Published in:
Open Access
08-09-2022 | Alzheimer's Disease | Original Article
Cerebral blood flow, amyloid burden, and cognition in cognitively normal individuals
Authors:
Jarith L. Ebenau, Denise Visser, Sander C. J. Verfaillie, Tessa Timmers, Mardou S. S. A. van Leeuwenstijn, Mara ten Kate, Albert D. Windhorst, Frederik Barkhof, Philip Scheltens, Niels D. Prins, Ronald Boellaard, Wiesje M. van der Flier, Bart N. M. van Berckel
Published in:
European Journal of Nuclear Medicine and Molecular Imaging
|
Issue 2/2023
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Abstract
Purpose
The role of cerebral blood flow (CBF) in the early stages of Alzheimer’s disease is complex and largely unknown. We investigated cross-sectional and longitudinal associations between CBF, amyloid burden, and cognition, in cognitively normal individuals with subjective cognitive decline (SCD).
Methods
We included 187 cognitively normal individuals with SCD from the SCIENCe project (65 ± 8 years, 39% F, MMSE 29 ± 1). Each underwent a dynamic (0–70 min) [18F]florbetapir PET and T1-weighted MRI scan, enabling calculation of mean binding potential (BPND; specific amyloid binding) and R1 (measure of relative (r)CBF). Eighty-three individuals underwent a second [18F]florbetapir PET (2.6 ± 0.7 years). Participants annually underwent neuropsychological assessment (follow-up time 3.8 ± 3.1 years; number of observations n = 774).
Results
A low baseline R1 was associated with steeper decline on tests addressing memory, attention, and global cognition (range betas 0.01 to 0.27, p < 0.05). High BPND was associated with steeper decline on tests covering all domains (range betas − 0.004 to − 0.70, p < 0.05). When both predictors were simultaneously added to the model, associations remained essentially unchanged. Additionally, we found longitudinal associations between R1 and BPND. High baseline BPND predicted decline over time in R1 (all regions, range betasBP×time − 0.09 to − 0.14, p < 0.05). Vice versa, low baseline R1 predicted increase in BPND in frontal, temporal, and composite ROIs over time (range betasR1×time − 0.03 to − 0.08, p < 0.05).
Conclusion
Our results suggest that amyloid accumulation and decrease in rCBF are two parallel disease processes without a fixed order, both providing unique predictive information for cognitive decline and each process enhancing the other longitudinally.