Rethinking Arterial Spin Labeling Perfusion in Neurodegeneration Considering Global and Regional Changes

Recent advancements in arterial spin labeling (ASL) MRI have significantly improved our understanding of cerebral perfusion in neurodegenerative diseases. Traditionally, the focus has been on regional perfusion deficits corresponding to specific neural pathologies. However, this localized approach may overlook the influence of global cerebral blood flow alterations. This manuscript proposes a nuanced perspective that considers the interplay between global and regional changes. By integrating a broader view of cerebral perfusion, we can enhance diagnostic accuracy, uncover new patterns in disease progression, and potentially refine treatment strategies. We advocate for a collaborative effort to validate and implement this comprehensive approach in clinical and research settings.