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Camargo A, Wang Z. Hypo- and hyper-perfusion in MCI and AD identified by different ASL MRI sequences. Brain Imaging Behav 2023; 17:306-319. [PMID: 36973476 PMCID: PMC10198885 DOI: 10.1007/s11682-023-00764-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2023] [Indexed: 03/29/2023]
Abstract
Arterial spin labeling (ASL) perfusion MRI has been increasingly used in Alzheimer's Disease (AD) research. However, ASL MRI sequences differ greatly in terms of arterial blood signal preparations and data acquisition strategies, both leading to a large difference of signal-to-noise ratio (SNR). It is of great translational importance to compare the several widely used ASL MRI sequences regarding sensitivity of ASL measured cerebral blood flow (CBF) for detecting the between-group difference across the AD continuum. To this end, this study compared three ASL MRI sequences in AD research, including the 2D Pulsed ASL (PASL), 3D Background Suppressed (BS) PASL, and 3D BS Pseudo-Continuous ASL (PCASL). We used data from 100 healthy and cognitively normal elderly control (NC) subjects, 75 patients with mild cognitive impairment (MCI), and 57 Alzheimer's disease (AD) subjects from the AD neuroimaging initiative (ADNI). Both cross-sectional perfusion difference and perfusion versus clinical assessment correlations were examined. The major findings included: 3D PCASL sequence identified stronger patient versus control CBF/rCBF differences than 2D PASL and 3D PASL; MCI showed reduced CBF and CBF redistribution; CBF in orbito-frontal cortex presents a new U-shape change pattern from normal aging to MCI and to AD; 3D PCASL identified a negative rCBF to memory correlation while 2D PASL showed a positive correlation.
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Affiliation(s)
- Aldo Camargo
- Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, HSF III Room 1173, 670 W Baltimore St, Baltimore, MD, 21201, USA
| | - Ze Wang
- Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, HSF III Room 1173, 670 W Baltimore St, Baltimore, MD, 21201, USA.
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Abstract
Arterial spin labeling (ASL) perfusion MRI is a non-invasive technique for quantifying and mapping cerebral blood flow (CBF). Depending on the tissue signal change after magnetically labeled arterial blood enters the brain tissue, ASL MRI signal can be affected by several factors, including the volume of arrived arterial blood, signal decay of labeled blood, physiological fluctuations of the brain and CBF, and head motion, etc. Some of them can be controlled using sophisticated state-of-art ASL MRI sequences, but the others can only be resolved with post-processing strategies. Over the decades, various post-processing methods have been proposed in the literature, and many post processing software packages have been released. This self-contained review provides a brief introduction to ASL MRI, recommendations for typical ASL MRI data acquisition protocols, an overview of the ASL data processing pipeline, and an introduction to typical methods used at each step in the pipeline. Although the main focus is on traditional heuristic model-based methods, a brief introduction to recent machine learning-based approaches is provided too.
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Affiliation(s)
- Ze Wang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
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Kapasouri EM, Ioannidis DC, Cameron D, Vassiliou VS, Hornberger M. The Utility of Arterial Spin Labeling MRI in Medial Temporal Lobe as a Vascular Biomarker in Alzheimer's Disease Spectrum: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2022; 12. [PMID: 36552974 DOI: 10.3390/diagnostics12122967] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/14/2022] [Accepted: 11/18/2022] [Indexed: 11/29/2022] Open
Abstract
We sought to systematically review and meta-analy the role of cerebral blood flow (CBF) in the medial temporal lobe (MTL) using arterial spin labeling magnetic resonance imaging (ASL-MRI) and compare this in patients with Alzheimer's disease (AD), individuals with mild cognitive impairment (MCI), and cognitively normal adults (CN). The prevalence of AD is increasing and leading to high healthcare costs. A potential biomarker that can identify people at risk of developing AD, whilst cognition is normal or only mildly affected, will enable risk-stratification and potential therapeutic interventions in the future. All studies investigated the role of CBF in the MTL and compared this among AD, MCI, and CN participants. A total of 26 studies were included in the systematic review and 11 in the meta-analysis. Three separate meta-analyses were conducted. Four studies compared CBF in the hippocampus of AD compared with the CN group and showed that AD participants had 2.8 mL/min/100 g lower perfusion compared with the CN group. Eight studies compared perfusion in the hippocampus of MCI vs. CN group, which showed no difference. Three studies compared perfusion in the MTL of MCI vs. CN participants and showed no statistically significant differences. CBF measured via ASL-MRI showed impairment in AD compared with the CN group in subregions of the MTL. CBF difference was significant in hippocampus between the AD and CN groups. However, MCI and CN group showed no significant difference in subregions of MTL.
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Ba L, Huang L, He Z, Deng S, Xie Y, Zhang M, Jacob C, Antonecchia E, Liu Y, Xiao W, Xie Q, Huang Z, Yi C, D'Ascenzo N, Ding F. Does Chronic Sleep Fragmentation Lead to Alzheimer's Disease in Young Wild-Type Mice? Front Aging Neurosci 2022; 13:759983. [PMID: 34992526 PMCID: PMC8724697 DOI: 10.3389/fnagi.2021.759983] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/22/2021] [Indexed: 12/18/2022] Open
Abstract
Chronic sleep insufficiency is becoming a common issue in the young population nowadays, mostly due to life habits and work stress. Studies in animal models of neurological diseases reported that it would accelerate neurodegeneration progression and exacerbate interstitial metabolic waste accumulation in the brain. In this paper, we study whether chronic sleep insufficiency leads to neurodegenerative diseases in young wild-type animals without a genetic pre-disposition. To this aim, we modeled chronic sleep fragmentation (SF) in young wild-type mice. We detected pathological hyperphosphorylated-tau (Ser396/Tau5) and gliosis in the SF hippocampus. 18F-labeled fluorodeoxyglucose positron emission tomography scan (18F-FDG-PET) further revealed a significant increase in brain glucose metabolism, especially in the hypothalamus, hippocampus and amygdala. Hippocampal RNAseq indicated that immunological and inflammatory pathways were significantly altered in 1.5-month SF mice. More interestingly, differential expression gene lists from stress mouse models showed differential expression patterns between 1.5-month SF and control mice, while Alzheimer's disease, normal aging, and APOEε4 mutation mouse models did not exhibit any significant pattern. In summary, 1.5-month sleep fragmentation could generate AD-like pathological changes including tauopathy and gliosis, mainly linked to stress, as the incremented glucose metabolism observed with PET imaging suggested. Further investigation will show whether SF could eventually lead to chronic neurodegeneration if the stress condition is prolonged in time.
