Cerebral perfusion correlates with amyloid deposition in patients with mild cognitive impairment due to Alzheimer's disease - 01/01/25

Doi : 10.1016/j.tjpad.2024.100031

Caixia Wang ^a,^b,^{^{1
Caixia Wang and Deli Ji contributed equally to this work.}}, Deli Ji ^a,^c,^{^{1
Caixia Wang and Deli Ji contributed equally to this work.}}, Xiao Su ^a,^d, Fang Liu ^a,^e, Yanxin Zhang ^a, Qingzheng Lu ^a, Li Cai ^f, Ying Wang ^f, Wen Qin ^g, Gebeili Xing ^a,^h, Peng Liu ^a,ⁱ, Xin Liu ^a,^j, Meili Liu ^b, Nan Zhang ^a,^k,^⁎
^a Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China, 154 Anshan Road Tianjin 300052, PR China
^b Department of Neurology, Baotou Central Hospital, Baotou 014040, PR China
^c Department of Neurology, Chifeng Municipal Hospital, Chifeng 024000, PR China
^d Inner Mongolia Medical University Affiliated Hospital, Hohhot 010000, PR China
^e Department of Neurology, Yulin First Hospital, Yulin City, Shanxi Province 719000, China
^f PET/CT Diagnostic Department, Tianjin Medical University General Hospital, Tianjin 300052, PR China
^g Department of Radiology, Tianjin Key Lab of Functional Imaging and Tianjin Institute of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, PR China
^h Department of Neurology, Inner Mongolia People's Hospital, Hohhot 010000, PR China
ⁱ Department of Neurology and Interventional Neurology, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao 266000, PR China
^j Department of Neurology, Affiliated Hospital of Hebei University, Baoding 071000, PR China
^k Department of Neurology, Tianjin Medical University General Hospital Airport Site, Tianjin 300052, PR China

^⁎Corresponding author: Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China, 154 Anshan Road Tianjin 300052, PR China.Department of Neurology, Tianjin Neurological InstituteTianjin Medical University General Hospital, Tianjin, China154 Anshan Road Tianjin 300052PR China

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Abstract

Background

Changes in cerebral blood flow (CBF) may contribute to the initial stages of the pathophysiological process in patients with Alzheimer's disease (AD). Hypoperfusion has been observed in several brain regions in patients with mild cognitive impairment (MCI). However, the clinical significance of CBF changes in the early stages of AD is currently unclear.

Objectives

The aim of this study was to investigate the characteristics, diagnostic value and cognitive correlation of cerebral perfusion measured with arterial spin labeling (ASL) magnetic resonance imaging (MRI) in patients with MCI due to AD.

Design, setting and participants

A total of fifty-nine MCI patients and 49 cognitively unimpaired controls (CUCs) were recruited and underwent multimodal MRI scans, including pseudocontinuous ASL, and neurocognitive testing. MCI patients were dichotomously classified according to the presence of amyloid deposition on ¹¹C-labelled Pittsburgh compound B (PiB) positron emission tomography (PET).

Measurements

The differences in CBF and expression of the AD-related perfusion pattern (ADRP), established by spatial covariance analysis in our previous study, were compared between the PiB+ MCI group and the CUC group and between the PiB+ and PiB- MCI groups. The diagnostic accuracy and correlations with cognitive function scores for CBF and ADRP expression were further analyzed.

Results

Hypoperfusion in the precuneus and posterior cingulate cortex (PCC) was more characteristic of patients with MCI due to AD than of those with non-AD-related MCI. The relative regional CBF value of the left precuneus best distinguished patients with MCI due to AD from CUCs and patients with MCI due to non-AD conditions. Cerebral perfusion, as indicated by either the relative regional CBF or the expression score of the ADRP, was strongly correlated with certain cognitive function scores.

Conclusions

Here, we show that changes in CBF in the precuneus/PCC are promising MRI biomarkers for the identification of an AD etiology in patients with MCI. ASL, a noninvasive and cost-effective tool, has broad application prospects in the screening and early diagnosis of AD.

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Keywords : Mild cognitive impairment, Alzheimer's disease, Cerebral blood flow, Arterial spin labeling, Ad-related perfusion pattern