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. 2024 Jan;20(1):136-144.
doi: 10.1002/alz.13408. Epub 2023 Jul 25.

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

Maud van Dinther  1 , Astrid M Hooghiemstra  2 , Esther E Bron  3 , Adriaan Versteeg  3 , Anna E Leeuwis  2   4 , Tugba Kalay  5 , Justine E Moonen  2 , Sanne Kuipers  6 , Walter H Backes  7 , Jacobus F A Jansen  7 , Mathias J P van Osch  8 , Geert-Jan Biessels  6 , Julie Staals  1 , Robert J van Oostenbrugge  1 ; Heart-Brain Connection consortium
Affiliations

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

Maud van Dinther et al. Alzheimers Dement. 2024 Jan.

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.

Keywords: arterial spin labeling; cerebral blood flow; cerebral perfusion; cognitive function; vascular cognitive impairment.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Author disclosures are available in the supporting information.

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