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Affiliation(s)
- Li Ba
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lifang Huang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ziyu He
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Saiyue Deng
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Xie
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Min Zhang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Cornelius Jacob
- Department of Biomedical Engineering, School of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Emanuele Antonecchia
- Department of Biomedical Engineering, School of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China.,Department of Medical Physics and Engineering, Istituto Neurologico Mediterraneo Neuromed Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), Pozzilli, Italy
| | - Yuqing Liu
- Department of Biomedical Engineering, School of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Wenchang Xiao
- Department of Biomedical Engineering, School of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Qingguo Xie
- Department of Biomedical Engineering, School of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China.,Department of Medical Physics and Engineering, Istituto Neurologico Mediterraneo Neuromed Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), Pozzilli, Italy.,Department of Electronic Engineering and Information Science, University of Science and Technology of China, Hefei, China
| | - Zhili Huang
- Department of Pharmacology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Chenju Yi
- Research Centre, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Nicola D'Ascenzo
- Department of Biomedical Engineering, School of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China.,Department of Medical Physics and Engineering, Istituto Neurologico Mediterraneo Neuromed Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), Pozzilli, Italy
| | - Fengfei Ding
- Department of Pharmacology, Shanghai Medical College, Fudan University, Shanghai, China
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Duan W, Sehrawat P, Zhou TD, Becker JT, Lopez OL, Gach HM, Dai W. Pattern of Altered Magnetization Transfer Rate in Alzheimer's Disease. J Alzheimers Dis 2022; 88:693-705. [PMID: 35694929 PMCID: PMC9382719 DOI: 10.3233/jad-220335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Biomarkers for Alzheimer's disease (AD) are crucial for early diagnosis and treatment monitoring once disease modifying therapies become available. OBJECTIVE This study aims to quantify the forward magnetization transfer rate (kfor) map from brain tissue water to macromolecular protons and use it to identify the brain regions with abnormal kfor in AD and AD progression. METHODS From the Cardiovascular Health Study (CHS) cognition study, magnetization transfer imaging (MTI) was acquired at baseline from 63 participants, including 20 normal controls (NC), 18 with mild cognitive impairment (MCI), and 25 AD subjects. Of those, 53 participants completed a follow-up MRI scan and were divided into four groups: 15 stable NC, 12 NC-to-MCI, 12 stable MCI, and 14 MCI/AD-to-AD subjects. kfor maps were compared across NC, MCI, and AD groups at baseline for the cross-sectional study and across four longitudinal groups for the longitudinal study. RESULTS We found a lower kfor in the frontal gray matter (GM), parietal GM, frontal corona radiata (CR) white matter (WM) tracts, frontal and parietal superior longitudinal fasciculus (SLF) WM tracts in AD relative to both NC and MCI. Further, we observed progressive decreases of kfor in the frontal GM, parietal GM, frontal and parietal CR WM tracts, and parietal SLF WM tracts in stable MCI. In the parietal GM, parietal CR WM tracts, and parietal SLF WM tracts, we found trend differences between MCI/AD-to-AD and stable NC. CONCLUSION Forward magnetization transfer rate is a promising biomarker for AD diagnosis and progression.
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Affiliation(s)
- Wenna Duan
- Department of Computer Science, State University of New York at Binghamton, Binghamton, NY
| | - Parshant Sehrawat
- Department of Computer Science, State University of New York at Binghamton, Binghamton, NY
| | - Tony D. Zhou
- Departments of Radiation Oncology, Radiology, and Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO
| | - James T. Becker
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
- Department of Psychiatry and Neurology, University of Pittsburgh, Pittsburgh, PA
| | - Oscar L. Lopez
- Department of Psychiatry and Neurology, University of Pittsburgh, Pittsburgh, PA
| | - H. Michael Gach
- Departments of Radiation Oncology, Radiology, and Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO
| | - Weiying Dai
- Department of Computer Science, State University of New York at Binghamton, Binghamton, NY
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Abstract
The neuroimaging method of multimodal magnetic resonance imaging (MRI) can identify the changes in brain structure and function caused by Alzheimer's disease (AD) at different stages, and it is a practical method to study the mechanism of AD progression. This paper reviews the studies of methods and biomarkers for predicting AD progression based on multimodal MRI. First, different approaches for predicting AD progression are analyzed and summarized, including machine learning, deep learning, regression, and other MRI analysis methods. Then, the effective biomarkers of AD progression under structural magnetic resonance imaging, diffusion tensor imaging, functional magnetic resonance imaging, and arterial spin labeling modes of MRI are summarized. It is believed that the brain changes shown on MRI may be related to the cognitive decline in different prodrome stages of AD, which is conducive to the further realization of early intervention and prevention of AD. Finally, the deficiencies of the existing studies are analyzed in terms of data set size, data heterogeneity, processing methods, and research depth. More importantly, future research directions are proposed, including enriching data sets, simplifying biomarkers, utilizing multimodal magnetic resonance, etc. In the future, the study of AD progression by multimodal MRI will still be a challenge but also a significant research hotspot.
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Affiliation(s)
- Ying Zhou
- School of Life Science, Beijing Institute of Technology, 5 South Zhongguancun Street, Beijing 100081, P.R. China
| | - Zeyu Song
- School of Life Science, Beijing Institute of Technology, 5 South Zhongguancun Street, Beijing 100081, P.R. China
| | - Xiao Han
- School of Life Science, Beijing Institute of Technology, 5 South Zhongguancun Street, Beijing 100081, P.R. China
| | - Hanjun Li
- School of Life Science, Beijing Institute of Technology, 5 South Zhongguancun Street, Beijing 100081, P.R. China
| | - Xiaoying Tang
- School of Life Science, Beijing Institute of Technology, 5 South Zhongguancun Street, Beijing 100081, P.R. China
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Zhang L, Xie D, Li Y, Camargo A, Song D, Lu T, Jeudy J, Dreizin D, Melhem ER, Wang Z. Improving Sensitivity of Arterial Spin Labeling Perfusion MRI in Alzheimer's Disease Using Transfer Learning of Deep Learning-Based ASL Denoising. J Magn Reson Imaging 2021; 55:1710-1722. [PMID: 34741576 DOI: 10.1002/jmri.27984] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Arterial spin labeling (ASL) perfusion magnetic resonance imaging (MRI) denoising through deep learning (DL) often faces insufficient training data from patients. One solution is to train DL models using healthy subjects' data which are more widely available and transfer them to patients' data. PURPOSE To evaluate the transferability of a DL-based ASL MRI denoising method (DLASL). STUDY TYPE Retrospective. SUBJECTS Four hundred and twenty-eight subjects (189 females) from three cohorts. FIELD STRENGTH/SEQUENCE 3 T two-dimensional (2D) echo-planar imaging (EPI)-based pseudo-continuous ASL (PCASL) and 2D EPI-based pulsed ASL (PASL) sequences. ASSESSMENT DLASL was trained using young healthy adults' PCASL data (Dataset 1: 250/30 subjects as training/validation set) and was directly transferred (DTF) to PCASL data from Dataset 2 (45 subjects test set) of normal controls (NC) and Alzheimer's disease (AD) groups. DLASL was fine-tuned (DLASLFT) and tested on PASL data from Dataset 3 (103 subjects test set) of NC and AD. An existing non-DL method (NonDL) was used for comparison. Cerebral blood flow (CBF) images from ASL MRI were compared between NC and AD to assess characteristic hypoperfusion (lower CBF) patterns in AD. CBF image quality and CBF map sensitivity for detecting hypoperfusion using peak t-value and suprathreshold cluster size are outcome measures. STATISTICAL TESTS Paired t-test, two-sample t-test, one-way analysis of variance, and Tukey honestly significant difference, and linear mixed-effects models were used. P < 0.05 was considered statistically significant. RESULTS Mean contrast-to-noise ratio (CNR) of Dataset 2 showed that DTF outperformed NonDL (AD: 3.38 vs. 2.64, NC: 3.80 vs. 3.36). On Dataset 3, DLASLFT outperformed NonDL measured by mean CNR (AD: 2.45 vs. 1.87, NC: 2.54 vs. 2.17) and mean radiologic score (2.86 vs. 2.44). Image quality improvement was significant on both test sets. DTF and DLASLFT improved sensitivity for detecting AD-related hypoperfusion patterns compared with NonDL. DATA CONCLUSION We demonstrated the DLASL's transferability across different ASL sequences and different populations. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Lei Zhang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Danfeng Xie
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Yiran Li
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Aldo Camargo
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Donghui Song
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Tong Lu
- Department of Mathematics, University of Maryland, College Park, College Park, Maryland, USA
| | - Jean Jeudy
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - David Dreizin
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Elias R Melhem
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Ze Wang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Baradaran H, Delic A, McNally JS, Alexander M, Majersik JJ, Parker DL, de Havenon A. Carotid Compliance and Parahippocampal and Hippocampal Volume over a 20-Year Period. Dement Geriatr Cogn Dis Extra 2021; 11:227-234. [PMID: 34721500 PMCID: PMC8543351 DOI: 10.1159/000518234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 06/30/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction We evaluated the association between carotid compliance, a measure of arterial stiffness, to parahippocampal volume (PHV) and hippocampal volume (HV) over 20 years later in the Atherosclerosis Risk in the Community study. Methods We included participants with common carotid compliance measurements at visit 1 (1987–1989) and volumetric brain MRI at visit 5 (2011–2013). The primary outcomes are pooled bilateral PHV and HV. We performed linear regression models adjusting for age, sex, vascular risk factors, and total brain volume. Results Of the 614 participants, higher compliance was correlated with higher PHV (R = 0.218[0.144–0.291], p < 0.001) and HV (R = 0.181 [0.105–0.255, p < 0.001]). The association was linear and significant after adjusting for confounders. At follow-up MRI, 30 patients with dementia had lower PHV and HV than patients without dementia (p < 0.001 and p < 0.001, respectively). Conclusion Carotid compliance is associated with higher PHV and HV when measured 20 years later, further supporting the link between arterial stiffness and cognitive decline.
