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Review
. 2022 Nov 27;12(12):2967.
doi: 10.3390/diagnostics12122967.

The Utility of Arterial Spin Labeling MRI in Medial Temporal Lobe as a Vascular Biomarker in Alzheimer's Disease Spectrum: A Systematic Review and Meta-Analysis

Efthymia Maria Kapasouri  1   2 , Diomidis C Ioannidis  1   2 , Donnie Cameron  2   3 , Vassilios S Vassiliou  2   4 , Michael Hornberger  2
Affiliations
Review

The Utility of Arterial Spin Labeling MRI in Medial Temporal Lobe as a Vascular Biomarker in Alzheimer's Disease Spectrum: A Systematic Review and Meta-Analysis

Efthymia Maria Kapasouri et al. Diagnostics (Basel). .

Abstract

We sought to systematically review and meta-analy the role of cerebral blood flow (CBF) in the medial temporal lobe (MTL) using arterial spin labeling magnetic resonance imaging (ASL-MRI) and compare this in patients with Alzheimer's disease (AD), individuals with mild cognitive impairment (MCI), and cognitively normal adults (CN). The prevalence of AD is increasing and leading to high healthcare costs. A potential biomarker that can identify people at risk of developing AD, whilst cognition is normal or only mildly affected, will enable risk-stratification and potential therapeutic interventions in the future. All studies investigated the role of CBF in the MTL and compared this among AD, MCI, and CN participants. A total of 26 studies were included in the systematic review and 11 in the meta-analysis. Three separate meta-analyses were conducted. Four studies compared CBF in the hippocampus of AD compared with the CN group and showed that AD participants had 2.8 mL/min/100 g lower perfusion compared with the CN group. Eight studies compared perfusion in the hippocampus of MCI vs. CN group, which showed no difference. Three studies compared perfusion in the MTL of MCI vs. CN participants and showed no statistically significant differences. CBF measured via ASL-MRI showed impairment in AD compared with the CN group in subregions of the MTL. CBF difference was significant in hippocampus between the AD and CN groups. However, MCI and CN group showed no significant difference in subregions of MTL.

Keywords: ASL; MRI; arterial spin labeling; cerebral blood flow; dementia; medial temporal lobe; mild cognitive decline.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
Full search strategy.
Figure A2
Figure A2
Eligibility template.
Figure 1
Figure 1
PRISMA flow diagram.
Figure 2
Figure 2
Critical appraisal of included studies (Alexopoulos 2012 [33], Alsop 2000 [34]. Alsop 2008 [35]. Asslani 2008 [36], Bangen 2012 [37], Binnewijzend 2013 [38], Chau 2020 [39], Chaydhary 2013 [40], Dai 2009 [41], Ding 2014 [42], Dolui 2020 [43], Duan 2020 [44], Glodzik 2011 [45], Huang Q 2019 [46], Kim 2013 [47], Lassila 2018 [48], Li 2020 [49], Okonkwo 2014 [50], Riederer 2018 [51], Tosun 2010 [52], Westerberg 2013 [54], Wierenga 2012 [55], Xie 2016 [56] Zou 2014 [57]).
Figure 3
Figure 3
Hippocampus: Alzheimer dementia vs. cognitively normal (Binnewijzend M. (2013) [38], Huang Q. (2019) [47], Li D. (2020) [50], Zou J.X. (2014) [58]).
Figure 4
Figure 4
Hippocampus: Mild cognitive impairment vs. cognitively normal (Alexopoulos P. (2012) [33], Dai W. (2009) [41], Dolui S (2020) [43], Glodzik L. (2011) [45], Huang Q. (2019) [47], Li D. (2020) [50], Westerberg C. (2013) [55], Wierenga C.E. (2012) [56]).
Figure 5
Figure 5
MTL: mild cognitive impairment vs. cognitively normal (Alexopoulos P. (2012) [33], Bangen K.J. (2012) [37], Westerberg C. (2013) [55]).
See this image and copyright information in PMC

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