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

doi:10.1002/alz.13408

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

Radiology & Nuclear Medicine

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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 language	English
Pages (from-to)	136-144
Number of pages	9
Journal	Alzheimer's and Dementia
Volume	20
Issue number	1
Early online date	25 Jul 2023
DOIs	https://doi.org/10.1002/alz.13408
Publication status	Published - 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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Cite this

van Dinther, M., Hooghiemstra, A. M., the Heart Brain Connection Consortium, Bron, E. E., Versteeg, A., Leeuwis, A. E., Kalay, T., Moonen, J. E., Kuipers, S., Backes, W. H., Jansen, J. F. A., van Osch, M. J. P., Biessels, G. J., Staals, J., & van Oostenbrugge, R. J. (2024). Lower cerebral blood flow predicts cognitive decline in patients with vascular cognitive impairment. Alzheimer's and Dementia, 20(1), 136-144. https://doi.org/10.1002/alz.13408

@article{dee562d85784426d8eb4493f5ebd1963,

title = "Lower cerebral blood flow predicts cognitive decline in patients with vascular cognitive impairment",

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.",

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

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 {\textquoteleft}CRUCIAL{\textquoteright} (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: {\textcopyright} 2023 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.",

year = "2024",

month = jan,

doi = "10.1002/alz.13408",

language = "English",

volume = "20",

pages = "136--144",

journal = "Alzheimer's and Dementia",

issn = "1552-5260",

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van Dinther, M, Hooghiemstra, AM, the Heart Brain Connection Consortium, Bron, EE, Versteeg, A, Leeuwis, AE, Kalay, T, Moonen, JE, Kuipers, S, Backes, WH, Jansen, JFA, van Osch, MJP, Biessels, GJ, Staals, J & van Oostenbrugge, RJ 2024, 'Lower cerebral blood flow predicts cognitive decline in patients with vascular cognitive impairment', Alzheimer's and Dementia, vol. 20, no. 1, pp. 136-144. https://doi.org/10.1002/alz.13408

TY - JOUR

T1 - Lower cerebral blood flow predicts cognitive decline in patients with vascular cognitive impairment

AU - van Dinther, Maud

AU - Hooghiemstra, Astrid M.

AU - the Heart Brain Connection Consortium

AU - Bron, Esther E.

AU - Versteeg, Adriaan

AU - Leeuwis, Anna E.

AU - Kalay, Tugba

AU - Moonen, Justine E.

AU - Kuipers, Sanne

AU - Backes, Walter H.

AU - Jansen, Jacobus F.A.

AU - van Osch, Mathias J.P.

AU - Biessels, Geert Jan

AU - Staals, Julie

AU - van Oostenbrugge, Robert J.

N1 - 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.

PY - 2024/1

Y1 - 2024/1

N2 - 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.

AB - 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.

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DO - 10.1002/alz.13408

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AN - SCOPUS:85165975754

SN - 1552-5260

VL - 20

SP - 136

EP - 144

JO - Alzheimer's and Dementia

JF - Alzheimer's and Dementia

IS - 1

ER -

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

Abstract

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