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Affiliation(s)
- Hediyeh Baradaran
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Alen Delic
- Department of Neurology, University of Utah, Salt Lake City, Utah, USA
| | - J Scott McNally
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Matthew Alexander
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA
| | | | - Dennis L Parker
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Adam de Havenon
- Department of Neurology, University of Utah, Salt Lake City, Utah, USA
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Duan W, Sehrawat P, Balachandrasekaran A, Bhumkar AB, Boraste PB, Becker JT, Kuller LH, Lopez OL, Gach HM, Dai W. Cerebral Blood Flow Is Associated with Diagnostic Class and Cognitive Decline in Alzheimer's Disease. J Alzheimers Dis 2021; 76:1103-1120. [PMID: 32597803 DOI: 10.3233/jad-200034] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Reliable cerebral blood flow (CBF) biomarkers using a noninvasive imaging technique are sought to facilitate early diagnosis and intervention in early Alzheimer's disease (AD). OBJECTIVE We aim to identify brain regions in which CBF values are affected and related to cognitive decline in early AD using a large cohort. METHODS Perfusion MRIs using continuous arterial spin labeling were acquired at 1.5 T in 58 normal controls (NC), 50 mild cognitive impairments (MCI), and 40 AD subjects from the Cardiovascular Health Study Cognition Study. Regional absolute CBF and normalized CBF (nCBF) values, without and with correction of partial volume effects, were compared across three groups. Association between regional CBF values and Modified Mini-Mental State Examination (3MSE) were investigated by multiple linear regression analyses adjusted for cardiovascular risk factors. RESULTS After correcting for partial volume effects and cardiovascular risk factors, ADs exhibited decreased nCBF with the strongest reduction in the bilateral posterior cingulate & precuneus region (p < 0.001) compared to NCs, and the strongest reduction in the bilateral superior medial frontal region (p < 0.001) compared to MCIs. MCIs exhibited the strongest nCBF decrease in the left hippocampus and nCBF increase in the right inferior frontal and insular region. The 3MSE scores within the symptomatic subjects were significantly associated with nCBF in the bilateral posterior and middle cingulate and parietal (p < 0.001), bilateral superior medial frontal (p < 0.001), bilateral temporoparietal (p < 0.02), and right hippocampus (p = 0.02) regions. CONCLUSION Noninvasive perfusion MRI can detect functional changes across diagnostic class and serve as a staging biomarker of cognitive status.
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Affiliation(s)
- Wenna Duan
- Department of Computer Science, State University of New York at Binghamton, Binghamton, NY, USA
| | - Parshant Sehrawat
- Department of Computer Science, State University of New York at Binghamton, Binghamton, NY, USA
| | | | - Ashish B Bhumkar
- Department of Computer Science, State University of New York at Binghamton, Binghamton, NY, USA
| | - Paresh B Boraste
- Department of Computer Science, State University of New York at Binghamton, Binghamton, NY, USA
| | - James T Becker
- Departments of Psychiatry, Psychology, and Neurology, University of Pittsburgh, PA, USA
| | - Lewis H Kuller
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Oscar L Lopez
- Departments of Neurology and Psychiatry, University of Pittsburgh, PA, USA
| | - H Michael Gach
- Departments of Radiation Oncology, Radiology, and Biomedical Engineering, Washington University, Saint Louis, MO, USA
| | - Weiying Dai
- Department of Computer Science, State University of New York at Binghamton, Binghamton, NY, USA
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Duan W, Zhou GD, Balachandrasekaran A, Bhumkar AB, Boraste PB, Becker JT, Kuller LH, Lopez OL, Gach HM, Dai W. Cerebral Blood Flow Predicts Conversion of Mild Cognitive Impairment into Alzheimer's Disease and Cognitive Decline: An Arterial Spin Labeling Follow-up Study. J Alzheimers Dis 2021; 82:293-305. [PMID: 34024834 DOI: 10.3233/jad-210199] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND This is the first longitudinal study to assess regional cerebral blood flow (rCBF) changes during the progression from normal control (NC) through mild cognitive impairment (MCI) and Alzheimer's disease (AD). OBJECTIVE We aim to determine if perfusion MRI biomarkers, derived from our prior cross-sectional study, can predict the onset and cognitive decline of AD. METHODS Perfusion MRIs using arterial spin labeling (ASL) were acquired in 15 stable-NC, 14 NC-to-MCI, 16 stable-MCI, and 18 MCI/AD-to-AD participants from the Cardiovascular Health Study (CHS) cognition study. Group comparisons, predictions of AD conversion and time to conversion, and Modified Mini-Mental State Examination (3MSE) from rCBF were performed. RESULTS Compared to the stable-NC group: 1) the stable-MCI group exhibited rCBF decreases in the right temporoparietal (p = 0.00010) and right inferior frontal and insula (p = 0.0094) regions; and 2) the MCI/AD-to-AD group exhibited rCBF decreases in the bilateral temporoparietal regions (p = 0.00062 and 0.0035). Compared to the NC-to-MCI group, the stable-MCI group exhibited a rCBF decrease in the right hippocampus region (p = 0.0053). The baseline rCBF values in the posterior cingulate cortex (PCC) (p = 0.0043), bilateral superior medial frontal regions (BSMF) (p = 0.012), and left inferior frontal (p = 0.010) regions predicted the 3MSE scores for all the participants at follow-up. The baseline rCBF in the PCC and BSMF regions predicted the conversion and time to conversion from MCI to AD (p < 0.05; not significant after multiple corrections). CONCLUSION We demonstrated the feasibility of ASL in detecting rCBF changes in the typical AD-affected regions and the predictive value of baseline rCBF on AD conversion and cognitive decline.
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Affiliation(s)
- Wenna Duan
- Computer Science, State University of New York at Binghamton, Binghamton, NY, USA
| | - Grace D Zhou
- Computer Science, State University of New York at Binghamton, Binghamton, NY, USA
| | | | - Ashish B Bhumkar
- Computer Science, State University of New York at Binghamton, Binghamton, NY, USA
| | - Paresh B Boraste
- Computer Science, State University of New York at Binghamton, Binghamton, NY, USA
| | - James T Becker
- Psychiatry, Psychology, and Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lewis H Kuller
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Oscar L Lopez
- Neurology and Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - H Michael Gach
- Radiation Oncology, Radiology, and Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO, USA
| | - Weiying Dai
- Computer Science, State University of New York at Binghamton, Binghamton, NY, USA
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Triantafyllou A, Ferreira JP, Kobayashi M, Micard E, Xie Y, Kearney-Schwartz A, Hossu G, Rossignol P, Bracard S, Benetos A. Longer Duration of Hypertension and MRI Microvascular Brain Alterations Are Associated with Lower Hippocampal Volumes in Older Individuals with Hypertension. J Alzheimers Dis 2021; 74:227-235. [PMID: 32039844 PMCID: PMC7175941 DOI: 10.3233/jad-190842] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Hippocampal atrophy is associated with cognitive decline. Determining the clinical features associated with hippocampal volume (HV)/atrophy may help in tailoring preventive strategies. OBJECTIVE This study was aimed to investigate the association between HV (at visit 2) and vascular status (both at visit 1 and visit 2) in a cohort of individuals aged 60+ with hypertension and without overt cognitive impairment at visit 1 (visit 1 and visit 2 were separated by approximately 8 years). METHODS Hippocampal volume was estimated in brain MRIs as HV both clinically with the Scheltens' Medial Temporal Atrophy score, and automatically with the Free Surfer Software application. A detailed medical history, somatometric measurements, cognitive tests, leukoaraiosis severity (Fazekas score), vascular parameters including pulse wave velocity, central blood pressure, and carotid artery plaques, as well as several biochemical parameters were also measured. RESULTS 113 hypertensive patients, 47% male, aged 75.1±5.6 years, participated in both visit 1 and visit 2 of the ADELAHYDE study. Age (β= -0.30) and hypertension duration (β= -0.20) at visit 1 were independently associated with smaller HV at visit 2 (p < 0.05 for all). In addition to these variables, low body mass index (β= 0.18), high MRI Fazekas score (β= -0.20), and low Gröber-Buschke total recall (β= 0.27) were associated with smaller HV at visit 2 (p < 0.05 for all). CONCLUSION In a cohort of older individuals without cognitive impairment at baseline, we described several factors associated with lower HV, of which hypertension duration can potentially be modified.
