title: Cerebral blood flow by arterial spin labeling in poststroke dementia.
abstract: OBJECTIVE
  To investigate the relationship between cerebral blood flow and dementia in older stroke survivors and subjects with Alzheimer disease (AD).
  
  
  METHODS
  This cohort study used arterial spin labeling MRI at 3 T to examine cerebral blood flow (CBF). We scanned 39 patients 6 years after stroke. They were older than 75 years at the time of stroke and free of dementia 3 months poststroke, with 8 subsequently developing dementia. We also scanned 17 subjects with AD and 29 healthy control subjects. We determined the perfusion in regions of interest (ROIs). Hippocampal volume was also measured using a previously validated automated procedure.
  
  
  RESULTS
  The gray matter/white matter CBF ratio was reduced globally in the poststroke dementia (PSD) group (1.55 SD = 0.12) relative to control subjects (1.78 SD = 0.18; p = 0.03). The CBF ratio in a parietal ROI was reduced in the AD (1.34 SD = 0.31; p = 0.003), PSD (1.32 SD = 0.22; p = 0.041), and poststroke no-dementia (PSND) (1.44 SD = 0.34; p = 0.014) groups relative to that of control subjects (1.70 SD = 0.32). In subjects without stroke, the best predictor of dementia was hippocampus volume, whereas in the stroke group, it was the global CBF gray matter/white matter ratio. Hippocampus volume was not significantly different between the AD and PSD groups, and both had reduced hippocampi relative to those of control subjects and the PSND group.
  
  
  CONCLUSIONS
  We found evidence for both vascular and AD pathology in PSD, suggesting that both the direct impact of the stroke and subsequent development of AD-type changes play a role in the etiology of PSD.
authors.affiliation: Institute for Ageing and Health, Newcastle University, Wolfson Research Centre, Campus for Ageing and Vitality, Newcastle upon Tyne, UK. m.j.firbank@ncl.ac.uk
authors.forename: M J
authors.initials: MJ
authors.lastname: Firbank
authors.forename: J
authors.initials: J
authors.lastname: He
authors.forename: A M
authors.initials: AM
authors.lastname: Blamire
authors.forename: B
authors.initials: B
authors.lastname: Singh
authors.forename: P
authors.initials: P
authors.lastname: Danson
authors.forename: R N
authors.initials: RN
authors.lastname: Kalaria
authors.forename: J T
authors.initials: JT
authors.lastname: O'Brien
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000473:pathology / Q000503:physiopathology; D001776:Blood Circulation Time / Q000379:methods; D001921:Brain / Q000098:blood supply*; D002536:Cerebral Arteries / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003704:Dementia / Q000209:etiology / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D013113:Spin Labels; D018709:Statistics, Nonparametric; D020521:Stroke / Q000150:complications
chemical_list: D013113:Spin Labels