Lower cerebral blood flow predicts cognitive decline in patients with vascular cognitive impairment

Maud van Dinther*, Astrid M. Hooghiemstra, the Heart Brain Connection Consortium, Esther E. Bron, Adriaan Versteeg, Anna E. Leeuwis, Tugba Kalay, Justine E. Moonen, Sanne Kuipers, Walter H. Backes, Jacobus F.A. Jansen, Mathias J.P. van Osch, Geert Jan Biessels, Julie Staals, Robert J. van Oostenbrugge

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

INTRODUCTION: 

Chronic cerebral hypoperfusion is one of the assumed pathophysiological mechanisms underlying vascular cognitive impairment (VCI). We investigated the association between baseline cerebral blood flow (CBF) and cognitive decline after 2 years in patients with VCI and reference participants. 

METHODS:

One hundred eighty-one participants (mean age 66.3 ± 7.4 years, 43.6% women) underwent arterial spin labeling (ASL) magnetic resonance imaging (MRI) and neuropsychological assessment at baseline and at 2-year follow-up. We determined the association between baseline global and lobar CBF and cognitive decline with multivariable regression analysis. 

RESULTS: 

Lower global CBF at baseline was associated with more global cognitive decline in VCI and reference participants. This association was most profound in the domain of attention/psychomotor speed. Lower temporal and frontal CBF at baseline were associated with more cognitive decline in memory. 

DISCUSSION: 

Our study supports the role of hypoperfusion in the pathophysiological and clinical progression of VCI. Highlights: Impaired cerebral blood flow (CBF) at baseline is associated with faster cognitive decline in VCI and normal aging. Our results suggest that low CBF precedes and contributes to the development of vascular cognitive impairment. CBF determined by ASL might be used as a biomarker to monitor disease progression or treatment responses in VCI.

Original languageEnglish
Pages (from-to)136-144
Number of pages9
JournalAlzheimer's and Dementia
Volume20
Issue number1
Early online date25 Jul 2023
DOIs
Publication statusPublished - Jan 2024

Bibliographical note

Funding Information:
This work is part of the Heart‐Brain Connection Crossroads (HBCx) Consortium of the Dutch CardioVascular Alliance (DCVA). HBCx has received funding from the Dutch Heart Foundation under grant agreements 2018‐28 and CVON 2012‐06. This specific research was also supported by the European Union's Horizon 2020 research and innovation programme ‘CRUCIAL’ (grant 848109). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Publisher Copyright:
© 2023 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.

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