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Affiliation(s)
- Areti Triantafyllou
- Department of Geriatric Medicine and Memory Clinic, CMRR Nancy-Lorraine CHU-Nancy, Nancy, France
| | - João Pedro Ferreira
- Université de Lorraine, INSERM CIC-P 1433, CHRU de Nancy, INSERM U1116, and FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France.,Department of Physiology and Cardiothoracic Surgery, Cardiovascular Research and Development Unit, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Masatake Kobayashi
- Université de Lorraine, INSERM CIC-P 1433, CHRU de Nancy, INSERM U1116, and FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France
| | - Emilien Micard
- CHRU-Nancy, Inserm, Université de Lorraine, CIC, Innovation Technologique, Nancy, France
| | - Yu Xie
- Université de Lorraine, Inserm, IADI, F-54000 Nancy, France
| | - Anna Kearney-Schwartz
- Department of Geriatric Medicine and Memory Clinic, CMRR Nancy-Lorraine CHU-Nancy, Nancy, France
| | - Gabriela Hossu
- CHRU-Nancy, Inserm, Université de Lorraine, CIC, Innovation Technologique, Nancy, France.,Université de Lorraine, Inserm, IADI, F-54000 Nancy, France
| | - Patrick Rossignol
- Université de Lorraine, INSERM CIC-P 1433, CHRU de Nancy, INSERM U1116, and FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France
| | - Serge Bracard
- Université de Lorraine, Inserm, IADI, F-54000 Nancy, France.,Department of Neuroradiology, CHU-Nancy, Nancy, France
| | - Athanase Benetos
- Department of Geriatric Medicine and Memory Clinic, CMRR Nancy-Lorraine CHU-Nancy, Nancy, France.,INSERM, U1116, Université de Lorraine, Vandoeuvre-les-Nancy, France
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12
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Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disease, for which aging remains the major risk factor. Aging is under a consistent pressure of increasing brain entropy (BEN) due to the progressive brain deteriorations. Noticeably, the brain constantly consumes a large amount of energy to maintain its functional integrity, likely creating or maintaining a big "reserve" to counteract the high entropy. Malfunctions of this latent reserve may indicate a critical point of disease progression. The purpose of this study was to characterize BEN in aging and AD and to test an inverse-U-shape BEN model: BEN increases with age and AD pathology in normal aging but decreases in the AD continuum. BEN was measured with resting state fMRI and compared across aging and the AD continuum. Associations of BEN with age, education, clinical symptoms, and pathology were examined by multiple regression. The analysis results highlighted resting BEN in the default mode network, medial temporal lobe, and prefrontal cortex and showed that: (1) BEN increased with age and pathological deposition in normal aging but decreased with age and pathological deposition in the AD continuum; (2) AD showed catastrophic BEN reduction, which was related to more severe cognitive impairment and daily function disability; and (3) BEN decreased with education years in normal aging, but not in the AD continuum. BEN evolution follows an inverse-U trajectory when AD progresses from normal aging to AD dementia. Education is beneficial for suppressing the entropy increase potency in normal aging.
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Affiliation(s)
- Ze Wang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, United States
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13
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Shi Y, Lu X, Zhang L, Shu H, Gu L, Wang Z, Gao L, Zhu J, Zhang H, Zhou D, Zhang Z. Potential Value of Plasma Amyloid-β, Total Tau, and Neurofilament Light for Identification of Early Alzheimer's Disease. ACS Chem Neurosci 2019; 10:3479-3485. [PMID: 31145586 DOI: 10.1021/acschemneuro.9b00095] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The objective of the study was to explore the potential value of plasma indicators for identifying amnesic mild cognitive impairment (aMCI) and determine whether levels of plasma indicators are related to the performance of cognitive function and brain tissue volumes. In total, 155 participants (68 aMCI patients and 87 health controls) were recruited in the present cross-sectional study. The levels of plasma amyloid-β (Aβ) 40, Aβ42, total tau (t-tau), and neurofilament light (NFL) were measured using an ultrasensitive quantitative method. Machine learning algorithms were performed for establishing an optimal model of identifying aMCI. Compared with healthy controls, Aβ40 and Aβ42 levels were lower and NFL levels were higher in plasma of aMCI patients with an exception of t-tau levels. In aMCI patients, the higher plasma Aβ40 levels were correlated with the impaired episodic memory and negative correlations were observed between plasma t-tau levels and global cognitive function and gray matter (GM) volume. In addition, the higher plasma NFL levels were correlated with reduced hippocampus volume and total GM volume of the left inferior and middle temporal gyrus. An integrated model included clinical features, hippocampus volume, and plasma Aβ42 and NFL and had the highest accuracy for detecting aMCI patients (accuracy, 74.2%). We demonstrated that plasma Aβ40, Aβ42, t-tau, and NFL may be useful to identify aMCI and correlate with cognitive decline and brain atrophy. Among these plasma indicators, Aβ42 and NFL are more valuable as key members of a peripheral biomarker panel to detect aMCI.
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Affiliation(s)
- Yachen Shi
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu 210009, China
| | - Xiang Lu
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu 210009, China
| | - Linhai Zhang
- School of Computer Science and Engineering, Key Laboratory of Computer Network and Information Integration, Ministry of Education, Southeast University, Nanjing, Jiangsu 210009, China
| | - Hao Shu
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu 210009, China
| | - Lihua Gu
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu 210009, China
| | - Zan Wang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu 210009, China
| | - Lijuan Gao
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu 210009, China
| | - Jianli Zhu
- Department of Psychology, Xinxiang Medical University, Xinxiang, Henan 453003, China
| | - Haisan Zhang
- Department of Psychology, Xinxiang Medical University, Xinxiang, Henan 453003, China
| | - Deyu Zhou
- School of Computer Science and Engineering, Key Laboratory of Computer Network and Information Integration, Ministry of Education, Southeast University, Nanjing, Jiangsu 210009, China
| | - Zhijun Zhang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu 210009, China
- Department of Psychology, Xinxiang Medical University, Xinxiang, Henan 453003, China
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14
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Maillard P, Fletcher E, Singh B, Martinez O, Johnson DK, Olichney JM, Farias ST, DeCarli C. Cerebral white matter free water: A sensitive biomarker of cognition and function. Neurology 2019; 92:e2221-e2231. [PMID: 30952798 PMCID: PMC6537135 DOI: 10.1212/wnl.0000000000007449] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 01/08/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To determine whether free water (FW) content, initially developed to correct metrics derived from diffusion tensor imaging and recently found to be strongly associated with vascular risk factors, may constitute a sensitive biomarker of white matter (WM) microstructural differences associated with cognitive performance but remains unknown. METHODS Five hundred thirty-six cognitively diverse individuals, aged 77 ± 8 years, received yearly comprehensive clinical evaluations and a baseline MRI examination of whom 224 underwent follow-up MRI. WM microstructural measures, including FW, fractional anisotropy, and mean diffusivity corrected for FW and WM hyperintensity burden were computed within WM voxels of each individual. Baseline and change in MRI metrics were then used as independent variables to explain baseline and change in episodic memory (EM), executive function (EF), and Clinical Dementia Rating (CDR) scores using linear, logistic, and Cox proportional-hazards regressions. RESULTS Higher baseline FW and WM hyperintensity were associated with lower baseline EM and EF, higher baseline CDR, accelerated EF and EM decline, and higher probability to transition to a more severe CDR stage (p values <0.01). Annual change in FW was also found to be associated with concomitant change in cognitive and functional performance (p values <0.01). CONCLUSIONS This study finds cross-sectional and longitudinal associations between FW content and trajectory of cognitive and functional performance in a large sample of cognitively diverse individuals. It supports the need to investigate the pathophysiologic process that manifests increased FW, potentially leading to more severe WM territory injury and promoting cognitive and functional decline.
