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Cerebral Hemodynamics as a Diagnostic Bridge Between Mild Cognitive Impairment and Late-Life Depression: A Multimodal
Sergiu-Florin Arnautu1,2, Diana-Aurora Arnautu2,3, Minodora Andor2,3
1Centre for Cognitive Research in Neuropsychiatric Pathology (NeuroPsy-Cog), Department of Neuro-Sciences, Victor Babes University of Medicine and Pharmacy, E. Murgu Sq., No. 2, 300041 Timisoara, Romania.
Insights
Transcranial Doppler ultrasound parameters, particularly resistive index (RI) and mean blood flow velocity (MBFV), effectively identify vascular contributions to cognitive impairment and depression in older adults. This multi-modal approach aids neurovascular profiling.
Area of Science:
- Neuroscience
- Gerontology
- Vascular Biology
Background:
- Vascular dysfunction contributes to cognitive impairment and late-life depression (LLD).
- The combined diagnostic value of cerebral hemodynamics, neuroimaging, and neuropsychological outcomes is underexplored.
- This study investigates TCD parameters, cognitive performance, and depressive symptoms in older adults with mild cognitive impairment (MCI) and LLD.
Purpose of the Study:
- To investigate associations between transcranial Doppler (TCD) ultrasound parameters and cognitive/affective status in older adults.
- To evaluate the integrative diagnostic value of TCD indices with MRI-derived white matter lesions (WMLs).
- To identify independent predictors of MCI using TCD and neuroimaging markers.
Main Methods:
- Cross-sectional study of 96 older adults (78 cognitively unimpaired, 18 MCI).
- Evaluations included cognitive tests (MMSE, MoCA), depression scale (GDS-15), MRI for WMLs (Fazekas score), and TCD ultrasonography.
- Hemodynamic variables: mean blood flow velocity (MBFV), end-diastolic velocity (EDV), pulsatility index (PI), resistive index (RI).
Main Results:
- MCI participants had lower MBFV/EDV and higher PI/RI compared to controls (p < 0.05).
- Lower MBFV/EDV and higher PI/RI independently predicted MCI (p < 0.05).
- Resistive index (RI) and MBFV showed excellent discriminative performance for MCI (AUC=0.919 and 0.879, respectively). PI correlated with depression severity; RI inversely correlated with GDS-15 scores.
Conclusions:
- TCD-derived hemodynamic parameters, especially RI and MBFV, are diagnostically useful for early vascular contributions to cognitive/affective dysfunction.
- Integrating TCD with MRI WML assessment and cognitive/mood measures offers a novel, practical multi-modal approach.
- This approach facilitates neurovascular profiling in aging populations.
Background:
Vascular dysfunction is increasingly recognized as a shared contributor to both cognitive impairment and late-life depression (LLD). However, the combined diagnostic value of cerebral hemodynamics, neuroimaging markers, and neuropsychological outcomes remains underexplored. This study aimed to investigate the associations be-tween transcranial Doppler (TCD) ultrasound parameters, cognitive performance, and depressive symptoms in older adults with mild cognitive impairment (MCI) and LLD. Importantly, we evaluated the integrative value of TCD-derived indices alongside MRI-confirmed white matter lesions (WMLs) and standardized neurocognitive and affective assessments.
Methods:
In this cross-sectional study, 96 older adults were enrolled including 78 cognitively unimpaired individuals and 18 with MCI. All participants underwent structured clinical, neuropsychological, and imaging evaluations including the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Geriatric Depression Scale (GDS-15), MRI-based Fazekas scoring of WMLs, and TCD ultrasonography of the middle cerebral artery. Hemodynamic variables included mean blood flow velocity (MBFV), end-diastolic velocity (EDV), pulsatility index (PI), and resistive index (RI). Logistic regression and receiver operating characteristic (ROC) analyses were used to identify independent predictors of MCI.
Results:
Participants with MCI showed significantly lower MBFV and EDV, and higher PI and RI (p < 0.05 for all) compared with cognitively unimpaired participants. In multivariate analysis, lower MBFV (OR = 0.64, p = 0.02) and EDV (OR = 0.70, p = 0.03), and higher PI (OR = 3.2, p < 0.01) and RI (OR = 1.9, p < 0.01) remained independently associated with MCI. ROC analysis revealed excellent discriminative performance for RI (AUC = 0.919) and MBFV (AUC = 0.879). Furthermore, PI correlated positively with depressive symptom severity, while RI was inversely related to the GDS-15 scores.
Conclusions:
Our findings underscore the diagnostic utility of TCD-derived hemodynamic parameters-particularly RI and MBFV-in identifying early vascular contributions to cognitive and affective dysfunction in older adults. The integration of TCD with MRI-confirmed WML assessment and standardized cognitive/mood measures represents a novel and clinically practical multi-modal approach for neurovascular profiling in aging populations.
