamus was negatively correlated with the category fluency test (p = .027, r = -0.495) in the PD-MCI group. This study shows that ATT may be a more sensitive marker than CBF for the MCI, and highlights the potential role of thalamus and inferior parietal region for MCI in early stage PD.
Insights
Arterial transit time (ATT), a measure of cerebral perfusion, is a more sensitive marker for mild cognitive impairment (MCI) in early Parkinson's disease (PD) than cerebral blood flow (CBF). Prolonged ATT in the right thalamus is linked to cognitive deficits in PD patients with MCI.
Area of Science:
- Neuroimaging
- Neurology
- Medical Physics
Background:
- Mild cognitive impairment (MCI) is a significant non-motor symptom in Parkinson's disease (PD), impacting patient functioning and quality of life.
- Cerebral perfusion changes, particularly arterial transit time (ATT), are increasingly recognized as potential biomarkers for neurological conditions.
- Multidelay multiparametric arterial spin labeling (ASL) offers a robust method for quantifying cerebral blood flow (CBF) and ATT without contrast agents.
Purpose of the Study:
- To investigate cerebral perfusion (CBF and ATT) using multidelay ASL in early-stage Parkinson's disease (PD) patients with and without mild cognitive impairment (MCI).
- To compare ATT and CBF between PD patients with MCI (PD-MCI), PD patients with normal cognition (PD-N), and healthy controls (HCs).
- To explore the relationship between ATT, CBF, and cognitive performance in PD patients.
Main Methods:
- Voxel-based analysis of magnetic resonance imaging (MRI) data acquired at 3.0T.
- Utilized multidelay multiparametric ASL to measure CBF and ATT in 39 early PD patients (22 PD-MCI, 17 PD-N) and 36 HCs.
- Employed analysis of variance (ANOVA) with post hoc tests for group comparisons and correlation analysis with clinical data.
Main Results:
- PD-MCI patients exhibited prolonged ATT in the right thalamus and right supramarginal gyrus compared to PD-N and/or HCs.
- PD-N patients showed shorter ATT in the left superior frontal cortex compared to HCs.
- Prolonged right thalamus ATT in PD-MCI patients negatively correlated with category fluency test performance.
Conclusions:
- Arterial transit time (ATT) appears to be a more sensitive indicator of MCI in early Parkinson's disease than cerebral blood flow (CBF).
- The right thalamus and inferior parietal regions are highlighted as potentially crucial areas for MCI development in early PD.
- Multidelay ASL provides valuable insights into the neurovascular mechanisms underlying cognitive impairment in Parkinson's disease.