Institute of Medical Sciences, The University of Toronto, ON, Canada.
Department of Medicine, Division of Neurology, University of Toronto and the University Health Network, Toronto, ON, Canada.
Can J Neurol Sci. 2020 May;47(3):366-373. doi: 10.1017/cjn.2020.30.
Recent investigations now suggest that cerebrovascular reactivity (CVR) is impaired in Alzheimer's disease (AD) and may underpin part of the disease's neurovascular component. However, our understanding of the relationship between the magnitude of CVR, the speed of cerebrovascular response, and the progression of AD is still limited. This is especially true in patients with mild cognitive impairment (MCI), which is recognized as an intermediate stage between normal aging and dementia. The purpose of this study was to investigate AD and MCI patients by mapping repeatable and accurate measures of cerebrovascular function, namely the magnitude and speed of cerebrovascular response (τ) to a vasoactive stimulus in key predilection sites for vascular dysfunction in AD.
Thirty-three subjects (age range: 52-83 years, 20 males) were prospectively recruited. CVR and τ were assessed using blood oxygen level-dependent MRI during a standardized carbon dioxide stimulus. Temporal and parietal cortical regions of interest (ROIs) were generated from anatomical images using the FreeSurfer image analysis suite.
Of 33 subjects recruited, 3 individuals were excluded, leaving 30 subjects for analysis, consisting of 6 individuals with early AD, 11 individuals with MCI, and 13 older healthy controls (HCs). τ was found to be significantly higher in the AD group compared to the HC group in both the temporal (p = 0.03) and parietal cortex (p = 0.01) following a one-way ANCOVA correcting for age and microangiopathy scoring and a Bonferroni post-hoc correction.
The study findings suggest that AD is associated with a slowing of the cerebrovascular response in the temporal and parietal cortices.
最近的研究表明,阿尔茨海默病(AD)患者的脑血管反应性(CVR)受损,这可能是该疾病神经血管成分的一部分。然而,我们对 CVR 的幅度、脑血管反应速度与 AD 进展之间关系的理解仍然有限。在轻度认知障碍(MCI)患者中尤其如此,MCI 被认为是正常衰老与痴呆之间的中间阶段。本研究旨在通过绘制脑血管功能的可重复且准确的测量值(即对血管功能障碍的 AD 关键易患部位的血管活性刺激的 CVR 和脑血管反应速度(τ)的幅度和速度)来研究 AD 和 MCI 患者。
前瞻性招募了 33 名受试者(年龄范围:52-83 岁,男性 20 名)。使用血氧水平依赖 MRI 在标准化的二氧化碳刺激期间评估 CVR 和 τ。使用 FreeSurfer 图像分析套件从解剖图像中生成颞叶和顶叶皮质感兴趣区(ROI)。
在招募的 33 名受试者中,有 3 人被排除,留下 30 名受试者进行分析,其中包括 6 名早期 AD 患者、11 名 MCI 患者和 13 名老年健康对照者(HCs)。在颞叶(p=0.03)和顶叶(p=0.01)皮质中,经过单因素方差分析校正年龄和微血管病变评分,并进行 Bonferroni 事后检验,AD 组的 τ 明显高于 HCs 组。
研究结果表明,AD 与颞叶和顶叶皮质中脑血管反应速度的减慢有关。