title: ASL perfusion MRI predicts cognitive decline and conversion from MCI to dementia.
abstract: 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.
authors.affiliation: Center for Imaging of Neurodegenerative Disease, San Francisco, CA, USA. linda.chao@ucsf.edu
authors.forename: Linda L
authors.initials: LL
authors.lastname: Chao
authors.forename: Shannon T
authors.initials: ST
authors.lastname: Buckley
authors.forename: John
authors.initials: J
authors.lastname: Kornak
authors.forename: Norbert
authors.initials: N
authors.lastname: Schuff
authors.forename: Catherine
authors.initials: C
authors.lastname: Madison
authors.forename: Kristine
authors.initials: K
authors.lastname: Yaffe
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Miller
authors.forename: Joel H
authors.initials: JH
authors.lastname: Kramer
authors.forename: Michael W
authors.initials: MW
authors.lastname: Weiner
mesh_terms: D000368:Aged; D001921:Brain / Q000098:blood supply / Q000473:pathology*; D002560:Cerebrovascular Circulation; D003072:Cognition Disorders / Q000175:diagnosis*; D003704:Dementia / Q000175:diagnosis*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011237:Predictive Value of Tests; D013113:Spin Labels
chemical_list: D013113:Spin Labels