Cerebrovascular reactivity in cerebral amyloid angiopathy, Alzheimer disease, and mild cognitive impairment

Autor: Aaron R. Switzer, Randall B. Stafford, Cheryl R. McCreary, Ikreet Cheema, Angela Zwiers, Ramnik Sekhon, Richard Frayne, Charlotte Zerna, Ana Alvarez-Veronesi, Anna Charlton, Eric E. Smith, Bradley G. Goodyear
Rok vydání: 2019
Předmět:
0301 basic medicine
Male
medicine.medical_specialty
genetic structures
Cross-sectional study
Stimulus (physiology)
behavioral disciplines and activities
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Alzheimer Disease
Internal medicine
mental disorders
Image Interpretation
Computer-Assisted
medicine
Humans
Cognitive Dysfunction
Prospective Studies
Prospective cohort study
Aged
Visual Cortex
business.industry
Echo-Planar Imaging
Middle Aged
medicine.disease
Confidence interval
Cerebral Amyloid Angiopathy
030104 developmental biology
Visual cortex
medicine.anatomical_structure
Cross-Sectional Studies
Cerebrovascular Circulation
Cardiology
Evoked Potentials
Visual
Female
Neurology (clinical)
Cerebral amyloid angiopathy
Alzheimer's disease
business
030217 neurology & neurosurgery
Cohort study
Zdroj: Neurology. 95(10)
ISSN: 1526-632X
Popis: ObjectiveTo assess cerebrovascular reactivity in response to a visual task in participants with cerebral amyloid angiopathy (CAA), Alzheimer disease (AD), and mild cognitive impairment (MCI) using fMRI.MethodsThis prospective cohort study included 40 patients with CAA, 22 with AD, 27 with MCI, and 25 healthy controls. Each participant underwent a visual fMRI task using a contrast-reversing checkerboard stimulus. Visual evoked potentials (VEPs) were used to compare visual cortex neuronal activity in 83 participants. General linear models using least-squares means, adjusted for multiple comparisons with the Tukey test, were used to estimate mean blood oxygen level–dependent (BOLD) signal change during the task and VEP differences between groups.ResultsAfter adjustment for age and hypertension, estimated mean BOLD response amplitude was as follows: CAA 1.88% (95% confidence interval [CI] 1.60%–2.15%), AD 2.26% (1.91%–2.61%), MCI 2.15% (1.84%–2.46%), and control 2.65% (2.29%–3.00%). Only patients with CAA differed from controls (p = 0.01). In the subset with VEPs, group was not associated with prolonged latencies or lower amplitudes. Lower BOLD amplitude response was associated with higher white matter hyperintensity (WMH) volumes in CAA (for each 0.1% lower BOLD response amplitude, the WMH volume was 9.2% higher, 95% CI 6.0%–12.4%) but not other groups (p = 0.002 for interaction) when controlling for age and hypertension.ConclusionsMean visual BOLD response amplitude was lowest in participants with CAA compared to controls, without differences in VEP latencies and amplitudes. This suggests that the impaired visual BOLD response is due to reduced vascular reactivity in CAA. In contrast to participants with CAA, the visual BOLD response amplitude did not differ between those with AD or MCI and controls.
Databáze: OpenAIRE
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