02655nas a2200253 4500008004100000022001400041245010600055210006900161260000900230300001400239490000700253520189200260100001602152700002302168700003102191700002302222700002302245700002102268700002102289700002002310700001802330700001702348856003602365 2020 eng d a1875-890800aCerebral Blood Flow Is Associated with Diagnostic Class and Cognitive Decline in Alzheimer's Disease.0 aCerebral Blood Flow Is Associated with Diagnostic Class and Cogn c2020 a1103-11200 v763 a

BACKGROUND: Reliable cerebral blood flow (CBF) biomarkers using a noninvasive imaging technique are sought to facilitate early diagnosis and intervention in early Alzheimer's disease (AD).

OBJECTIVE: We aim to identify brain regions in which CBF values are affected and related to cognitive decline in early AD using a large cohort.

METHODS: Perfusion MRIs using continuous arterial spin labeling were acquired at 1.5 T in 58 normal controls (NC), 50 mild cognitive impairments (MCI), and 40 AD subjects from the Cardiovascular Health Study Cognition Study. Regional absolute CBF and normalized CBF (nCBF) values, without and with correction of partial volume effects, were compared across three groups. Association between regional CBF values and Modified Mini-Mental State Examination (3MSE) were investigated by multiple linear regression analyses adjusted for cardiovascular risk factors.

RESULTS: After correcting for partial volume effects and cardiovascular risk factors, ADs exhibited decreased nCBF with the strongest reduction in the bilateral posterior cingulate & precuneus region (p < 0.001) compared to NCs, and the strongest reduction in the bilateral superior medial frontal region (p < 0.001) compared to MCIs. MCIs exhibited the strongest nCBF decrease in the left hippocampus and nCBF increase in the right inferior frontal and insular region. The 3MSE scores within the symptomatic subjects were significantly associated with nCBF in the bilateral posterior and middle cingulate and parietal (p < 0.001), bilateral superior medial frontal (p < 0.001), bilateral temporoparietal (p < 0.02), and right hippocampus (p = 0.02) regions.

CONCLUSION: Noninvasive perfusion MRI can detect functional changes across diagnostic class and serve as a staging biomarker of cognitive status.

1 aDuan, Wenna1 aSehrawat, Parshant1 aBalachandrasekaran, Arvind1 aBhumkar, Ashish, B1 aBoraste, Paresh, B1 aBecker, James, T1 aKuller, Lewis, H1 aLopez, Oscar, L1 aGach, Michael1 aDai, Weiying uhttps://chs-nhlbi.org/node/838202708nas a2200253 4500008004100000022001400041245016400055210006900219260000900288300001200297490000700309520189300316100001602209700001902225700003102244700002302275700002302298700002102321700002102342700002002363700001802383700001702401856003602418 2021 eng d a1875-890800aCerebral Blood Flow Predicts Conversion of Mild Cognitive Impairment into Alzheimer's Disease and Cognitive Decline: An Arterial Spin Labeling Follow-up Study.0 aCerebral Blood Flow Predicts Conversion of Mild Cognitive Impair c2021 a293-3050 v823 a

BACKGROUND: This is the first longitudinal study to assess regional cerebral blood flow (rCBF) changes during the progression from normal control (NC) through mild cognitive impairment (MCI) and Alzheimer's disease (AD).

OBJECTIVE: We aim to determine if perfusion MRI biomarkers, derived from our prior cross-sectional study, can predict the onset and cognitive decline of AD.

METHODS: Perfusion MRIs using arterial spin labeling (ASL) were acquired in 15 stable-NC, 14 NC-to-MCI, 16 stable-MCI, and 18 MCI/AD-to-AD participants from the Cardiovascular Health Study (CHS) cognition study. Group comparisons, predictions of AD conversion and time to conversion, and Modified Mini-Mental State Examination (3MSE) from rCBF were performed.

RESULTS: Compared to the stable-NC group: 1) the stable-MCI group exhibited rCBF decreases in the right temporoparietal (p = 0.00010) and right inferior frontal and insula (p = 0.0094) regions; and 2) the MCI/AD-to-AD group exhibited rCBF decreases in the bilateral temporoparietal regions (p = 0.00062 and 0.0035). Compared to the NC-to-MCI group, the stable-MCI group exhibited a rCBF decrease in the right hippocampus region (p = 0.0053). The baseline rCBF values in the posterior cingulate cortex (PCC) (p = 0.0043), bilateral superior medial frontal regions (BSMF) (p = 0.012), and left inferior frontal (p = 0.010) regions predicted the 3MSE scores for all the participants at follow-up. The baseline rCBF in the PCC and BSMF regions predicted the conversion and time to conversion from MCI to AD (p < 0.05; not significant after multiple corrections).

CONCLUSION: We demonstrated the feasibility of ASL in detecting rCBF changes in the typical AD-affected regions and the predictive value of baseline rCBF on AD conversion and cognitive decline.

1 aDuan, Wenna1 aZhou, Grace, D1 aBalachandrasekaran, Arvind1 aBhumkar, Ashish, B1 aBoraste, Paresh, B1 aBecker, James, T1 aKuller, Lewis, H1 aLopez, Oscar, L1 aGach, Michael1 aDai, Weiying uhttps://chs-nhlbi.org/node/877302317nas a2200229 4500008004100000022001400041245011300055210006900168260001600237520160000253100001801853700001901871700003101890700001901921700002101940700002101961700001401982700002001996700001702016700001802033856003602051 2023 eng d a2152-525000aProspective Longitudinal Perfusion in Probable Alzheimer's Disease Correlated with Atrophy in Temporal Lobe.0 aProspective Longitudinal Perfusion in Probable Alzheimers Diseas c2023 May 093 a

Reduced cerebral blood flow (CBF) in the temporoparietal region and gray matter volumes (GMVs) in the temporal lobe were previously reported in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). However, the temporal relationship between reductions in CBF and GMVs requires further investigation. This study sought to determine if reduced CBF is associated with reduced GMVs, or vice versa. Data came from 148 volunteers of the Cardiovascular Health Study Cognition Study (CHS-CS), including 58 normal controls (NC), 50 MCI, and 40 AD who had perfusion and structural MRIs during 2002-2003 (Time 2). Sixty-three of the 148 volunteers had follow-up perfusion and structural MRIs (Time 3). Forty out of the 63 volunteers received prior structural MRIs during 1997-1999 (Time 1). The relationships between GMVs and subsequent CBF changes, and between CBF and subsequent GMV changes were investigated. At Time 2, we observed smaller GMVs (p<0.05) in the temporal pole region in AD compared to NC and MCI. We also found associations between: (1) temporal pole GMVs at Time 2 and subsequent declines in CBF in this region (p=0.0014) and in the temporoparietal region (p=0.0032); (2) hippocampal GMVs at Time 2 and subsequent declines in CBF in the temporoparietal region (p=0.012); and (3) temporal pole CBF at Time 2 and subsequent changes in GMV in this region (p = 0.011). Therefore, hypoperfusion in the temporal pole may be an early event driving its atrophy. Perfusion declines in the temporoparietal and temporal pole follow atrophy in this temporal pole region.

1 aZhou, Tony, D1 aZhang, Zongpai1 aBalachandrasekaran, Arvind1 aRaji, Cyrus, A1 aBecker, James, T1 aKuller, Lewis, H1 aGe, Yulin1 aLopez, Oscar, L1 aDai, Weiying1 aGach, Michael uhttps://chs-nhlbi.org/node/9389