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European Radiology
Published in: European Radiology 3/2017

Open Access 01-03-2017 | Neuro

Lower cerebral blood flow is associated with faster cognitive decline in Alzheimer’s disease

Authors: Marije R. Benedictus, Annebet E. Leeuwis, Maja A.A. Binnewijzend, Joost P.A. Kuijer, Philip Scheltens, Frederik Barkhof, Wiesje M. van der Flier, Niels D. Prins

Published in: European Radiology | Issue 3/2017

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Abstract

Objective

To determine whether lower cerebral blood flow (CBF) is associated with faster cognitive decline in patients with Alzheimer’s disease (AD).

Methods

We included 88 patients with dementia due to AD from the Amsterdam Dementia Cohort. Mean follow-up was 2 ± 1 years. Linear mixed models were used to determine associations of lower whole brain and regional pseudo-continuous arterial spin labelling measured CBF with rate of cognitive decline as measured with repeated mini-mental state examination (MMSE). Model 1 was adjusted for age, sex, and education. Model 2 was additionally adjusted for normalized gray matter volume, medial temporal lobe atrophy, white matter hyperintensities, microbleeds, and lacunes. Analyses were repeated after partial volume correction (PVC) of CBF. Statistical significance was set at p ≤ 0.05.

Results

Patients were 65 ± 7 years old, 44 (50 %) were women, and mean baseline MMSE was 22 ± 4. Annual decline (β[SE]) on the MMSE was estimated at -2.11 (0.25) points per year. Lower whole brain (β[SE]-0.50[0.25]; p ≤ 0.05) and parietal (β[SE]-0.59[0.25]; p < 0.05) CBF were associated with faster cognitive decline. PVC cortical CBF was not associated with cognitive decline.

Conclusions

Lower CBF, in particular in the posterior brain regions, may have value as a prognostic marker for rate of cognitive decline in AD.

Key points

• In AD, lower CBF is associated with more rapid cognitive decline.
• Decreasing CBF does not reach a plateau early in AD.
• PcASL-CFB has additive value to conventional structural MRI measures in AD.
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Metadata
Title
Lower cerebral blood flow is associated with faster cognitive decline in Alzheimer’s disease
Authors
Marije R. Benedictus
Annebet E. Leeuwis
Maja A.A. Binnewijzend
Joost P.A. Kuijer
Philip Scheltens
Frederik Barkhof
Wiesje M. van der Flier
Niels D. Prins
Publication date
01-03-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 3/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4450-z

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