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Misery Perfusion with Preserved Vascular Reactivity in Alzheimer's Disease
Author(s) -
NAGATA KEN,
BUCHAN ROBERT J.,
YOKOYAMA ERIKO,
KONDOH YASUSHI,
SATO MIKA,
TERASHI HIROO,
SATOH YUICHI,
WATAHIKI YASUHITO,
SENOVA MELIS,
HIRATA YUTAKA,
HATAZAWA JUN
Publication year - 1997
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/j.1749-6632.1997.tb48479.x
Subject(s) - hypocapnia , cerebral blood flow , hyperventilation , hypercapnia , cardiology , perfusion , anesthesia , pathophysiology , medicine , hemodynamics , cerebral perfusion pressure , acidosis
To elucidate the hemodynamic pathophysiology underlying Alzheimer's disease (AD), cerebral blood flow (CBF), cerebral metabolic rate of oxygen (CMRO 2 ) and oxygen extraction fraction (OEF) were measured with positron emission tomography in 10 patients with probable AD and in 20 age‐matched normal volunteers. By the 15 O intravenous bolus injection method, CBF was measured during resting state, CO 2 inhalation (hypercapnia) and hyperventilation (hypocapnia), and the vascular reactivity (VR) was estimated by comparing the CBF changes (ΔCBF%/PaCO 2 mmHg) in the hyper‐ or hypocapnic to the resting state. By the 15 O 2 single‐breath method or 15 O steady‐state method, CMRO 2 and OEF were measured during resting state. Based on 26 regions of interest, local CBF, CMRO 2 and OEF were compared statistically between the two groups. As compared with the control group, the mean CBF and CMRO 2 decreased to as low as 77.0% and 88.4% of the normal values, respectively, while the mean OEF increased by 12.1% ( p < 0.05 ) in AD patients. These changes were most pronounced in the supramarginal and superior temporal gyri. There was no focal change in VR in the AD group, and no significant difference was seen in VR to either hyper‐ or hypocapnia between AD and control groups. The results may suggest a vascular involvement, possibly at the capillary level, that might cause a relative misery perfusion syndrome accompanied by preserved vascular reactivity in AD.