Lower cerebral blood flow is associated with faster cognitive decline in Alzheimer's disease.
Lower cerebral blood flow is associated with faster cognitive decline in Alzheimer's disease.
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DOI：
10.1007/s00330-016-4450-z
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发表时间：
2017-03
影响因子：
5.9
通讯作者：
Prins ND
中科院分区：
文献类型：
--
作者：
Benedictus MR;Leeuwis AE;Binnewijzend MA;Kuijer JP;Scheltens P;Barkhof F;van der Flier WM;Prins ND
确定较低的脑血流量（CBF）是否与阿尔茨海默病（AD）患者认知能力下降更快有关。我们纳入了来自阿姆斯特丹痴呆队列的88例AD痴呆患者。平均随访2±1年。采用线性混合模型来确定全脑下部和区域伪连续动脉自旋标记测量的CBF与重复迷你精神状态检查（MMSE）测量的认知衰退率之间的关系。模型1根据年龄、性别和教育程度进行了调整。模型2对规范化灰质体积、内侧颞叶萎缩、白质高信号、微出血和凹窝进行了额外调整。在CBF部分容积校正（PVC）后重复分析。p≤0.05为差异有统计学意义。患者年龄65±7岁，女性44例（50%），平均基线MMSE为22±4。MMSE的年下降（β[SE]）估计为每年-2.11（0.25）点。全脑（β[SE]-0.50[0.25], p≤0.05）和顶叶（β[SE]-0.59[0.25], p < 0.05） CBF与认知能力下降较快相关。PVC皮质CBF与认知能力下降无关。较低的脑血流，特别是在脑后部区域，可能作为AD患者认知能力下降率的预后标志具有价值。•在AD中，较低的CBF与更快的认知能力下降有关。•减少CBF在阿尔茨海默病早期不会达到平台期。•PcASL-CFB对AD的常规结构MRI测量具有附加价值。
To determine whether lower cerebral blood flow (CBF) is associated with faster cognitive decline in patients with Alzheimer’s disease (AD). We included 88 patients with dementia due to AD from the Amsterdam Dementia Cohort. Mean follow-up was 2 ± 1 years. Linear mixed models were used to determine associations of lower whole brain and regional pseudo-continuous arterial spin labelling measured CBF with rate of cognitive decline as measured with repeated mini-mental state examination (MMSE). Model 1 was adjusted for age, sex, and education. Model 2 was additionally adjusted for normalized gray matter volume, medial temporal lobe atrophy, white matter hyperintensities, microbleeds, and lacunes. Analyses were repeated after partial volume correction (PVC) of CBF. Statistical significance was set at p ≤ 0.05. Patients were 65 ± 7 years old, 44 (50 %) were women, and mean baseline MMSE was 22 ± 4. Annual decline (β[SE]) on the MMSE was estimated at -2.11 (0.25) points per year. Lower whole brain (β[SE]-0.50[0.25]; p ≤ 0.05) and parietal (β[SE]-0.59[0.25]; p < 0.05) CBF were associated with faster cognitive decline. PVC cortical CBF was not associated with cognitive decline. Lower CBF, in particular in the posterior brain regions, may have value as a prognostic marker for rate of cognitive decline in AD. • In AD, lower CBF is associated with more rapid cognitive decline. • Decreasing CBF does not reach a plateau early in AD. • PcASL-CFB has additive value to conventional structural MRI measures in AD.