Effects of hypoperfusion in Alzheimer's disease.
Effects of hypoperfusion in Alzheimer's disease.
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DOI：
10.3233/jad-2011-0010
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Prabhakaran V
中科院分区：
文献类型：
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作者：
Austin BP;Nair VA;Meier TB;Xu G;Rowley HA;Carlsson CM;Johnson SC;Prabhakaran V
低灌注在阿尔茨海默病（AD）中的作用是了解该疾病发病机制的重要组成部分。灌注中断不仅在整个疾病表现中都很明显，而且在阿尔茨海默病的临床前阶段（即轻度认知障碍）以及由于家族史或遗传因素导致阿尔茨海默病高风险的认知健康人群中也表现出来。研究使用了多种成像方式（如SPECT， MRI， PET）来研究AD，但随着其最近的技术进步和无创使用血液作为内源性示踪剂，动脉自旋标记（ASL） MRI已成为越来越受欢迎的成像技术。通过大量的ASL研究，现在已经知道AD与整体和局部脑灌注不足有关，并且在与疾病状态相关的区域（一致报道在楔前叶/后扣带皮层和外侧顶叶皮层）和与疾病风险相关的区域之间存在相当大的重叠。关于阿尔茨海默病的血流量减少是该疾病的原因还是结果，存在争议。尽管如此，阿尔茨海默病的低灌注与大脑的结构和功能变化有关，并提供了一种有希望的生物标志物，可以潜在地识别临床前状态的阿尔茨海默病，并用于探索预防或至少减缓疾病进展的治疗方法。最后，鉴于灌注是一种血管现象，我们从血管病变模型（即卒中）提供见解，并说明灌注中断对AD患者脑结构和功能的影响，并最终影响认知。
The role of hypoperfusion in Alzheimer’s disease (AD) is a vital component to understanding the pathogenesis of this disease. Disrupted perfusion is not only evident throughout disease manifestation, it is also demonstrated during the pre-clinical phase of AD (i.e., mild cognitive impairment) as well as in cognitively healthy persons at high-risk for developing AD due to family history or genetic factors. Studies have used a variety of imaging modalities (e.g., SPECT, MRI, PET) to investigate AD, but with its recent technological advancements and non-invasive use of blood water as an endogenous tracer, arterial spin labeling (ASL) MRI has become an imaging technique of growing popularity. Through numerous ASL studies, it is now known that AD is associated with both global and regional cerebral hypoperfusion and that there is considerable overlap between the regions implicated in the disease state (consistently reported in precuneus/posterior cingulate and lateral parietal cortex) and those implicated in disease risk. Debate exists as to whether decreased blood flow in AD is a cause or consequence of the disease. Nonetheless, hypoperfusion in AD is associated with both structural and functional changes in the brain and offers a promising putative biomarker that could potentially identify AD in its pre-clinical state and be used to explore treatments to prevent, or at least slow, the progression of the disease. Finally, given that perfusion is a vascular phenomenon, we provide insights from a vascular lesion model (i.e., stroke) and illustrate the influence of disrupted perfusion on brain structure and function and, ultimately, cognition in AD.