Radiology, University of Washington Medical Center, Seattle, WA, USA.
Radiology, University of Washington Medical Center, Seattle, WA, USA.
Neurobiol Aging. 2018 May;65:77-85. doi: 10.1016/j.neurobiolaging.2018.01.006. Epub 2018 Jan 31.
Cerebrovascular disease, especially small vessel pathology, is the leading comorbidity in degenerative disorders. We applied arterial spin labeling and cerebrovascular reserve (CVR) imaging to quantify small vessel disease and study its effect on cognitive symptoms in nondemented older adults from a community-based cohort. We evaluated baseline cerebral blood flow (CBF) using arterial spin labeling and percent signal change as a marker of CVR using blood-oxygen level-dependent imaging following a breath-hold stimulus. Measurements were performed in and near white matter hyperintensities, which are currently the standard to assess severity of vascular pathology. We show that similar to other studies (1) CBF and CVR are markedly reduced in the hyperintensities as well as in the tissue surrounding them, indicating susceptibility to infarction; (2) low CBF and CVR are significantly correlated with poor cognitive performance; and (3) in addition, compared to a 58.4% reduction in CBF, larger exhaustion (79.3%) of CVR was observed in the hyperintensities with a faster, nonlinear rate of decline. We conclude that CVR may be a more sensitive biomarker of small vessel disease than CBF.
脑血管疾病，特别是小血管病变，是退行性疾病的主要合并症。我们应用动脉自旋标记和脑血管储备（CVR）成像来量化小血管疾病，并研究其对来自社区队列的非痴呆老年人认知症状的影响。我们使用血氧水平依赖成像在屏息刺激后，通过动脉自旋标记评估基线脑血流（CBF），并使用信号变化百分比作为 CVR 的标志物。测量在和紧邻脑白质高信号区进行，这些区域是目前评估血管病变严重程度的标准。我们表明，与其他研究类似（1）CBF 和 CVR 在高信号区及其周围组织中明显降低，表明易发生梗塞；（2）低 CBF 和 CVR 与认知表现不佳显著相关；（3）此外，与 CBF 减少 58.4%相比，在高信号区中 CVR 的耗竭（79.3%）更大，下降速度更快且呈非线性。我们得出结论，与 CBF 相比，CVR 可能是小血管疾病更敏感的生物标志物。
