title: Brain perfusion SPECT imaging and acetazolamide challenge in vascular cognitive impairment.
abstract: Cerebrovascular disease is recognized as a common cause of cognitive impairment and dementia, alone or coexisting with other neurodegenerative diseases, mostly Alzheimer's disease. Vascular cognitive impairment (VCI) is a part of the heterogenous disorders group related to cerebral vessel disease. Although age is one of the most important risk factors for VCI, other common cardiovascular risk factors are also involved. By investigating these risk factors, a high proportion of these cognitive disorders can be prevented and/or delayed. Until now, only treatment of midlife arterial hypertension has been recognized as a preventing factor of vascular dementia. Brain MRI is becoming the method of choice to investigate cerebral vascular pathologies. However, this form of morphological imaging remains inadequate and does not provide useful functional information during VCI exploration, despite which functional imaging such as brain perfusion single-photon computed tomography, performed in baseline conditions and/or after an acetazolamide challenge, is underutilized in VCI exploration. The common strategies for VCI screening have not been standardized until now, and therefore further long-term imaging studies are needed to establish early diagnostic protocols. The present review summarizes the potential benefits of brain perfusion single-photon computed tomography imaging and possible scintigraphic quantification of cerebral hemodynamic reserves in investigation of VCI.
authors.affiliation: Nuclear Medicine Department, AP-HP, Hôtel Dieu Hospital, Paris, France. kwfarid@hotmail.com
authors.forename: Karim
authors.initials: K
authors.lastname: Farid
authors.forename: Slavomir
authors.initials: S
authors.lastname: Petras
authors.forename: Valérie
authors.initials: V
authors.lastname: Ducasse
authors.forename: Sylvie
authors.initials: S
authors.lastname: Chokron
authors.forename: Gérard
authors.initials: G
authors.lastname: Helft
authors.forename: Jacques
authors.initials: J
authors.lastname: Blacher
authors.forename: Nadine
authors.initials: N
authors.lastname: Caillat-Vigneron
mesh_terms: D000086:Acetazolamide; D001921:Brain / Q000000981:diagnostic imaging*; D002257:Carbonic Anhydrase Inhibitors; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000000981:diagnostic imaging*; D003072:Cognition Disorders / Q000175:diagnosis / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging; D012307:Risk Factors; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed
chemical_list: D002257:Carbonic Anhydrase Inhibitors; D000086:Acetazolamide