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Affiliation(s)
- Pauline Maillard
- From the Imaging of Dementia and Aging Laboratory and Center for Neurosciences (P.M., E.F., B.S., O.M., C.D.), Davis, CA; and Department of Neurology (D.K.J., J.M.O., S.T.F., C.D.), University of California, Davis.
| | - Evan Fletcher
- From the Imaging of Dementia and Aging Laboratory and Center for Neurosciences (P.M., E.F., B.S., O.M., C.D.), Davis, CA; and Department of Neurology (D.K.J., J.M.O., S.T.F., C.D.), University of California, Davis
| | - Baljeet Singh
- From the Imaging of Dementia and Aging Laboratory and Center for Neurosciences (P.M., E.F., B.S., O.M., C.D.), Davis, CA; and Department of Neurology (D.K.J., J.M.O., S.T.F., C.D.), University of California, Davis
| | - Oliver Martinez
- From the Imaging of Dementia and Aging Laboratory and Center for Neurosciences (P.M., E.F., B.S., O.M., C.D.), Davis, CA; and Department of Neurology (D.K.J., J.M.O., S.T.F., C.D.), University of California, Davis
| | - David K Johnson
- From the Imaging of Dementia and Aging Laboratory and Center for Neurosciences (P.M., E.F., B.S., O.M., C.D.), Davis, CA; and Department of Neurology (D.K.J., J.M.O., S.T.F., C.D.), University of California, Davis
| | - John M Olichney
- From the Imaging of Dementia and Aging Laboratory and Center for Neurosciences (P.M., E.F., B.S., O.M., C.D.), Davis, CA; and Department of Neurology (D.K.J., J.M.O., S.T.F., C.D.), University of California, Davis
| | - Sarah T Farias
- From the Imaging of Dementia and Aging Laboratory and Center for Neurosciences (P.M., E.F., B.S., O.M., C.D.), Davis, CA; and Department of Neurology (D.K.J., J.M.O., S.T.F., C.D.), University of California, Davis
| | - Charles DeCarli
- From the Imaging of Dementia and Aging Laboratory and Center for Neurosciences (P.M., E.F., B.S., O.M., C.D.), Davis, CA; and Department of Neurology (D.K.J., J.M.O., S.T.F., C.D.), University of California, Davis
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15
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Guo Y, Li X, Zhang M, Chen N, Wu S, Lei J, Wang Z, Wang R, Wang J, Liu H. Age‑ and brain region‑associated alterations of cerebral blood flow in early Alzheimer's disease assessed in AβPPSWE/PS1ΔE9 transgenic mice using arterial spin labeling. Mol Med Rep 2019; 19:3045-3052. [PMID: 30816468 PMCID: PMC6423566 DOI: 10.3892/mmr.2019.9950] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 02/06/2019] [Indexed: 02/07/2023] Open
Abstract
It has been suggested that cerebral blood flow (CBF) alterations may be involved in the pathogenesis of Alzheimer's disease (AD). However, how CBF changes with age has not been detailed in AD, particularly in its early stages. The objective of the present study was to evaluate CBF in four brain regions (the hippocampus, entorhinal cortex, frontoparietal cortex and thalamus) of mice in four age groups, to mimic the respective stages of AD in humans [2 months (pre-clinical), 3.5 months (sub-clinical), 5 months (early-clinical) and 8 months (mid-clinical)], to understand the age-associated changes in selected brain regions and to elucidate the underlying vascular mechanisms. CBF was measured using magnetic resonance imaging-arterial spin labelling (ASL) under identical conditions across the age groups of AβPPSWE/PS1ΔE9 (APP/PS1) transgenic mice with AD. The results indicated age- and brain region-associated changes in CBF were associated with early AD. More precisely, an age-dependent increase in CBF (in the pre- and sub-clinical AD groups) was observed in the frontoparietal cortex and thalamus. Conversely, increased CBF demonstrated an age-dependent decline (in the early- and mid-clinical AD groups) in all examined brain regions. Among the regions, the thalamus had the greatest increase in CBF in the 2 and 3.5 months age groups, which was substantially different compared with the age-matched controls. An extension of vessel area was also noted to be age- and brain region-dependent. In particular, correlation analysis revealed significant associations of CBF with vessel area in the frontoparietal cortex and thalamus of APP/PS1 mice at ages 2 and 3.5 months, indicating that CBF increase may arise from vessel extension. The results of the present study suggested that ASL can detect age- and brain region-associated changes in CBF in mice with AD, and that ASL-measured CBF increase may be a potential diagnostic biomarker for early AD. The observation that CBF increase resulted from vessel extension may aid in the understanding of the vascular role in age-associated development of AD pathology, and provide preclinical evidence for AD patient management.
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Affiliation(s)
- Yapei Guo
- Department of Neurology, The Fifth Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Xueyuan Li
- Department of Neurosurgery, The First Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Min Zhang
- Department of Neurology, The Fifth Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Ningning Chen
- Department of Neurology, The Fifth Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Shitao Wu
- Department of Neurology, The Fifth Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Jianfeng Lei
- Center for Medical Experiments and Testing, Capital Medical University, Beijing 100069, P.R. China
| | - Zhanjing Wang
- Center for Medical Experiments and Testing, Capital Medical University, Beijing 100069, P.R. China
| | - Renzhi Wang
- Department of Neurosurgery, Peking Union Medical College Hospital, Beijing 100052, P.R. China
| | - Jianping Wang
- Department of Neurology, The Fifth Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Hengfang Liu
- Department of Neurology, The Fifth Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
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16
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Xie L, Das SR, Pilania A, Daffner M, Stockbower GE, Dolui S, Yushkevich PA, Detre JA, Wolk DA. Task-enhanced arterial spin labeled perfusion MRI predicts longitudinal neurodegeneration in mild cognitive impairment. Hippocampus 2018; 29:26-36. [PMID: 30207006 DOI: 10.1002/hipo.23026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 07/09/2018] [Accepted: 09/02/2018] [Indexed: 12/11/2022]
Abstract
Mild cognitive impairment (MCI) is considered a prodromal stage of Alzheimer's disease (AD), but is also recognized to be a heterogeneous condition. Biomarkers that predict AD progression in MCI are of clinical significance because they can be used to better identify appropriate candidates for therapeutic intervention studies. It has been hypothesized that comparing to structural measurements, functional ones may be more sensitive to early disease abnormalities and the sensitivity could be further enhanced when combined with cognitive task, a "brain stress test." In this study, we investigated the value of regional cerebral blood flow (CBF), measured by arterial spin labeled perfusion MRI (ASL MRI) during a memory-encoding task, in predicting the estimated rate of hippocampal atrophy, an established marker of AD progression. Thirty-one amnestic MCI patients (20 male and 11 female; age: 70.9 ± 6.5 years, range from 56 to 83 years; mini mental status examination: 27.8 ± 1.8) and 42 normal control subjects (13 male and 29 female; age: 70.6 ± 8.8 years, range from 55 to 88 years; mini mental status examination: 29.1 ± 1.2) were included in this study. We compared the predictive value of CBF during task to CBF during rest and structural volumetry. Both region-of-interest and voxelwise analyses showed that baseline CBF measurements during task (strongest effect in fusiform gyrus, region-of-interest analysis statistics: r = 0.56, p = .003), but not resting ASL MRI or structural volumetry, were correlated with the estimated rate of hippocampal atrophy in amnestic MCI patients. Further, stepwise linear regression demonstrated that resting ASL MRI and volumetry did not provide complementary information in prediction. These results support the notion that physiologic measures during a cognitive challenge may increase the ability to detect subtle functional changes that predict progression. As such, ASL MRI could have important utility in stratifying candidates for AD treatment trials.
