Wang Caixia, Ji Deli, Su Xiao, Liu Fang, Zhang Yanxin, Lu Qingzheng, Cai Li, Wang Ying, Qin Wen, Xing Gebeili, Liu Peng, Liu Xin, Liu Meili, Zhang Nan
Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China, 154 Anshan Road Tianjin 300052, PR China; Department of Neurology, Baotou Central Hospital, Baotou 014040, PR China.
Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China, 154 Anshan Road Tianjin 300052, PR China; Department of Neurology, Chifeng Municipal Hospital, Chifeng 024000, PR China.
J Prev Alzheimers Dis. 2025 Feb;12(2):100031. doi: 10.1016/j.tjpad.2024.100031. Epub 2025 Jan 1.
Changes in cerebral blood flow (CBF) may contribute to the initial stages of the pathophysiological process in patients with Alzheimer's disease (AD). Hypoperfusion has been observed in several brain regions in patients with mild cognitive impairment (MCI). However, the clinical significance of CBF changes in the early stages of AD is currently unclear.
The aim of this study was to investigate the characteristics, diagnostic value and cognitive correlation of cerebral perfusion measured with arterial spin labeling (ASL) magnetic resonance imaging (MRI) in patients with MCI due to AD.
DESIGN, SETTING AND PARTICIPANTS: A total of fifty-nine MCI patients and 49 cognitively unimpaired controls (CUCs) were recruited and underwent multimodal MRI scans, including pseudocontinuous ASL, and neurocognitive testing. MCI patients were dichotomously classified according to the presence of amyloid deposition on C-labelled Pittsburgh compound B (PiB) positron emission tomography (PET).
The differences in CBF and expression of the AD-related perfusion pattern (ADRP), established by spatial covariance analysis in our previous study, were compared between the PiB+ MCI group and the CUC group and between the PiB+ and PiB- MCI groups. The diagnostic accuracy and correlations with cognitive function scores for CBF and ADRP expression were further analyzed.
Hypoperfusion in the precuneus and posterior cingulate cortex (PCC) was more characteristic of patients with MCI due to AD than of those with non-AD-related MCI. The relative regional CBF value of the left precuneus best distinguished patients with MCI due to AD from CUCs and patients with MCI due to non-AD conditions. Cerebral perfusion, as indicated by either the relative regional CBF or the expression score of the ADRP, was strongly correlated with certain cognitive function scores.
Here, we show that changes in CBF in the precuneus/PCC are promising MRI biomarkers for the identification of an AD etiology in patients with MCI. ASL, a noninvasive and cost-effective tool, has broad application prospects in the screening and early diagnosis of AD.
脑血流量（CBF）的变化可能在阿尔茨海默病（AD）患者病理生理过程的初始阶段起作用。在轻度认知障碍（MCI）患者的几个脑区已观察到灌注不足。然而，AD早期CBF变化的临床意义目前尚不清楚。
本研究旨在探讨动脉自旋标记（ASL）磁共振成像（MRI）测量的脑灌注在AD所致MCI患者中的特征、诊断价值及与认知的相关性。
设计、设置和参与者：共招募了59例MCI患者和49例认知未受损对照（CUC），并接受了多模态MRI扫描，包括伪连续ASL和神经认知测试。MCI患者根据C标记的匹兹堡化合物B（PiB）正电子发射断层扫描（PET）上淀粉样蛋白沉积的情况进行二分法分类。
比较PiB+MCI组与CUC组以及PiB+和PiB-MCI组之间CBF的差异以及我们先前研究中通过空间协方差分析建立的AD相关灌注模式（ADRP）的表达。进一步分析CBF和ADRP表达的诊断准确性及其与认知功能评分的相关性。
与非AD相关MCI患者相比，楔前叶和后扣带回皮质（PCC）灌注不足是AD所致MCI患者更具特征性的表现。左侧楔前叶的相对区域CBF值最能将AD所致MCI患者与CUC以及非AD所致MCI患者区分开来。相对区域CBF或ADRP表达评分所显示的脑灌注与某些认知功能评分密切相关。
在此，我们表明楔前叶/PCC的CBF变化是识别MCI患者AD病因的有前景的MRI生物标志物。ASL作为一种无创且经济有效的工具，在AD的筛查和早期诊断中具有广阔的应用前景。
