Roher Alex E, Garami Zsolt, Alexandrov Andrei V, Kokjohn Tyler A, Esh Chera L, Kalback Walter M, Vedders Linda J, Wilson Jeffrey R, Sabbagh Marwan N, Beach Thomas G
Longtine Center for Molecular Biology and Genetics, Sun Health Research Institute, Sun City AZ 85351, USA.
Neurol Res. 2006 Sep;28(6):672-8. doi: 10.1179/016164106X130470.
Recent post-mortem studies have reported that the severity of atheromatous deposits in the circle of Willis is significantly greater, relative to non-demented (ND) elderly persons, in subjects with neuropathologically diagnosed Alzheimer's disease (AD). Additionally, the severity of intracranial atherosclerosis correlates significantly with the densities of neuritic plaques and neurofibrillary tangles. In this study, we examine the arteries of the circle of Willis by transcranial Doppler (TCD) ultrasonography.
TCD was used to measure, in 25 AD patients and 30 ND elderly subjects, mean flow velocities and pulsatility indices in 16 different segments of the circle of Willis. The data were compared with and without adjustment for age, gender and systolic blood pressure.
The AD patients had systematically higher pulsatility indices (p<0.005) than the ND group. Incremental increases of pulsatility indices in these segments had odds ratios ranging from 1.8 to 48 for the presence of AD when adjusted for age, gender and systolic blood pressure. The left internal carotid artery siphon and the left posterior cerebral artery were the two vessels that were strongly associated with AD diagnosis. Mean flow velocities were generally lower in patients with AD but the differences did not reach the significance level.
The pulsatility indices of the arteries of AD patients were generally greater than those of similarly-aged ND subjects. This difference is most likely due to increased arterial wall rigidity imposed by atherosclerotic changes. Atherosclerotic disease of intracranial arteries may be a risk factor for AD.
最近的尸检研究报告称，与非痴呆（ND）老年人相比，经神经病理学诊断为阿尔茨海默病（AD）的受试者 Willis 环处动脉粥样硬化沉积物的严重程度明显更高。此外，颅内动脉粥样硬化的严重程度与神经炎性斑块和神经原纤维缠结的密度显著相关。在本研究中，我们通过经颅多普勒（TCD）超声检查 Willis 环的动脉。
使用 TCD 测量 25 例 AD 患者和 30 例 ND 老年受试者 Willis 环 16 个不同节段的平均流速和搏动指数。对数据进行了年龄、性别和收缩压调整与否的比较。
AD 患者的搏动指数系统性地高于 ND 组（p<0.005）。在调整年龄、性别和收缩压后，这些节段搏动指数的增加与 AD 存在的比值比范围为 1.8 至 48。左颈内动脉虹吸段和左大脑后动脉是与 AD 诊断密切相关的两条血管。AD 患者的平均流速通常较低，但差异未达到显著水平。
AD 患者动脉的搏动指数通常高于同龄 ND 受试者。这种差异很可能是由于动脉粥样硬化改变导致动脉壁僵硬度增加。颅内动脉粥样硬化疾病可能是 AD 的一个危险因素。
