Influence of cerebral blood flow on volumetric loss related to Alzheimer’s disease

Influência do fluxo sanguíneo cerebral na perda volumétrica relacionada à doença de Alzheimer

ABSTRACT

CBF measured with Arterial Spin Labeling (ASL) obtained by Magnetic Resonance Imaging (MRI) may become an important biomarker by showing changes in early stages of AD, such as in the prodromal stage of Mild Cognitive Impairment (MCI).

Objective:  Verify the correlation between atrophy and CBF in patients with MCI and mild phase ADD, to demonstrate whether changes in CBF can be considered as vascular biomarkers in the diagnosis of the DA continuum.

Methods:  11 healthy volunteers, 16 MCI and 15 mild ADD were evaluated. Images of the brain were acquired, including CBF measured with Arterial Spin Labeling (ASL).

Results:  When comparing MCI with control, a reduction in normalized CBF was observed in left posterior cingulate (estimated difference -0.38; p=0.02), right posterior cingulate (estimated difference -0.45; p=0.02) and right precuneus (estimated difference -0.28; p <0.01); also increase in normalized CBF in right upper temporal pole (estimated difference 0.22; p=0.03). It was also observed that in MCI, the smaller the gray matter volume, the smaller the CBF in the left posterior cingulate; as well as the greater the cerebrospinal fluid volume, consequent to the encephalic volumetric reduction associated with atrophy, the greater the CBF in the right superior temporal pole. When comparing controls, MCI and mild AD, in relation to the other variables, no other correlations were observed between CBF and atrophy.

Conclusion:  In patients with MCI, the reduction of CBF in the left posterior cingulate correlated with gray matter atrophy, as well as the increase of CBF in the right upper temporal pole correlated with an increase in cerebrospinal fluid consequent to the encephalic volumetric reduction associated with atrophy, demonstrating the influence of CBF in AD related brain atrophy. These findings position CBF as a possible vascular biomarker for early-stage AD diagnoses.

Keywords:
Alzheimer Disease; Cognitive Dysfunction; Magnetic Resonance Imaging; Cerebrovascular Circulation