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Regional cerebral perfusion alterations in subjective cognitive decline measured by arterial spin labeling MRI
Author(s) -
Schwarz Claudia,
Hetzer Stefan,
Benson Gloria,
Horn Nora,
Wurdack Katharina,
Wirth Miranka,
Flöel Agnes
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.046351
Subject(s) - cerebral blood flow , cognitive decline , cognition , medicine , cardiology , effects of sleep deprivation on cognitive performance , cerebral perfusion pressure , confounding , perfusion , dementia , psychology , disease , psychiatry
Background Individuals with subjective cognitive decline (SCD) are at high risk of developing Alzheimer's disease (AD) (Jessen et al., 2014). Changes in cerebral perfusion, particularly cerebral blood flow (CBF), are a feature of AD and has also been shown in pre‐dementia stages (Binnewijzend et al., 2016). This study investigates regional CBF and its association with cognition in individuals with SCD and healthy older adults. Method Cognitive performance and cerebral perfusion were assessed in 81 individuals with SCD (age 68±5 years) and 46 healthy controls (age 71±6 years). Regional CBF (mL/100g/min) was assessed by arterial spin labeling MRI and quantified in AD‐vulnerable regions (Wirth et al., 2016). The preclinical Alzheimer’s cognitive composite (PACC5) and composite scores for selected cognitive domains were calculated. General linear models were conducted to assess group differences in regional CBF as well as associations between regional CBF and cognitive performance. Interaction effect of group and regional CBF on cognitive performance was determined using the same method. All analyses were adjusted for potential confounders (including sex, age, and body mass index). Result Participants with SCD showed decreased CBF in the hippocampus (p=.038) and the basal ganglia (p=.014) compared to healthy controls. Moreover, participants with SCD exhibited greater CBF in the inferior temporal gyrus than healthy controls (p=.006). Across all participants, CBF in the basal ganglia was positively associated with executive function (p=.016), memory (p=.018), and PACC5 (p=.001). Exploratory investigations within each group revealed these associations only in healthy controls (p=.032, .037, .004, respectively). However, no effect of group was found on the relationship between regional CBF and cognitive performance. Conclusion Our findings indicate that alterations of cerebral perfusion are already detectable in the stage of SCD, in particular in the hippocampus, basal ganglia, and inferior temporal gyrus. In addition, cognitive performance was positively associated with CBF in the basal ganglia across all subjects; however, this effect was mainly driven by the healthy controls. Thus, our findings may point towards early pathological changes affecting the association between regional CBF and cognition in SCD, which needs to be evaluated in further studies.