期刊
ALZHEIMER DISEASE & ASSOCIATED DISORDERS
卷 24, 期 1, 页码 19-27出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/WAD.0b013e3181b4f736
关键词
mild cognitive impairment; dementia; cognitive and functional decline; ASL perfusion MRI; hippocampal volume
资金
- NIH NIA [NIA R01 AG010897]
- NATIONAL INSTITUTE ON AGING [R01AG010897] Funding Source: NIH RePORTER
We compared the predictive value of cerebral perfusion as measured by arterial-spin labeling magnetic resonance imaging (ASL-MRI) with MRI-derived hippocampal volume for determining future cognitive and functional decline and subsequent conversion from mild cognitive impairment to dementia. Forty-eight mild cognitive impairment subjects received structural and ASL-MRI scans at baseline and clinical and neuropsychologic assessments annually. Thirteen subjects became demented during the period of longitudinal observation (2.7 +/- 1.0 y). Cox regression analyses suggest that baseline hippocampal volume [relative risk (RR) = 0.99, P = 0.004], baseline right inferior parietal (RR = 0.64, P = 0.01) and right middle frontal (RR = 0.73, P = 0.01) perfusion were associated with conversion to dementia. Results from linear mixed effects modeling suggest that baseline perfusion from the right precuneus predicted subsequent declines in Clinical Dementia Rating Sum of Boxes (P = 0.002), Functional Activates Questionnaire (P = 0.01), and selective attention (ie, Stroop switching, P = 0.009) whereas baseline perfusion from the right middle frontal cortex predicted subsequent episodic memory decline (ie, total recognition discriminability score from the California Verbal Learning Test, P = 0.03). These results suggest that hypoperfusion as detected by ASL-MRI can predict subsequent clinical, functional, and cognitive decline and may be useful for identifying candidates for future Alzheimer disease treatment trials.
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