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Updated: Dec 15, 2025
Author Spotlight: Noninvasive Cerebral Blood Flow Determination in Human Functional Brain Region for Diagnosis of Neurological Disorders
Published on: May 31, 2024
The cerebral blood flow deficits in Parkinson's disease with mild cognitive impairment using arterial spin labeling
Dilek Betul Arslan1, Hakan Gurvit2, Ozan Genc1
1Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey.
Abstract:
Parkinson's disease (PD) with mild cognitive impairment (PD-MCI) is currently diagnosed based on an arbitrarily predefined standard deviation of neuropsychological test scores, and more objective biomarkers for PD-MCI diagnosis are needed. The purpose of this study was to define possible brain perfusion-based biomarkers of not only mild cognitive impairment, but also risky gene carriers in PD using arterial spin labeling magnetic resonance imaging (ASL-MRI). Fifteen healthy controls (HC), 26 cognitively normal PD (PD-CN), and 27 PD-MCI subjects participated in this study. ASL-MRI data were acquired by signal targeting with alternating radio-frequency labeling with Look-Locker sequence at 3 T. Single nucleotide polymorphism genotyping for rs9468 [microtubule-associated protein tau (MAPT) H1/H1 versus H1/H2 haplotype] was performed using a Stratagene Mx3005p real-time polymerase chain-reaction system (Agilent Technologies, USA). There were 15 subjects with MAPT H1/H1 and 11 subjects with MAPT H1/H2 within PD-MCI, and 33 subjects with MAPT H1/H1 and 19 subjects with MAPT H1/H2 within all PD. Voxel-wise differences of cerebral blood flow (CBF) values between HC, PD-CN and PD-MCI were assessed by one-way analysis of variance followed by pairwise post hoc comparisons. Further, the subgroup of PD patients carrying the risky MAPT H1/H1 haplotype was compared with noncarriers (MAPT H1/H2 haplotype) in terms of CBF by a two-sample t test. A pattern that could be summarized as "posterior hypoperfusion" (PH) differentiated the PD-MCI group from the HC group with an accuracy of 92.6% (sensitivity = 93%, specificity = 93%). Additionally, the PD patients with MAPT H1/H1 haplotype had decreased perfusion than the ones with H1/H2 haplotype at the posterior areas of the visual network (VN), default mode network (DMN), and dorsal attention network (DAN). The PH-type pattern in ASL-MRI could be employed as a biomarker of both current cognitive impairment and future cognitive decline in PD.
Insights
Objective biomarkers are needed for Parkinson's disease with mild cognitive impairment (PD-MCI). Arterial spin labeling MRI identified a "posterior hypoperfusion" pattern that accurately detects PD-MCI and predicts cognitive decline in PD patients.
Area of Science:
- Neuroimaging
- Neurology
- Genetics
Background:
- Parkinson's disease (PD) diagnosis relies on subjective cognitive assessments.
- Objective biomarkers are crucial for diagnosing mild cognitive impairment (MCI) in PD patients (PD-MCI).
- The microtubule-associated protein tau (MAPT) H1/H1 haplotype is a known risk factor for neurodegenerative diseases.
Purpose of the Study:
- To identify brain perfusion biomarkers for PD-MCI using arterial spin labeling magnetic resonance imaging (ASL-MRI).
- To investigate ASL-MRI markers in relation to the MAPT H1/H1 haplotype in PD patients.
- To establish objective diagnostic tools for cognitive impairment in Parkinson's disease.
Main Methods:
- ASL-MRI was used to measure cerebral blood flow (CBF) in 15 healthy controls (HC), 26 cognitively normal PD (PD-CN), and 27 PD-MCI subjects.
- Genotyping for the MAPT H1/H1 and H1/H2 haplotypes was performed.
- Voxel-wise analysis compared CBF between groups and correlated it with MAPT genotype.
Main Results:
- A "posterior hypoperfusion" (PH) pattern identified PD-MCI from HC with 92.6% accuracy.
- PD patients with the MAPT H1/H1 haplotype showed reduced perfusion in posterior visual, default mode, and dorsal attention networks compared to H1/H2 carriers.
- CBF patterns in ASL-MRI distinguish PD-MCI and correlate with genetic risk factors.
Conclusions:
- ASL-MRI-detected posterior hypoperfusion is a promising objective biomarker for PD-MCI.
- This imaging pattern may predict future cognitive decline in Parkinson's disease.
- Brain perfusion imaging combined with genetic information offers a powerful approach for PD cognitive assessment.
