Regional cerebral perfusion in patients with amnestic mild cognitive impairment: effect of cerebral small vessel disease

Objective To explore the effort of cerebral small vessel disease (CSVD) on regional cerebral perfusion in patients with mild cognitive impairment (MCI) using NeuroGam (TM) software and evaluate the capability of brain perfusion single photon emission computed tomography (SPECT) in distinguishing MCI with and without CSVD. Methods 34 amnestic MCI subjects entered this study, conducting neuropsychological tests, MRI and (99m)Technetium ethyl cystine dimer brain perfusion SPECT imaging. All subjects were divided into those with CSVD and those without CSVD. Perfusion value was measured with Brodmann area (BA) mapping in these two groups. Automated software (NeuroGam (TM)) was used for semi-quantitative analyses of perfusion value and comparison with normal database. Results Compared with normal database, perfusion levels in BAs 23-left, 28 and 36-left of MCI without CSVD group had great deviations, while perfusion levels in BAs 21, 23, 24, 25, 28, 36, 38 and 47-left of MCI with CSVD group had great deviations. Furthermore, compared with CSVD group, there was significantly lower perfusion value in BA 7-left (P < 0.001) in MCI without CSVD group. Conclusions CSVD could interact with pathological changes related to AD, exacerbating hypoperfusion in BAs 21, 23, 28, 36, 38 while compensating for cerebral blood perfusion disorder in BA 7-left in MCI patients. Meanwhile, MCI patients with CSVD shared similar hypoperfusion with vascular cognitive impairment (VCI) in BAs 24, 25 and 47L. Brain perfusion SPECT may help improve our ability to differentiate MCI with and without CSVD.

Automated summary

This study aimed to investigate the impact of CSVD on regional cerebral perfusion in MCI patients using NeuroGam (TM) software and brain perfusion SPECT imaging, and evaluate the ability of SPECT in distinguishing MCI with and without CSVD. The results indicate that CSVD may exacerbate hypoperfusion in certain brain areas in MCI patients, while also compensating for cerebral blood perfusion disorder in other areas. Brain perfusion SPECT may be helpful in differentiating MCI patients with and without CSVD.