动脉自旋标记 (ASL) 灌注 MRI 可预测老年人的认知功能：一项 4 年的纵向研究。
Arterial-spin-labeling (ASL) perfusion MRI predicts cognitive function in elderly individuals: A 4-year longitudinal study.
机构信息
Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan.
出版信息
J Magn Reson Imaging. 2018 Aug;48(2):449-458. doi: 10.1002/jmri.25938. Epub 2018 Jan 2.
BACKGROUND
With the disappointing outcomes of clinical trials on patients with Alzheimer's disease or mild cognitive impairment (MCI), there is increasing attention to understanding cognitive decline in normal elderly individuals, with the goal of identifying subjects who are most susceptible to imminent cognitive impairment.
PURPOSE/HYPOTHESIS: To evaluate the potential of cerebral blood flow (CBF) as a biomarker by investigating the relationship between CBF at baseline and cognition at follow-up.
STUDY TYPE
Prospective longitudinal study with a 4-year time interval.
POPULATION
309 healthy subjects aged 20-89 years old.
FIELD STRENGTH/SEQUENCE: 3T pseudo-continuous-arterial-spin-labeling MRI.
ASSESSMENT
CBF at baseline and cognitive assessment at both baseline and follow-up.
STATISTICAL TESTS
Linear regression analyses with age, systolic blood pressure, physical activity, and baseline cognition as covariates.
RESULTS
Linear regression analyses revealed that whole-brain CBF at baseline was predictive of general fluid cognition at follow-up. This effect was observed in the older group (age ≥54 years, β = 0.221, P = 0.004), but not in younger or entire sample (β = 0.018, P = 0.867 and β = 0.089, P = 0.098, respectively). Among major brain lobes, frontal CBF had the highest sensitivity in predicting future cognition, with a significant effect observed for fluid cognition (β = 0.244 P = 0.001), episodic memory (β = 0.294, P = 0.001), and reasoning (β = 0.186, P = 0.027). These associations remained significant after accounting for baseline cognition. Voxelwise analysis revealed that medial frontal cortex and anterior cingulate cortex, part of the default mode network (DMN), are among the most important regions in predicting fluid cognition.
DATA CONCLUSION
In a healthy aging cohort, CBF can predict general cognitive ability as well as specific domains of cognitive function.
LEVEL OF EVIDENCE
1 Technical Efficacy: Stage 3 J. MAGN. RESON. IMAGING 2018;48:449-458.
背景
由于对阿尔茨海默病或轻度认知障碍（MCI）患者的临床试验结果令人失望，人们越来越关注理解正常老年人的认知下降，目的是确定最容易发生即将发生的认知障碍的受试者。
目的/假设：通过研究基线时脑血流（CBF）与随访时认知之间的关系，评估 CBF 作为生物标志物的潜力。
研究类型
具有 4 年时间间隔的前瞻性纵向研究。
人群
309 名年龄在 20-89 岁的健康受试者。
磁场强度/序列：3T 伪连续动脉自旋标记 MRI。
评估
基线时的 CBF 和基线及随访时的认知评估。
统计检验
线性回归分析，以年龄、收缩压、体力活动和基线认知作为协变量。
结果
线性回归分析显示，基线时的全脑 CBF 可预测随访时的一般液体认知。这种效应在年龄较大的组（年龄≥54 岁，β=0.221，P=0.004）中观察到，但在年龄较小的组或整个样本中未观察到（β=0.018，P=0.867 和β=0.089，P=0.098，分别）。在主要脑叶中，额叶 CBF 在预测未来认知方面具有最高的敏感性，在液体认知（β=0.244，P=0.001）、情景记忆（β=0.294，P=0.001）和推理（β=0.186，P=0.027）方面具有显著效果。在考虑基线认知后，这些关联仍然具有统计学意义。体素分析显示，内侧额叶皮层和前扣带皮层，默认模式网络（DMN）的一部分，是预测液体认知最重要的区域之一。
数据结论
在健康的老龄化队列中，CBF 可以预测一般认知能力以及认知功能的特定领域。
证据水平
1 技术功效：第 3 阶段 J. MAGN. RESON. IMAGING 2018;48:449-458.
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