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Published on: January 28, 2014
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Biomarkers
1Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 24, 2025
Summary
MRI biomarkers show promise for detecting vascular contributions to cognitive impairment and dementia (VCID). Key measures like cerebral blood flow, oxygen extraction fraction, and cerebrovascular reactivity offer new diagnostic tools for VCID.
Area of Science:
- Neuroimaging
- Neurology
- Biomarker Discovery
Background:
- Magnetic Resonance Imaging (MRI) is crucial for assessing cerebrovascular function.
- MRI offers potential for developing biomarkers for vascular contributions to cognitive impairment and dementia (VCID).
Purpose of the Study:
- To review recent advancements in MRI-based biomarkers for cerebrovascular physiology.
- To explore the potential role of these biomarkers in diagnosing and understanding VCID.
Main Methods:
- Discussion of three key MRI-measured cerebrovascular parameters: cerebral blood flow (CBF), oxygen extraction fraction (OEF), and cerebrovascular reactivity (CVR).
- Cerebral blood flow (CBF) is measured using non-contrast arterial spin labeling (ASL) MRI.
- Oxygen extraction fraction (OEF) and cerebrovascular reactivity (CVR) are assessed to understand oxygen supply/demand balance and vascular function, respectively.
Main Results:
- CBF is globally reduced in VCID, unlike in Alzheimer's dementia where it's linked to neural activity.
- Elevated OEF in VCID correlates with vascular risk factors and progresses longitudinally.
- Diminished CVR is strongly associated with cognitive scores (MoCA) and executive function, independent of Alzheimer's pathology.
Conclusions:
- MRI-based cerebrovascular measures show significant potential as biomarkers for cognitive impairment.
- These biomarkers are particularly valuable for VCID, where diagnostic options are limited.
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