Cerebral blood flow in Alzheimer's disease
Background: Alzheimer's disease (AD) dementia is a consequence of heterogeneous and complex interactions of age-related neurodegeneration and vascular-associated pathologies. Evidence has accumulated that there is increased atherosclerosis/arteriosclerosis of the intracranial arteries in AD and that this may be additive or synergistic with respect to the generation of hypoxia/ischemia and cognitive dysfunction. The effectiveness of pharmacologic therapies and lifestyle modification in reducing cardiovascular disease has prompted a reconsideration of the roles that cardiovascular disease and cerebrovascular function play in the pathogenesis of dementia. Methods: Using two-dimensional phase-contrast magnetic resonance imaging, we quantified cerebral blood flow within the internal carotid, basilar, and middle cerebral arteries in a group of individuals with mild to moderate AD (n = 8) and compared the results with those from a group of age-matched nondemented control (NDC) subjects (n = 9). Clinical and psychometric testing was performed on all individuals, as well as obtaining their magnetic resonance imaging-based hippocampal volumes. Results: Our experiments reveal that total cerebral blood flow was 20% lower in the AD group than in the NDC group, and that these values were directly correlated with pulse pressure and cognitive measures. The AD group had a significantly lower pulse pressure (mean AD 48, mean NDC 71; P = 0.0004). A significant group difference was also observed in their hippocampal volumes. Composite z-scores for clinical, psychometric, hippocampal volume, and hemodynamic data differed between the AD and NDC subjects, with values in the former being significantly lower (t = 12.00, df = 1, P = 0.001) than in the latter. Conclusion: These results indicate an association between brain hypoperfusion and the dementia of AD. Cardiovascular disease combined with brain hypoperfusion may participate in the pathogenesis/pathophysiology of neurodegenerative diseases. Future longitudinal and larger-scale confirmatory investigations measuring multidomain parameters are warranted. © 2012 Roher et al, publisher and licensee Dove Medical Press Ltd.
Vascular Health and Risk Management
Digital Object Identifier (DOI)
Roher, Alex E.; Debbins, Josef P.; Malek-Ahmadi, Michael; Chen, Kewei; Pipe, James G.; Maze, Sharmeen; Belden, Christine; Maarouf, Chera L.; Thiyyagura, Pradeep; Mo, Hua; Hunter, Jesse M.; Kokjohn, Tyler A.; Walker, Douglas G.; Kruchowsky, Jane C.; Belohlavek, Marek; Sabbagh, Marwan N.; and Beach, Thomas G., "Cerebral blood flow in Alzheimer's disease" (2012). Neurology. 791.