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. 2008 Oct 1;42(4):1267-74.
doi: 10.1016/j.neuroimage.2008.06.006. Epub 2008 Jun 17.

Hippocampal hyperperfusion in Alzheimer's disease

David C Alsop  1 , Melynda Casement, Cedric de Bazelaire, Tamara Fong, Daniel Z Press
Affiliations

Hippocampal hyperperfusion in Alzheimer's disease

David C Alsop et al. Neuroimage. .

Abstract

Many of the regions with the earliest atrophy in Alzheimer's Disease (AD) do not show prominent deficits on functional imaging studies of flow or metabolism. This paradox may provide unique insights into the pathophysiology of AD. We sought to examine the relationship between function and atrophy in AD using MRI blood flow and anatomic imaging. 22 subjects diagnosed with AD, mean Mini Mental State Exam (MMSE) score 22.2, and 16 healthy elderly controls were imaged with a volumetric arterial spin labeling blood flow MRI technique and an anatomical imaging method using the identical spatial resolution, image orientation, and spatial encoding strategy. Cerebral blood flow (CBF) and gray matter (GM) maps derived from the imaging were transformed to a standard anatomical space. GM and CBF maps were tested for significant differences between groups. Additionally, images were tested for regions with significant mismatch of the CBF and GM differences between groups. CBF was significantly lower in the bilateral precuneus, parietal association cortex and the left inferior temporal lobe but was non-significantly increased in the hippocampus and other medial temporal structures. After correction for GM loss, CBF was significantly elevated in the hippocampus and other medial temporal structures. The hippocampus and other regions affected early in AD are characterized by elevated atrophy-corrected perfusion per cm(3) of tissue. This suggests compensatory or pathological elevation of neural activity, inflammation, or elevated production of vasodilators.

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Figures

Figure 1
Figure 1. ASL Blood flow maps before atrophy correction in two subjects
Images from a 73 year old male diagnosed with probable AD (MMSE 28), top row, demonstrate prominent hyperintensity in the hippocampal region bilaterally and reduced flow in the parietal and inferior temporal cortex, relative to 79 year old male control subject, bottom row.
Figure 2
Figure 2. Regions significantly different between the AD group and controls
Surface projections of clusters with significantly decreased CBF (A) and GM density (B) highlight very different brain regions. Analysis of CBF-atrophy mismatch (C), shows where regions of more greatly decreased CBF (red) and more greatly decreased GM density(green) were found. The region of most significant CBF-atrophy mismatch was the hippocampus (D), as indicated by the value of the T statistic shown on the color scale.
Figure 2
Figure 2. Regions significantly different between the AD group and controls
Surface projections of clusters with significantly decreased CBF (A) and GM density (B) highlight very different brain regions. Analysis of CBF-atrophy mismatch (C), shows where regions of more greatly decreased CBF (red) and more greatly decreased GM density(green) were found. The region of most significant CBF-atrophy mismatch was the hippocampus (D), as indicated by the value of the T statistic shown on the color scale.
See this image and copyright information in PMC

References

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