Dai Weiying, Lopez Oscar L, Carmichael Owen T, Becker James T, Kuller Lewis H, Gach H Michael
Department of Radiology, Harvard Medical School, Boston, Mass, USA.
Radiology. 2009 Mar;250(3):856-66. doi: 10.1148/radiol.2503080751. Epub 2009 Jan 21.
To examine regional cerebral blood flow (rCBF) in incident mild cognitive impairment (MCI) and Alzheimer disease (AD) by using continuous arterial spin-labeling (CASL) magnetic resonance (MR) imaging.
This study was approved by the local institutional review board and was compliant with HIPAA regulations. Informed consent was obtained. rCBF was measured in 38 control subjects, 29 MCI patients, and 37 AD patients who were participating in a longitudinal epidemiologic study. Multisection CASL MR imaging with alternating single and double adiabatic inversion pulses and ramp-sampled echo-planar imaging were performed to acquire 19 contiguous axial sections. Voxel-level rCBF was compared among groups by using an analysis of variance design; clusters of voxels with significant group differences were identified. Multiple regression models controlled for age, sex, and presence of hypertension and related the mean rCBF in those clusters to the presence of MCI and AD.
MCI and AD patients had decreased rCBF in the posterior cingulate gyrus (P = .01) with extension to the medial precuneus compared with that in control subjects. MCI patients had increased rCBF in the left hippocampus (P < .001), right amygdala (P = .007), and rostral head of the right caudate nucleus and ventral putamen and globus pallidus (P = .003) compared with that in control subjects. AD patients had decreased rCBF relative to that in control subjects and MCI patients in the left inferior parietal (P = .005), left lateral frontal (P < .001), left superior temporal (P = .001), and left orbitofrontal (P = .003) cortices. AD patients had increased rCBF in the right anterior cingulate gyrus (P = .02) compared with that in control subjects.
The transition from normal cognition to AD is associated with dynamic pathologic processes in the brain, and this is reflected by both decreases and increases in rCBF. Increases in rCBF suggest a cellular and vascular compensatory process associated with incipient AD.
http://radiology.rsnajnls.org/cgi/content/full/2503080751/DC1.
采用连续动脉自旋标记（CASL）磁共振（MR）成像检查初发轻度认知障碍（MCI）和阿尔茨海默病（AD）患者的局部脑血流量（rCBF）。
本研究经当地机构审查委员会批准，并符合健康保险流通与责任法案（HIPAA）规定。已获得知情同意。对参与一项纵向流行病学研究的38名对照受试者、29名MCI患者和37名AD患者测量rCBF。采用具有交替单绝热反转脉冲和双绝热反转脉冲以及斜坡采样回波平面成像的多层面CASL MR成像，获取19个连续的轴位层面。通过方差分析设计比较各组间体素水平的rCBF；识别出具有显著组间差异的体素簇。采用多元回归模型控制年龄、性别和高血压的存在情况，并将这些簇中的平均rCBF与MCI和AD的存在情况相关联。
与对照受试者相比，MCI和AD患者的后扣带回rCBF降低（P = .01），并延伸至内侧楔前叶。与对照受试者相比，MCI患者左侧海马（P < .001）、右侧杏仁核（P = .007）以及右侧尾状核头部和腹侧壳核及苍白球的喙部rCBF增加（P = .003）。与对照受试者和MCI患者相比，AD患者左侧顶下叶（P = .005）、左侧额外侧（P < .001）、左侧颞上叶（P = .001）和左侧眶额皮质（P = .003）的rCBF降低。与对照受试者相比，AD患者右侧前扣带回rCBF增加（P = .02）。
从正常认知到AD的转变与大脑中的动态病理过程相关，这在rCBF的降低和增加中均有体现。rCBF增加提示与早期AD相关的细胞和血管代偿过程。
http://radiology.rsnajnls.org/cgi/content/full/2503080751/DC1
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