The Effects of Intracranial Stenosis on Cerebral Perfusion and Cognitive Performance

Autor: Jan Petr, Saima Hilal, Henri J.M.M. Mutsaerts, Doeschka A. Ferro, Hugo J. Kuijf, Christopher Chen, Geert Jan Biessels
Přispěvatelé: Radiology and nuclear medicine
Rok vydání: 2021
Předmět:
Male
medicine.medical_specialty
Epidemiology
Population
Hemodynamics
Neuroimaging
Constriction
Pathologic
Neuropsychological Tests
030218 nuclear medicine & medical imaging
Cellular and Molecular Neuroscience
03 medical and health sciences
Cerebral circulation
0302 clinical medicine
Cognition
Developmental Neuroscience
Internal medicine
medicine
Humans
Cognitive Dysfunction
Neuropsychological assessment
Cerebral perfusion pressure
education
Aged
education.field_of_study
medicine.diagnostic_test
business.industry
Vascular disease
Health Policy
General Neuroscience
Brain
General Medicine
medicine.disease
Magnetic Resonance Imaging
Psychiatry and Mental health
Clinical Psychology
Stenosis
Cerebrovascular Disorders
Cerebral blood flow
Cerebrovascular Circulation
Cardiology
Female
Spin Labels
Neurology (clinical)
Geriatrics and Gerontology
business
030217 neurology & neurosurgery
Zdroj: Hilal, S, Mutsaerts, H J M M, Ferro, D A, Petr, J, Kuijf, H J, Biessels, G J & Chen, C 2021, ' The effects of intracranial stenosis on cerebral perfusion and cognitive performance ', Journal of Alzheimer's disease : JAD, vol. 79, no. 3, pp. 1369-1380 . https://doi.org/10.3233/JAD-201131
Journal of Alzheimer's disease : JAD, 79(3), 1369-1380. IOS Press
ISSN: 1875-8908
1387-2877
DOI: 10.3233/JAD-201131
Popis: Background: Intracranial stenosis (ICS) may contribute to cognitive dysfunction by decreased cerebral blood flow (CBF) which can be measured quantitatively by arterial spin labelling (ASL). Interpretation of CBF measurements with ASL, however, becomes difficult in patients with vascular disease due to prolonged arterial transit time (ATT). Recently, spatial coefficient of variation (sCoV) of ASL signal has been proposed that approximates ATT and utilized as a proxy marker for assessment of hemodynamic status of cerebral circulation. Objective: We investigate the association of ICS with CBF and sCoV parameters and its eventual effects on cognition in a memory clinic population. Methods: We included 381 patients (mean age = 72.3±7.9 years, women = 53.7%) who underwent 3T MRI and detailed neuropsychological assessment. ICS was defined as≥50% stenosis in any intracranial vessel on 3D Time-of-Flight MR Angiography. Gray matter sCoV and CBF were obtained from 2D EPI pseudo-continuous ASL images. Results: ICS was present in 58 (15.2%) patients. Patients with ICS had higher gray matter sCoV and lower CBF. The association with sCoV remained statistically significant after correction for cardiovascular risk factors. Moreover, ICS was associated with worse performance on visuoconstruction, which attenuated with higher sCoV. Mediation analysis showed that there was an indirect effect of ICS on visuoconstruction via sCoV. Conclusion: These findings suggest that compromised CBF as detected by higher sCoV is related to cognitive impairment among individuals diagnosed with ICS. We also showed that sCoV partially mediates the link between ICS and cognition. Therefore, sCoV may provide valuable hemodynamic information in patients with vascular disease.
Databáze: OpenAIRE
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