NESMOS Department, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome.
S. Lucia Foundation, Experimental Neuro-Psychobiology Laboratory, Clinical and Behavioral Neurology, Rome, Italy.
Alzheimer Dis Assoc Disord. 2019 Jul-Sep;33(3):212-219. doi: 10.1097/WAD.0000000000000331.
The aims of this study were to assess vascular dysfunction in patients with Alzheimer disease (AD) by investigating cerebral vasomotor reactivity using transcranial Doppler ultrasound (TCD) and to evaluate any correlations between cerebral vasoreactivity and endothelium dysfunction. Moreover, the frequency of circulating progenitor cells (CPCs) and the blood concentration of vascular/inflammatory markers were evaluated.
We recruited 35 AD subjects and 17 age-matched, sex-matched, and education-matched healthy control subjects. Cerebral vasomotor reactivity was assessed by means of the TCD-based breath-holding index test (BHI). The level of CPCs was evaluated by means of flow cytometry from venous blood samples, while blood vascular/inflammatory markers were measured by means of enzyme-linked immunosorbent assay.
Both cerebral assay blood flow velocity in the middle cerebral artery (MCAFV) and BHI values were significantly lower in AD subjects than in healthy controls (P<0.05). A positive trend was found between MCAFV and BHI values and Mini-Mental State Evaluation (MMSE) scores. Moreover, the hematopoietic progenitor cells' count was found to be lower in patients with AD than in controls (P<0.05). Finally, a significantly higher expression of the plasma chemokine CCL-2 was observed in AD patients than in healthy controls.
Our results confirm that cerebral hemodynamic deterioration may be a critical marker of cognitive decline. Further studies are needed to investigate the role of circulating CPCs and chemokines as potential contributors to neurovascular dysfunction.
本研究旨在通过经颅多普勒超声(TCD)评估阿尔茨海默病(AD)患者的血管功能障碍,并用其评估脑血管反应性,并评估脑血管反应性与内皮功能障碍之间的任何相关性。此外,还评估了循环祖细胞(CPCs)的频率和血管/炎症标志物的血液浓度。
我们招募了 35 名 AD 患者和 17 名年龄、性别和教育程度匹配的健康对照者。通过 TCD 基础的屏气指数测试(BHI)评估脑血管反应性。通过静脉血样的流式细胞术评估 CPCs 水平,通过酶联免疫吸附测定法测量血管/炎症标志物的血液浓度。
AD 患者的大脑中动脉(MCAFV)血流速度和 BHI 值均明显低于健康对照组(P<0.05)。MCAFV 和 BHI 值与简易精神状态评价(MMSE)评分之间存在正相关趋势。此外,AD 患者的造血祖细胞计数低于对照组(P<0.05)。最后,AD 患者的血浆趋化因子 CCL-2 表达明显高于健康对照组。
我们的研究结果证实,脑血流动力学恶化可能是认知能力下降的关键标志物。需要进一步研究以调查循环 CPCs 和趋化因子作为神经血管功能障碍潜在贡献者的作用。