title: Cerebral blood flow measured with 3D pseudocontinuous arterial spin-labeling MR imaging in Alzheimer disease and mild cognitive impairment: a marker for disease severity.
abstract: OBJECTIVE
  To compare quantitative cerebral blood flow (CBF) values in patients with Alzheimer disease (AD), patients with mild cognitive impairment (MCI), and subjects with subjective complaints by using a whole-brain three-dimensional (3D) pseudocontinuous arterial spin-labeling (ASL) technique at 3.0 T.
  
  
  METHODS
  The local institutional review board approved the study. All subjects provided informed consent. Whole-brain 3D fast spin-echo pseudocontinuous ASL images were acquired at 3.0 T in 71 patients with AD (mean age, 65 years ± 7; 55% women), 35 patients with MCI (mean age, 65 years ± 8; 42% women), and 73 subjects with subjective complaints (mean age, 60 years ± 9; 39% women) who visited a memory clinic. Analyses were performed by using both uncorrected maps and maps corrected for partial volume effects. Regional CBF was compared by using analyses of variance; permutation tests were used for voxel-wise comparisons. Associations with cognition (Mini-Mental State Examination) were investigated by using linear regression analyses. All analyses were corrected for age and sex.
  
  
  RESULTS
  Uncorrected CBF was decreased in patients with AD compared with subjects with subjective complaints (27 mL/100 g/min ± 5 vs 33 mL/100 g/min ± 5; P < .001), with strongest reductions in the parietal lobes (22 mL/100 g/min ± 6 vs 30 mL/100 g/min ± 5; ie, decrease of 27%). Corrected cortical CBF showed similar results. In patients with MCI, CBF was decreased in the precuneus and the parietal and occipital lobes compared with subjects with subjective complaints. Voxel-wise comparisons confirmed the region of interest-based findings, showing the largest CBF differences in the precuneus and bilateral parietal cortex. Uncorrected and corrected cortical CBF were associated with cognition across diagnostic groups (β = 0.46 and β = 0.42, P < .001) and within the AD group (β = 0.41 and β = 0.42, P < .001).
  
  
  CONCLUSIONS
  CBF measured with 3D pseudocontinuous ASL MR imaging helps detect functional changes in the prodromal and more advanced stages of AD and is a marker for disease severity.
authors.affiliation: Department of Radiology, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands. m.binnewijzend@vumc.nl
authors.forename: Maja A A
authors.initials: MA
authors.lastname: Binnewijzend
authors.forename: Joost P A
authors.initials: JP
authors.lastname: Kuijer
authors.forename: Marije R
authors.initials: MR
authors.lastname: Benedictus
authors.forename: Wiesje M
authors.initials: WM
authors.lastname: van der Flier
authors.forename: Alle Meije
authors.initials: AM
authors.lastname: Wink
authors.forename: Mike P
authors.initials: MP
authors.lastname: Wattjes
authors.forename: Bart N M
authors.initials: BN
authors.lastname: van Berckel
authors.forename: Philip
authors.initials: P
authors.lastname: Scheltens
authors.forename: Frederik
authors.initials: F
authors.lastname: Barkhof
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000503:physiopathology*; D000704:Analysis of Variance; D002560:Cerebrovascular Circulation / Q000502:physiology*; D016009:Chi-Square Distribution; D060825:Cognitive Dysfunction / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D016014:Linear Models; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D013113:Spin Labels
chemical_list: D013113:Spin Labels