Relationship between cerebral blood flow and later cognitive decline in hypertensive patients with cerebral small vessel disease.
Vascular risk factors are thought to be important for dementia. However, there is little evidence for a prospective association between cerebral blood flow and the risk of cognitive decline. Twenty-seven cognitively intact hypertensive patients aged 55 years and older with lacunar infarction or white matter lesions in magnetic resonance imaging (MRI) underwent positron emission tomography (PET) to measure cerebral blood flow (CBF) and cerebral vascular reactivity (CVR). Cognitive function was assessed at baseline and 3 years later with the mini-mental state examination (MMSE). Patients whose MMSE score fell by more than three points were classified as having cognitive decline. Six patients showed cognitive decline. Baseline CBF in these patients was significantly lower than that of the 21 patients without cognitive decline (31.2+/-2.4 vs. 42.6+/-5.9 ml per 100 g min(-1), respectively; P<0.001). A moderate linear association was found between CBF and change in MMSE score over a 3-year period (r=0.59, P=0.001), not between CBF and baseline MMSE score. In contrast, no association between CVR and later cognitive decline was found. This study suggests that cerebral hypoperfusion is associated with later cognitive decline.
Kitagawa
Kazuo
K
Department of Neurology, Osaka University Graduate School of Medicine, Suita, Japan. kitagawa@medone.med.osaka-u.ac.jp
Oku
Naohiko
N
Kimura
Yasuyuku
Y
Yagita
Yoshiki
Y
Sakaguchi
Manabu
M
Hatazawa
Jun
J
Sakoda
Saburo
S
D000368:Aged; D050197:Atherosclerosis / Q000150:complications / Q000523:psychology; D002544:Cerebral Infarction / Q000473:pathology / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D003072:Cognition Disorders / Q000209:etiology* / Q000523:psychology; D003704:Dementia / Q000209:etiology / Q000523:psychology; D003920:Diabetes Mellitus / Q000473:pathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000523:psychology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D049268:Positron-Emission Tomography; D012307:Risk Factors