Taghvaei Mohammad, Dolui Sudipto, Sadaghiani Shokufeh, Shakibajahromi Banafsheh, Brown Christopher, Khandelwal Pulkit, Xie Sharon X, Das Sandhitsu, Yushkevich Paul A, Wolk David A, Detre John A
Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Alzheimers Dement. 2025 Jan;21(1):e14382. doi: 10.1002/alz.14382. Epub 2024 Dec 3.
Alzheimer's disease (AD) typically involves both neurodegenerative and vascular pathologies, each associated with reductions in cerebral blood flow (CBF). However, it remains unclear whether vascular and neural contributions to regional CBF can be differentiated.
Using 3D background-suppressed arterial spin labeled perfusion magnetic resonance imaging, we evaluated regional CBF in a cohort of 257 participants across the AD continuum and assessed the impact of risk factors for both AD and small vessel disease (SVD) on regional CBF.
Vascular risk factors (VRFs) were associated with reduced CBF in normal-appearing periventricular white matter, while amyloid positivity was associated with reduced CBF in the posterior cingulate cortex and precuneus. Putative SVD-sensitive regions in white matter exhibited diagnosis-related CBF changes comparable to those in typical AD cortical regions.
Spatial patterns of hypoperfusion may differentiate AD and VRF-related effects on regional CBF. Our findings also support the contribution of SVD in AD pathogenesis.
We used 3D background-suppressed pCASL MRI to evaluate CBF across the AD continuum. Putative SVD-sensitive regions in white matter exhibited diagnosis-related CBF changes. AD and/or SVD risk correlated with reduced CBF in AD and/or SVD-related regions. VRFs were associated with more widespread CBF reductions than amyloid positivity. Spatial patterns of hypoperfusion may differentiate AD and VRF-related effects.
阿尔茨海默病（AD）通常涉及神经退行性病变和血管病变，两者均与脑血流量（CBF）减少有关。然而，尚不清楚血管和神经因素对局部脑血流量的影响是否可以区分。
我们使用三维背景抑制动脉自旋标记灌注磁共振成像技术，评估了257名处于AD疾病连续体不同阶段的参与者的局部脑血流量，并评估了AD和小血管疾病（SVD）的危险因素对局部脑血流量的影响。
血管危险因素（VRFs）与脑室周围正常白质区域的脑血流量减少有关，而淀粉样蛋白阳性与后扣带回皮质和楔前叶的脑血流量减少有关。白质中假定的SVD敏感区域显示出与典型AD皮质区域类似的、与诊断相关的脑血流量变化。
灌注不足的空间模式可能区分AD和VRF对局部脑血流量的影响。我们的研究结果也支持SVD在AD发病机制中的作用。
我们使用三维背景抑制动脉自旋标记磁共振成像（pCASL MRI）评估整个AD疾病连续体的脑血流量。白质中假定的SVD敏感区域显示出与诊断相关的脑血流量变化。AD和/或SVD风险与AD和/或SVD相关区域的脑血流量减少相关。与淀粉样蛋白阳性相比，VRFs与更广泛的脑血流量减少有关。灌注不足的空间模式可能区分AD和VRF相关的影响。