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Affiliation(s)
- Long Xie
- Penn Image Computing and Science Laboratory (PICSL), Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sandhitsu R Das
- Penn Image Computing and Science Laboratory (PICSL), Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Penn Memory Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Arun Pilania
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Penn Memory Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Molly Daffner
- Penn Memory Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Center for Functional Neuroimaging, Department of Neurology, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Grace E Stockbower
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Penn Memory Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sudipto Dolui
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Center for Functional Neuroimaging, Department of Neurology, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Paul A Yushkevich
- Penn Image Computing and Science Laboratory (PICSL), Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - John A Detre
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Center for Functional Neuroimaging, Department of Neurology, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - David A Wolk
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Penn Memory Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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17
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Chen JJ. Functional MRI of brain physiology in aging and neurodegenerative diseases. Neuroimage 2018; 187:209-225. [PMID: 29793062 DOI: 10.1016/j.neuroimage.2018.05.050] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 05/16/2018] [Accepted: 05/20/2018] [Indexed: 12/14/2022] Open
Abstract
Brain aging and associated neurodegeneration constitute a major societal challenge as well as one for the neuroimaging community. A full understanding of the physiological mechanisms underlying neurodegeneration still eludes medical researchers, fuelling the development of in vivo neuroimaging markers. Hence it is increasingly recognized that our understanding of neurodegenerative processes likely will depend upon the available information provided by imaging techniques. At the same time, the imaging techniques are often developed in response to the desire to observe certain physiological processes. In this context, functional MRI (fMRI), which has for decades provided information on neuronal activity, has evolved into a large family of techniques well suited for in vivo observations of brain physiology. Given the rapid technical advances in fMRI in recent years, this review aims to summarize the physiological basis of fMRI observations in healthy aging as well as in age-related neurodegeneration. This review focuses on in-vivo human brain imaging studies in this review and on disease features that can be imaged using fMRI methods. In addition to providing detailed literature summaries, this review also discusses future directions in the study of brain physiology using fMRI in the clinical setting.
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Affiliation(s)
- J Jean Chen
- Rotman Research Institute at Baycrest Centre, Canada; Department of Medical Biophysics, University of Toronto, Canada.
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18
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Hays CC, Zlatar ZZ, Campbell L, Meloy MJ, Wierenga CE. Subjective Cognitive Decline Modifies the Relationship Between Cerebral Blood Flow and Memory Function in Cognitively Normal Older Adults. J Int Neuropsychol Soc 2018; 24:213-23. [PMID: 28974274 DOI: 10.1017/S135561771700087X] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Subjective cognitive decline (SCD), or self-reported cognitive decline despite normal neuropsychological test performance, is a risk factor for objective cognitive decline and Alzheimer's disease (AD). While brain mechanisms contributing to SCD are not well defined, studies show associations with vascular risk factors and altered cerebral blood flow (CBF), raising the hypothesis that those with SCD might be experiencing vascular dysregulation, or a disruption in the normal relationship between CBF and cognition. We examined whether the association between CBF and verbal memory performance differs between those with SCD (SCD+) and those without SCD (SCD-). METHODS Linear mixed-effects models were used to investigate whether the voxel-wise relationship between arterial spin labeling (ASL) MRI-measured CBF and verbal memory performance was modified by SCD among a group of 70 cognitively normal older adults (35 SCD+, 35 SCD-; mean age=72) matched on age, gender, and symptoms of depression. RESULTS Results indicated that the SCD- group exhibited positive associations between verbal memory and CBF within the posterior cingulate cortex, middle temporal gyrus, and inferior frontal gyrus, whereas the SCD+ group displayed negative associations between verbal memory and CBF within the posterior cingulate cortex, middle temporal gyrus, hippocampus, fusiform gyrus, and inferior frontal gyrus. CONCLUSIONS Findings suggest that, while higher CBF is supportive of memory function in those without SCD, higher CBF may no longer support memory function in those presenting with SCD, perhaps reflecting neurovascular dysregulation. (JINS, 2018, 24, 213-223).
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19
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Petr J, Platzek I, Hofheinz F, Mutsaerts HJMM, Asllani I, van Osch MJP, Seidlitz A, Krukowski P, Gommlich A, Beuthien-Baumann B, Jentsch C, Maus J, Troost EGC, Baumann M, Krause M, van den Hoff J. Photon vs. proton radiochemotherapy: Effects on brain tissue volume and perfusion. Radiother Oncol 2018; 128:121-127. [PMID: 29370984 DOI: 10.1016/j.radonc.2017.11.033] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 11/16/2017] [Accepted: 11/21/2017] [Indexed: 01/16/2023]
Abstract
BACKGROUND AND PURPOSE To compare the structural and hemodynamic changes of healthy brain tissue in the cerebral hemisphere contralateral to the tumor following photon and proton radiochemotherapy. MATERIALS AND METHODS Sixty-seven patients (54.9 ±14.0 years) diagnosed with glioblastoma undergoing adjuvant photon (n = 47) or proton (n = 19) radiochemotherapy with temozolomide after tumor resection underwent T1-weighted and arterial spin labeling MRI. Changes in volume and perfusion before and 3 to 6 months after were compared between therapies. RESULTS A decrease in gray matter (GM) (-2.2%, P<0.001) and white matter (WM) (-1.2%, P<0.001) volume was observed in photon-therapy patients compared to the pre-radiotherapy baseline. In contrast, for the proton-therapy group, no significant differences in GM (0.3%, P = 0.64) or WM (-0.4%, P = 0.58) volume were observed. GM volume decreased with 0.9% per 10 Gy dose increase (P<0.001) and differed between the radiation modalities (P<0.001). Perfusion decreased in photon-therapy patients (-10.1%, P = 0.002), whereas the decrease in proton-therapy patients, while comparable in magnitude, did not reach statistical significance (-9.1%, P = 0.12). There was no correlation between perfusion decrease and either dose (P = 0.64) or radiation modality (P = 0.94). CONCLUSIONS Our results show that the tissue volume decrease depends on radiation dose delivered to the healthy hemisphere and differs between treatment modalities. In contrast, the decrease in perfusion was comparable for both irradiation modalities. We conclude that proton therapy may reduce brain-volume loss when compared to photon therapy.
