Neurovascular decoupling is associated with severity of cerebral amyloid angiopathy
| Autor: | Daniela Flück, Emily Donaldson, Marc J. Poulin, Cheryl R. McCreary, Neelan Pillay, Richard Frayne, Gordon H. Fick, Eric E. Smith, Stefano Peca, Gopukumar Kumarpillai, Karla Sanchez, Craig D. Steinback, Nandavar Shobha, Anna Charlton, Andrew E. Beaudin, Bradley G. Goodyear |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty genetic structures Ultrasonography Doppler Transcranial Posterior cerebral artery Article Cohort Studies medicine.artery Internal medicine mental disorders medicine Image Processing Computer-Assisted Humans Aged Brain Electroencephalography Carbon Dioxide Cerebral Arteries Middle Aged medicine.disease Magnetic Resonance Imaging Transcranial Doppler Oxygen Cerebral Amyloid Angiopathy Visual cortex medicine.anatomical_structure Cross-Sectional Studies Frontal lobe Anesthesia Middle cerebral artery Cardiology Evoked Potentials Visual Female Neurology (clinical) Cerebral amyloid angiopathy Psychology Occipital lobe Photic Stimulation Motor cortex |
| Zdroj: | Neurology. 81(19) |
| ISSN: | 1526-632X |
| Popis: | We used functional MRI (fMRI), transcranial Doppler ultrasound, and visual evoked potentials (VEPs) to determine the nature of blood flow responses to functional brain activity and carbon dioxide (CO2) inhalation in patients with cerebral amyloid angiopathy (CAA), and their association with markers of CAA severity.In a cross-sectional prospective cohort study, fMRI, transcranial Doppler ultrasound CO2 reactivity, and VEP data were compared between 18 patients with probable CAA (by Boston criteria) and 18 healthy controls, matched by sex and age. Functional MRI consisted of a visual task (viewing an alternating checkerboard pattern) and a motor task (tapping the fingers of the dominant hand).Patients with CAA had lower amplitude of the fMRI response in visual cortex compared with controls (p = 0.01), but not in motor cortex (p = 0.22). In patients with CAA, lower visual cortex fMRI amplitude correlated with higher white matter lesion volume (r = -0.66, p = 0.003) and more microbleeds (r = -0.78, p0.001). VEP P100 amplitudes, however, did not differ between CAA and controls (p = 0.45). There were trends toward reduced CO2 reactivity in the middle cerebral artery (p = 0.10) and posterior cerebral artery (p = 0.08).Impaired blood flow responses in CAA are more evident using a task to activate the occipital lobe than the frontal lobe, consistent with the gradient of increasing vascular amyloid severity from frontal to occipital lobe seen in pathologic studies. Reduced fMRI responses in CAA are caused, at least partly, by impaired vascular reactivity, and are strongly correlated with other neuroimaging markers of CAA severity. |
| Databáze: | OpenAIRE |
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