Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
Dement Geriatr Cogn Disord. 2009;28(3):220-4. doi: 10.1159/000237740. Epub 2009 Sep 16.
BACKGROUND/AIMS: Vascular pathology is increasingly seen as a factor contributing to the development of Alzheimer's disease (AD). With this in mind we hypothesized that this vascular pathology could be directly detected in the arteries contributing to the cerebral circulation of mild cognitive impairment (MCI) and AD patients by means of wall shear stress (WSS) measurements.
In this study we investigated the mean wall shear stress (MWSS), diastolic wall shear stress (DWSS) and systolic wall shear stress (SWSS) in the carotid and basilar arteries of control subjects (mean age: 72; SD: 8.8), patients suffering from MCI (mean age: 76; SD: 6.7), and patients suffering from AD (mean age: 72; SD: 8.2) that were consecutively referred to our outpatient memory clinic using in-house developed software on gradient echo phase-contrast MRI sequences.
We found that all these parameters were significantly lower in the carotid arteries of patients suffering from AD or MCI when compared to control subjects. In the basilar artery only DWSS was lower in MCI or AD patients compared to control subjects. In none of the arteries a difference was found for any WSS parameter between MCI and AD patients. WSS parameters were significantly associated (corrected for age and sex) with the degree of cognitive impairment.
Increased vascular pathology, as expressed by lower WSS measures, was found in patients suffering from MCI and AD compared to normal controls. This might point to the involvement of vascular pathology in the development of AD.
背景/目的:血管病理学越来越被认为是导致阿尔茨海默病(AD)发展的一个因素。考虑到这一点,我们假设这种血管病理学可以通过壁面切应力(WSS)测量直接检测到轻度认知障碍(MCI)和 AD 患者的大脑循环动脉中。
在这项研究中,我们使用自行开发的梯度回波相位对比 MRI 序列软件,调查了对照组(平均年龄:72;SD:8.8)、MCI 患者(平均年龄:76;SD:6.7)和 AD 患者(平均年龄:72;SD:8.2)颈内和基底动脉的平均壁面切应力(MWSS)、舒张期壁面切应力(DWSS)和收缩期壁面切应力(SWSS)。
我们发现,与对照组相比,AD 或 MCI 患者的颈内动脉的所有这些参数都显著降低。在基底动脉中,只有 DWSS 在 MCI 或 AD 患者中低于对照组。在任何动脉中,MCI 和 AD 患者之间的任何 WSS 参数均无差异。WSS 参数与认知障碍的严重程度显著相关(校正年龄和性别)。
与正常对照组相比,MCI 和 AD 患者的血管病理学增加,表现为较低的 WSS 测量值。这可能表明血管病理学参与了 AD 的发展。