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Affiliation(s)
- Jan Petr
- Helmholtz-Zentrum Dresden-Rossendorf, PET Center, Institute of Radiopharmaceutical Cancer Research, Germany.
| | - Ivan Platzek
- Department of Radiology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany
| | - Frank Hofheinz
- Helmholtz-Zentrum Dresden-Rossendorf, PET Center, Institute of Radiopharmaceutical Cancer Research, Germany
| | - Henri J M M Mutsaerts
- Sunnybrook Research Institute, Toronto, Canada; Department of Radiology, Academic Medical Center Amsterdam, The Netherlands; Department of Radiology, University Medical Center Utrecht, The Netherlands; Rochester Institute of Technology, Rochester, USA; Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands
| | - Iris Asllani
- Rochester Institute of Technology, Rochester, USA
| | | | - Annekatrin Seidlitz
- Department of Radiation Oncology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; OncoRay - National Center for Radiation Research in Oncology (NCRO), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, and Helmholtz-Zentrum Dresden-Rossendorf, Germany; German Cancer Consortium (DKTK), Dresden, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Pawel Krukowski
- Department of Neuroradiology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany
| | - Andreas Gommlich
- OncoRay - National Center for Radiation Research in Oncology (NCRO), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, and Helmholtz-Zentrum Dresden-Rossendorf, Germany; Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiooncology, Germany
| | - Bettina Beuthien-Baumann
- German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Nuclear Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany
| | - Christina Jentsch
- Department of Radiation Oncology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; OncoRay - National Center for Radiation Research in Oncology (NCRO), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, and Helmholtz-Zentrum Dresden-Rossendorf, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany; National Center for Tumor Disease (NCT), Dresden, Germany
| | - Jens Maus
- Helmholtz-Zentrum Dresden-Rossendorf, PET Center, Institute of Radiopharmaceutical Cancer Research, Germany
| | - Esther G C Troost
- Department of Radiation Oncology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; OncoRay - National Center for Radiation Research in Oncology (NCRO), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, and Helmholtz-Zentrum Dresden-Rossendorf, Germany; German Cancer Consortium (DKTK), Dresden, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany; Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiooncology, Germany; National Center for Tumor Disease (NCT), Dresden, Germany
| | - Michael Baumann
- Department of Radiation Oncology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; OncoRay - National Center for Radiation Research in Oncology (NCRO), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, and Helmholtz-Zentrum Dresden-Rossendorf, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany; Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiooncology, Germany
| | - Mechthild Krause
- Department of Radiation Oncology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; OncoRay - National Center for Radiation Research in Oncology (NCRO), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, and Helmholtz-Zentrum Dresden-Rossendorf, Germany; German Cancer Consortium (DKTK), Dresden, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany; Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiooncology, Germany; National Center for Tumor Disease (NCT), Dresden, Germany
| | - Jörg van den Hoff
- Helmholtz-Zentrum Dresden-Rossendorf, PET Center, Institute of Radiopharmaceutical Cancer Research, Germany; Department of Nuclear Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany
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Zhang Y, Yang Y, Wang Z, Bian R, Jiang W, Yin Y, Yue Y, Hou Z, Yuan Y. Altered Regional Cerebral Blood Flow of Right Cerebellum Posterior Lobe in Asthmatic Patients With or Without Depressive Symptoms. Front Psychiatry 2018; 9:225. [PMID: 29892237 PMCID: PMC5985698 DOI: 10.3389/fpsyt.2018.00225] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 05/08/2018] [Indexed: 12/29/2022] Open
Abstract
Background: Asthma is a chronic disease appeared to be associated with depression. But the underpinnings of depression in asthma remain unknown. In order to understand the neural mechanisms of depression in asthma, we used cerebral blood flow (CBF) to probe the difference between depressed asthmatic (DA) and non-depressed asthmatic (NDA) patients. Methods: Eighteen DA patients, 24 NDA patients and 57 healthy controls (HC) received pulsed arterial spin labeling (pASL) scan for measuring CBF, resting-state functional magnetic resonance imaging (rs-fMRI) scan, severity of depression and asthma control assessment, respectively. Results: Compared to NDA, DA patients showed increased regional CBF (rCBF) in the right cerebellum posterior lobe. Compared to HC, DA, and NDA patients all showed significantly decreased rCBF in the right cerebellum posterior lobe. Conclusions: We showed the first evidence of altered rCBF in the right cerebellum posterior lobe in asthma using pASL, which appeared to be involved in the neuropathology in asthma. Clinical Trial Registration: An investigation of therapeutic mechanism in asthmatic patients: based on the results of Group Cognitive Behavioral Therapy (Registration number: ChiCTR-COC-15007442) (http://www.chictr.org.cn/usercenter.aspx).
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Affiliation(s)
- Yuqun Zhang
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.,Institute of Psychosomatics, School of Medicine, Southeast University, Nanjing, China
| | - Yuan Yang
- Department of Respiration, ZhongDa Hospital, Southeast University, Nanjing, China
| | - Ze Wang
- Center for Cognition and Brain Disorders and the Affiliated Hospital, Hangzhou Normal University, Hangzhou, China
| | - Rongrong Bian
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.,Institute of Psychosomatics, School of Medicine, Southeast University, Nanjing, China
| | - Wenhao Jiang
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.,Institute of Psychosomatics, School of Medicine, Southeast University, Nanjing, China
| | - Yingying Yin
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.,Institute of Psychosomatics, School of Medicine, Southeast University, Nanjing, China
| | - Yingying Yue
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.,Institute of Psychosomatics, School of Medicine, Southeast University, Nanjing, China
| | - Zhenghua Hou
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.,Institute of Psychosomatics, School of Medicine, Southeast University, Nanjing, China
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.,Institute of Psychosomatics, School of Medicine, Southeast University, Nanjing, China
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Polak T, Herrmann MJ, Müller LD, Zeller JBM, Katzorke A, Fischer M, Spielmann F, Weinmann E, Hommers L, Lauer M, Fallgatter AJ, Deckert J. Near-infrared spectroscopy (NIRS) and vagus somatosensory evoked potentials (VSEP) in the early diagnosis of Alzheimer’s disease: rationale, design, methods, and first baseline data of the Vogel study. J Neural Transm (Vienna) 2017; 124:1473-1488. [DOI: 10.1007/s00702-017-1781-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 08/23/2017] [Indexed: 01/06/2023]
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22
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Li XY, Men WW, Zhu H, Lei JF, Zuo FX, Wang ZJ, Zhu ZH, Bao XJ, Wang RZ. Age- and Brain Region-Specific Changes of Glucose Metabolic Disorder, Learning, and Memory Dysfunction in Early Alzheimer's Disease Assessed in APP/PS1 Transgenic Mice Using 18F-FDG-PET. Int J Mol Sci 2016; 17:E1707. [PMID: 27763550 DOI: 10.3390/ijms17101707] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 10/01/2016] [Accepted: 10/04/2016] [Indexed: 12/30/2022] Open
Abstract
Alzheimer’s disease (AD) is a leading cause of dementia worldwide, associated with cognitive deficits and brain glucose metabolic alteration. However, the associations of glucose metabolic changes with cognitive dysfunction are less detailed. Here, we examined the brains of APP/presenilin 1 (PS1) transgenic (Tg) mice aged 2, 3.5, 5 and 8 months using 18F-labed fluorodeoxyglucose (18F-FDG) microPET to assess age- and brain region-specific changes of glucose metabolism. FDG uptake was calculated as a relative standardized uptake value (SUVr). Morris water maze (MWM) was used to evaluate learning and memory dysfunction. We showed a glucose utilization increase in multiple brain regions of Tg mice at 2 and 3.5 months but not at 5 and 8 months. Comparisons of SUVrs within brains showed higher glucose utilization than controls in the entorhinal cortex, hippocampus, and frontal cortex of Tg mice at 2 and 3.5 months but in the thalamus and striatum at 3.5, 5 and 8 months. By comparing SUVrs in the entorhinal cortex and hippocampus, Tg mice were distinguished from controls at 2 and 3.5 months. In MWM, Tg mice aged 2 months shared a similar performance to the controls (prodromal-AD). By contrast, Tg mice failed training tests at 3.5 months but failed all MWM tests at 5 and 8 months, suggestive of partial or complete cognitive deficits (symptomatic-AD). Correlation analyses showed that hippocampal SUVrs were significantly correlated with MWM parameters in the symptomatic-AD stage. These data suggest that glucose metabolic disorder occurs before onset of AD signs in APP/PS1 mice with the entorhinal cortex and hippocampus affected first, and that regional FDG uptake increase can be an early biomarker for AD. Furthermore, hippocampal FDG uptake is a possible indicator for progression of Alzheimer’s cognition after cognitive decline, at least in animals.
