Correlation Between Cerebral Venous Oxygen Level and Cognitive Status in Patients With Alzheimer’s Disease Using Quantitative Susceptibility Mapping

Abstract

PurposeTo quantitatively assess the blood oxygen levels of the cerebral vein using quantitative susceptibility mapping (QSM), and to analyze the correlation between magnetic susceptibility value (MSV) and clinical laboratory indicators/cognitive scores in patients with Alzheimer’s disease (AD).Materials and MethodsFifty-nine patients (21 males and 38 females) with clinically confirmed AD (AD group) and 22 control subjects (12 males, 10 females; CON group) were recruited. Clinical data and laboratory examination indexes were collected. All patients underwent Mini-mental State Examination, Montreal Cognitive Assessment, Clock Drawing Task, and Activity of Daily Living Scale test, as well as a routine MRI and enhanced gradient echo T2 star weighted angiography (ESWAN).ResultsHigher cerebral venous MSV was observed in AD group compared to CON group, significant differences were observed for bilateral thalamus veins and left dentate nucleus veins. The MSV of bilateral thalamus veins, bilateral internal cerebral veins, and bilateral dentate nucleus veins had significant negative correlation with Mini-mental State Examination score; the MSV of bilateral thalamus veins, bilateral dentate nucleus veins, right septal vein had a significant negative correlation with Montreal Cognitive Assessment scores; a significant negative correlation between the MSV of bilateral thalamus veins, left dentate nucleus vein, right septal vein and the Clock Drawing Task score; the MSV of bilateral thalamus veins, left dentate nucleus vein had a significant negative correlation with Activity of Daily Living Scale score. The MSV of left dentate nucleus vein was positively correlated with the course of the disease, the MSV of bilateral septal vein were positively correlated with the total cholesterol, and the MSV of left septal vein had a positive correlation with LDL.ConclusionDecreasing cerebral venous oxygen level in AD patients may affect cognitive status, and associated with the deterioration of the disease in AD patients.

Cerebral oxygen metabolism from MRI susceptibility

“…This result agrees with the higher OEF found by Chiang et al in cognitively impaired subjects ( Chiang et al, 2022 ). However, between-group differences in the average were only moderately significant in veins located in the thalamus and dentate nucleus ( Liu et al, 2020 ). This study also found significant correlations between the average venous and clinical scores assessing cognitive status (i.e., the Mini-mental State Examination, Montréal Cognitive Assessment and Clock Drawing Task, and Activity of Daily Living Scale), demonstrating a relationship between the average venous and clinical cognitive assessment.…”

“…One study on Alzheimer’s disease ( Liu et al, 2020 ) has used QSM to measure the average in various cerebral veins of patients relative to elderly healthy controls, based on the hypothesis that cerebral blood flow impairment in Alzheimer’s disease may be associated with cognitive decline. The average venous was generally higher in patients than in controls, corresponding to lower venous oxygen levels.…”

The Venular Side of Cerebral Amyloid Angiopathy: Proof of Concept of a Neglected Issue

“…A different approach has been performed using high-field MRI in evaluating deep medullary veins tortuosity as a marker for SVD [119]. This application, as the evaluation of collagenosis of the deep medullary veins [11,94,97] and the measurement of venous oxygen levels [120], is outside the aims of this review, and they will not be specifically addressed. Moreover, superficial cortical veins (SCVs) were evaluated using MRI in a study on 344 healthy volunteers aiming to establish a relation between cognition and the diameter, length, or tortuosity index of the SCVs in the bilateral cerebral hemispheres without success [121].…”

Validation of a new 3D quantitative BOLD based cerebral oxygen extraction mapping

“…As such, imagingbased, noninvasive measurements of the parameters have been of great interest to clinics. In particular, recent MRI-based methods, 2,3 which aim to be a nonradiative, cost-efficient alternative to gold standard PET-based measurements using 15 O-labeled radioactive tracers, have shown promise that regional OEF may serve as a potential biomarker in a number of brain diseases, including ischemic stroke, 4 multiple sclerosis, 5 Alzheimer's disease, 6 and cognitive impairment. 7 Two representative MRI techniques among the few that enable OEF mapping are calibrated BOLD (cBOLD) 8 and quantitative BOLD (qBOLD).…”