Decreased cerebral blood flow velocity in apolipoprotein E <i>ɛ</i>4 allele carriers with mild cognitive impairment

Sun, Zhongwu; Zhu, Yi-Ming; Liu, H.-Y.; Liu, Jiajia; Zhu, Xiaoqun; Zhou, Jiang‐Ning; Liu, Runde

doi:10.1111/j.1468-1331.2006.01579.x

Cited by 27 publications

(22 citation statements)

References 31 publications

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“…Another measure showing predictive value in AD is CBF velocity (CBFv), which may distinguish between normal controls, individuals at genetic risk, adults with MCI, and AD patients (Maalikjy Akkawi et al 2003; Maalikjy Akkawi et al 2005; Sun et al 2007; Claassen et al 2009). Similarly, research looking at flow territory asymmetry, using vessel encoding ASL (VE-ASL), suggests that it is a promising predictor of cognitive decline, and should be the focus of further investigation (Donahue et al 2014).…”

Section: Future Directions and Emerging Biomarkersmentioning

confidence: 99%

The Utility of Cerebral Blood Flow as a Biomarker of Preclinical Alzheimer’s Disease

2016

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There is accumulating evidence suggesting that changes in brain perfusion are present long before the clinical symptoms of Alzheimer’s disease (AD), perhaps even before amyloid-β accumulation or brain atrophy. This evidence, consistent with the vascular hypothesis of AD, implicates cerebral blood flow (CBF) in the pathogenesis of AD and suggests its utility as a biomarker of preclinical AD. The extended preclinical phase of AD holds particular significance for disease-modification, as treatment would likely be most effective in this early asymptomatic stage of disease. This highlights the importance of identifying reliable and accurate biomarkers of AD that can differentiate normal aging from preclinical AD prior to clinical symptom manifestation. Cerebral perfusion, as measured by arterial spin labeling magnetic resonance imaging (ASL-MRI), has been shown to distinguish between normal controls and adults with AD. In addition to demonstrating diagnostic utility, CBF has shown usefulness as a tool for identifying those who are at risk for AD and for predicting subtle cognitive decline and conversion to mild cognitive impairment (MCI) and AD. Taken together, this evidence not only implicates CBF as a useful biomarker for tracking disease severity and progression, but also suggests that ASL-measured CBF may be useful for identifying candidates for future AD treatment trials, especially in the preclinical, asymptomatic phases of the disease.

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Section: Future Directions and Emerging Biomarkersmentioning

confidence: 99%

The Utility of Cerebral Blood Flow as a Biomarker of Preclinical Alzheimer’s Disease

2016

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“…Previous studies have demonstrated associations between decreased MFV and older age [37] , mild cognitive impairment [38] , Alzheimer or vascular dementia [39] . In our study, higher MFV is associated with normal SPECT perfusion, fewer WMA, higher MoCA scores and older age.…”

Section: Discussionmentioning

confidence: 96%

Brain Microvasculature Involvement in ANCA Positive Vasculitis

2016

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Objective: Endothelial dysfunction is associated with arterial stiffness, a factor that is increasingly recognised as an important determinant of cardiovascular risk. High-flow organs such as the brain and kidneys are particularly sensitive to excessive pressure and flow pulsatility. High, local blood flow is associated with low microvascular impedance, which facilitates the penetration of excessive pulsatile energy into the microvascular bed leading to tissue damage. Systemic endothelial dysfunction and arterial stiffness have been demonstrated in peripheral vessels in associated vasculitis (AAV). Although, the brain involvement is not infrequent in AAV, it has not been evaluated previously. Our aim is to evaluate the involvement of the brain microvasculature in AAV. Methods: Twenty-three patients with inactive AAV were studied. Brain blood flow was assessed by transcranial Doppler (TCD) and single-photon positron emission tomography (SPECT), structural brain involvement by brain MRI and cognitive scores by Montreal Cognitive Assessment (MoCA) test. Results: Lower mean flow velocity (MFV) was associated to altered SPECT perfusion, higher white matter changes (WMC), lower MoCA scores and younger age (p < 0.05). Middle cerebral artery pulsatility index (MCA-PI) was related to hypertension, diabetes, lower scores on MoCA, increased vasculitis damage index (VDI) and perfusion impairment in SPECT (p < 0.05). These data were reproduced for all intracranial arteries. Up to 88.9% of patients had WMC on MRI. A higher lesion load was associated with age, decreased MoCA and fewer MFV with higher PI. The multivariable linear regression analysis showed that the greater the lesion loads, greater the bifrontal atrophy, MCA-PI and lower MoCA scores. Up to 60.9% of patients presented a decreased MoCA score (p = 0.012). It appeared to be related to VDI (p = 0.04), WMC (p = 0.004) and altered SPECT (p = 0.05). Conclusions: The alterations in brain perfusion SPECT, the presence of white matter lesions on MRI, as well as increased PI and RI with lower MFV of the cerebral vessels in TCD suggest the presence of microangiopathy in asymptomatic AAV that could lead to cognitive impairment.

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“…For instance, people suffering from MCI were shown to have a significantly decreased blood flow in the middle and anterior cerebral artery when compared to controls [6]. Moreover, the Rotterdam Study demonstrated that cerebral hypoperfusion precedes and possibly contributes to the onset of clinical dementia [4].…”

Section: Relationship Between Endothelial Vasodilator Function Andmentioning

confidence: 99%

“…With increasing life expectancy, dementia is a global public health problem with no cure or effective medical treatment currently available [1]. A growing body of evidence suggests that the initiation and progression of dementia is a consequence of poor cerebral vascular function and hypoperfusion [2,3,4,5,6]. The maintenance of cerebral blood flow (CBF) is crucial for normal brain functioning.…”

Section: Introductionmentioning

confidence: 99%

Effects of Long-Chain Omega-3 Polyunsaturated Fatty Acids on Endothelial Vasodilator Function and Cognition—Are They Interrelated?

2017

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Long-chain omega-3 polyunsaturated fatty acids (LCn-3 PUFA) may improve brain functions by acting on endothelial cells in the cerebrovasculature to facilitate vasodilatation and perfusion. The aim of this review is to explore this hypothesis by analyzing the effect of LCn-3 PUFA supplementation on systemic vasodilator and cognitive function and finding evidence to link LCn-3 PUFA intake, vasodilator function and cognition. Forty randomized controlled trials examining the effect of LCn-3 PUFA supplementation in humans on either endothelial vasodilator function or cognition were identified and pooled effects measured with a weighted analysis. Compared to placebo, LCn-3 PUFA tended to increase flow-mediated dilatation and significantly improved cognitive function. Emerging evidence links vasodilator dysfunction to cognitive impairment, but evidence that LCn-3 PUFA can improve cognition through enhancements of vasodilator function is still lacking. Further research is needed to determine: (1) whether LCn-3 PUFA can enhance dilatation of cerebral vessels; (2) if improvements in cerebrovascular responsiveness by LCn-3 PUFA are accompanied by cognitive benefits; and (3) the target population groups.

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Decreased cerebral blood flow velocity in apolipoprotein E ɛ4 allele carriers with mild cognitive impairment

Cited by 27 publications

References 31 publications

The Utility of Cerebral Blood Flow as a Biomarker of Preclinical Alzheimer’s Disease

The Utility of Cerebral Blood Flow as a Biomarker of Preclinical Alzheimer’s Disease

Brain Microvasculature Involvement in ANCA Positive Vasculitis

Effects of Long-Chain Omega-3 Polyunsaturated Fatty Acids on Endothelial Vasodilator Function and Cognition—Are They Interrelated?

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