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Hays CC, Zlatar ZZ, Wierenga CE. The Utility of Cerebral Blood Flow as a Biomarker of Preclinical Alzheimer's Disease. Cell Mol Neurobiol 2016; 36:167-79. [PMID: 26898552 DOI: 10.1007/s10571-015-0261-z] [Citation(s) in RCA: 132] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 08/25/2015] [Indexed: 12/20/2022]
Abstract
There is accumulating evidence suggesting that changes in brain perfusion are present long before the clinical symptoms of Alzheimer's disease (AD), perhaps even before amyloid-β accumulation or brain atrophy. This evidence, consistent with the vascular hypothesis of AD, implicates cerebral blood flow (CBF) in the pathogenesis of AD and suggests its utility as a biomarker of preclinical AD. The extended preclinical phase of AD holds particular significance for disease modification, as treatment would likely be most effective in this early asymptomatic stage of disease. This highlights the importance of identifying reliable and accurate biomarkers of AD that can differentiate normal aging from preclinical AD prior to clinical symptom manifestation. Cerebral perfusion, as measured by arterial spin labeling magnetic resonance imaging (ASL-MRI), has been shown to distinguish between normal controls and adults with AD. In addition to demonstrating diagnostic utility, CBF has shown usefulness as a tool for identifying those who are at risk for AD and for predicting subtle cognitive decline and conversion to mild cognitive impairment and AD. Taken together, this evidence not only implicates CBF as a useful biomarker for tracking disease severity and progression, but also suggests that ASL-measured CBF may be useful for identifying candidates for future AD treatment trials, especially in the preclinical, asymptomatic phases of the disease.
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Affiliation(s)
- Chelsea C Hays
- VA San Diego Healthcare System, 3350 La Jolla Village Dr., MC 151B, San Diego, CA, 92161, USA.,SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, Suite 103, San Diego, CA, 92120, USA
| | - Zvinka Z Zlatar
- VA San Diego Healthcare System, 3350 La Jolla Village Dr., MC 151B, San Diego, CA, 92161, USA.,Department of Psychiatry, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA
| | - Christina E Wierenga
- VA San Diego Healthcare System, 3350 La Jolla Village Dr., MC 151B, San Diego, CA, 92161, USA. .,Department of Psychiatry, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA.
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Abstract
There is a strong link between hypoperfusion and white matter (WM) damage in patients with leukoaraiosis and vascular cognitive impairment (VCI). Other than management of vascular risk factors, there is no treatment for WM damage and VCI that delays progression of the disease process to dementia. Observational studies suggest that exercise may prevent or slow down the progression of Alzheimer's disease (AD) and VCI. However, getting patients to exercise is challenging especially with advancing age and disability. Remote ischemic conditioning, an "exercise equivalent", allows exercise to be given with a "device" in the home for long periods of time. Since RIC increases CBF in pre-clinical studies and in humans, RIC may be an ideal therapy to treat VCI and WM disease and perhaps even sporadic AD. By using MRI imaging of WM progression, a sample size in the range of about 100 subjects per group could determine if RIC has activity in WM disease and VCI.
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Affiliation(s)
- David C Hess
- Department of Neurology Medical College of Georgia, Georgia Regent's University, Augusta, GA USA
| | - Mohammad B Khan
- Department of Neurology Medical College of Georgia, Georgia Regent's University, Augusta, GA USA
| | - Nasrul Hoda
- Department of Medical Laboratory, Imaging, and Radiologic Sciences, College of Allied Health Sciences, Georgia Regent's University, Augusta, GA USA
| | - John C Morgan
- Department of Neurology Medical College of Georgia, Georgia Regent's University, Augusta, GA USA
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Grade M, Hernandez Tamames JA, Pizzini FB, Achten E, Golay X, Smits M. A neuroradiologist's guide to arterial spin labeling MRI in clinical practice. Neuroradiology 2015; 57:1181-202. [PMID: 26351201 DOI: 10.1007/s00234-015-1571-z] [Citation(s) in RCA: 173] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 08/05/2015] [Indexed: 01/01/2023]
Abstract
Arterial spin labeling (ASL) is a non-invasive MRI technique to measure cerebral blood flow (CBF). This review provides a practical guide and overview of the clinical applications of ASL of the brain, as well its potential pitfalls. The technical and physiological background is also addressed. At present, main areas of interest are cerebrovascular disease, dementia and neuro-oncology. In cerebrovascular disease, ASL is of particular interest owing to its quantitative nature and its capability to determine cerebral arterial territories. In acute stroke, the source of the collateral blood supply in the penumbra may be visualised. In chronic cerebrovascular disease, the extent and severity of compromised cerebral perfusion can be visualised, which may be used to guide therapeutic or preventative intervention. ASL has potential for the detection and follow-up of arteriovenous malformations. In the workup of dementia patients, ASL is proposed as a diagnostic alternative to PET. It can easily be added to the routinely performed structural MRI examination. In patients with established Alzheimer’s disease and frontotemporal dementia, hypoperfusion patterns are seen that are similar to hypometabolism patterns seen with PET. Studies on ASL in brain tumour imaging indicate a high correlation between areas of increased CBF as measured with ASL and increased cerebral blood volume as measured with dynamic susceptibility contrast-enhanced perfusion imaging. Major advantages of ASL for brain tumour imaging are the fact that CBF measurements are not influenced by breakdown of the blood–brain barrier, as well as its quantitative nature, facilitating multicentre and longitudinal studies.
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Steketee RM, Bron EE, Meijboom R, Houston GC, Klein S, Mutsaerts HJ, Mendez Orellana CP, de Jong FJ, van Swieten JC, van der Lugt A, Smits M. Early-stage differentiation between presenile Alzheimer's disease and frontotemporal dementia using arterial spin labeling MRI. Eur Radiol 2016; 26:244-53. [PMID: 26024845 DOI: 10.1007/s00330-015-3789-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Revised: 04/01/2015] [Accepted: 04/09/2015] [Indexed: 11/16/2022]
Abstract
Objective To investigate arterial spin labeling (ASL)-MRI for the early diagnosis of and differentiation between the two most common types of presenile dementia: Alzheimer’s disease (AD) and frontotemporal dementia (FTD), and for distinguishing age-related from pathological perfusion changes. Methods Thirteen AD and 19 FTD patients, and 25 age-matched older and 22 younger controls underwent 3D pseudo-continuous ASL-MRI at 3 T. Gray matter (GM) volume and cerebral blood flow (CBF), corrected for partial volume effects, were quantified in the entire supratentorial cortex and in 10 GM regions. Sensitivity, specificity and diagnostic performance were evaluated in regions showing significant CBF differences between patient groups or between patients and older controls. Results AD compared with FTD patients had hypoperfusion in the posterior cingulate cortex, differentiating these with a diagnostic performance of 74 %. Compared to older controls, FTD patients showed hypoperfusion in the anterior cingulate cortex, whereas AD patients showed a more widespread regional hypoperfusion as well as atrophy. Regional atrophy was not different between AD and FTD. Diagnostic performance of ASL to differentiate AD or FTD from controls was good (78-85 %). Older controls showed global hypoperfusion compared to young controls. Conclusion ASL-MRI contributes to early diagnosis of and differentiation between presenile AD and FTD. Key Points • ASL-MRI facilitates differentiation of early Alzheimer’s disease and frontotemporal dementia. • Posterior cingulate perfusion is lower in Alzheimer’s disease than frontotemporal dementia. • Compared to controls, Alzheimer’s disease patients show hypoperfusion in multiple regions. • Compared to controls, frontotemporal dementia patients show focal anterior cingulate hypoperfusion. • Global decreased perfusion in older adults differs from hypoperfusion in dementia.
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