ASL perfusion MRI predicts cognitive decline and conversion from MCI to dementia.
ASL perfusion MRI predicts cognitive decline and conversion from MCI to dementia.
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DOI：
10.1097/wad.0b013e3181b4f736
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发表时间：
2010-01
影响因子：
2.1
通讯作者：
Weiner MW
中科院分区：
文献类型：
--
作者：
Chao LL;Buckley ST;Kornak J;Schuff N;Madison C;Yaffe K;Miller BL;Kramer JH;Weiner MW
我们比较了动脉自旋标记磁共振成像（ASL-MRI）测量的脑灌注与MRI衍生的海马体积对确定未来认知和功能下降以及随后从轻度认知障碍向痴呆的转化的预测价值。48名轻度认知障碍受试者在基线时接受结构和ASL-MRI扫描，每年进行临床和神经心理学评估。13名受试者在纵向观察期间（2.7 ± 1.0年）发生痴呆。考克斯回归分析表明，基线海马体积[相对危险度（RR）= 0.99，P = 0.004]，基线右下顶叶（RR = 0.64，P = 0.01）和右中额叶（RR = 0.73，P = 0.01）灌注与痴呆的转化相关。线性混合效应模型的结果表明，右楔前叶的基线灌注预测了随后的临床痴呆评分总和的下降。（P = 0.002），功能激活问卷（P = 0.01）选择性注意（即Stroop转换，P = 0.009），而右中额叶皮层的基线灌注预测随后的情景记忆下降，（即，来自加州言语学习测试的总识别辨别力得分，P = 0.03）。这些结果表明，通过ASL-MRI检测到的灌注不足可以预测随后的临床，功能和认知能力下降，并可能有助于确定未来阿尔茨海默病治疗试验的候选人。
We compared the predictive value of cerebral perfusion as measured by arterial-spin labeling magnetic resonance imaging (ASL-MRI) with MRI-derived hippocampal volume for determining future cognitive and functional decline and subsequent conversion from mild cognitive impairment to dementia. Forty-eight mild cognitive impairment subjects received structural and ASL-MRI scans at baseline and clinical and neuropsychologic assessments annually. Thirteen subjects became demented during the period of longitudinal observation (2.7 ± 1.0 y). Cox regression analyses suggest that baseline hippocampal volume [relative risk (RR) = 0.99, P = 0.004], baseline right inferior parietal (RR = 0.64, P = 0.01) and right middle frontal (RR = 0.73, P = 0.01) perfusion were associated with conversion to dementia. Results from linear mixed effects modeling suggest that baseline perfusion from the right precuneus predicted subsequent declines in Clinical Dementia Rating Sum of Boxes (P = 0.002), Functional Activates Questionnaire (P = 0.01), and selective attention (ie, Stroop switching, P = 0.009) whereas baseline perfusion from the right middle frontal cortex predicted subsequent episodic memory decline (ie, total recognition discriminability score from the California Verbal Learning Test, P = 0.03). These results suggest that hypoperfusion as detected by ASL-MRI can predict subsequent clinical, functional, and cognitive decline and may be useful for identifying candidates for future Alzheimer disease treatment trials.