Soman Shania, Raghavan Sheelakumari, Rajesh P G, Varma Ravi Prasad, Mohanan Nandini, Ramachandran Sushama S, Thomas Bejoy, Kesavadas Chandrasekharan, Menon Ramshekhar N
Cognition and Behavioural Neurology Section, Department of Neurology, Sree ChitraTirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
Department of Imaging Sciences and Interventional Radiology, Sree ChitraTirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
Ann Indian Acad Neurol. 2021 Jul-Aug;24(4):559-565. doi: 10.4103/aian.AIAN_848_20. Epub 2021 Apr 5.
Cerebral blood flow (CBF) measurement using arterial spin labelling (ASL) MRI sequences has recently emerged as a prominent tool in dementia research.
To establish association between quantified regional cerebral perfusion and gray matter (GM) volumes with cognitive measures in mild cognitive impairment (MCI) and early Alzheimer's Dementia (AD), using three dimensional fast spin echo pseudo-continuous ASL MRI sequences.
Hospital-based cross-sectional study.
Three age-matched groups, i.e., 21 cognitively normal healthy controls (HC), 20 MCI and 19 early AD patients diagnosed using neuropsychological tests and who consented for multimodality 3T MRI were recruited for the study.
Statistical parametric mapping and regions of interest (ROI) multivariate analysis of variance was used to ascertain differences between patients and controls on MRI-volumetry and ASL. Linear regression was used to assess relationship between CBF with GM atrophy and neuropsychological test measures.
Compared to HC, patients with MCI and AD had significantly lower quantified perfusion in posterior cingulate and lingual gyri, over hippocampus in MCI, with no differences noted between MCI and AD. Atrophy over the middle temporal gyrus and hippocampus differentiated AD from MCI. No significant positive correlations were noted between perfusion and GM volumes in ROI with the exception of temporal neocortex. Significantly positive coefficient b-value (p < 0.01) were apparent between global cognition with CBF in precuneus, temporal neocortex and precuneus volume, with negative b-values noted between medial temporal CBF for global cognition and recall scores.
ROI-based CBF measurements differentiated MCI and AD from HC; volumetry of medial and neocortical temporal GM separates AD from MCI. Correlations between CBF and neuropsychology are variable and require further longitudinal studies to gauge its predictive utility on cognitive trajectory in MCI.
使用动脉自旋标记（ASL）MRI序列测量脑血流量（CBF）最近已成为痴呆症研究中的一种重要工具。
使用三维快速自旋回波伪连续ASL MRI序列，在轻度认知障碍（MCI）和早期阿尔茨海默病（AD）中建立定量区域脑灌注与灰质（GM）体积与认知指标之间的关联。
基于医院的横断面研究。
招募了三个年龄匹配的组，即21名认知正常的健康对照（HC）、20名MCI患者和19名早期AD患者，这些患者通过神经心理学测试诊断，并同意进行多模态3T MRI检查。
采用统计参数映射和感兴趣区域（ROI）多变量方差分析来确定患者和对照在MRI体积测量和ASL方面的差异。使用线性回归评估CBF与GM萎缩和神经心理学测试指标之间的关系。
与HC相比，MCI和AD患者在后扣带回和舌回的定量灌注显著降低，MCI患者海马区也有降低，MCI和AD之间未发现差异。颞中回和海马区的萎缩将AD与MCI区分开来。除颞叶新皮质外，ROI中灌注与GM体积之间未发现显著正相关。在楔前叶、颞叶新皮质的CBF与整体认知以及楔前叶体积之间存在显著正系数b值（p < 0.01），在颞叶内侧CBF与整体认知和回忆分数之间存在负b值。
基于ROI的CBF测量可将MCI和AD与HC区分开来；颞叶内侧和新皮质GM的体积测量可将AD与MCI区分开来。CBF与神经心理学之间的相关性是可变的，需要进一步的纵向研究来评估其对MCI认知轨迹的预测效用。
