Lower cerebral blood flow is associated with impairment in multiple cognitive domains in Alzheimer's disease.
BACKGROUND
We examined the association between decreased cerebral blood flow (CBF) and cognitive impairment in Alzheimer's disease (AD), mild cognitive impairment (MCI), and subjective cognitive decline (SCD).


METHODS
We included 161 AD, 95 MCI, and 143 SCD patients from the Amsterdam Dementia Cohort. We used 3-T pseudo-continuous arterial spin labeling to estimate whole-brain and regional partial volume-corrected CBF. Neuropsychological tests covered global cognition and five cognitive domains. Associations were investigated using linear regression analyses.


RESULTS
In the whole sample, reduced overall and regional CBF was associated with impairment in all cognitive domains. We found significant interactions between diagnosis and CBF for language and between diagnosis and parietal CBF for global cognition and executive functioning. Stratification showed that decreased CBF was associated with worse performance in AD patients but not in MCI or SCD.


CONCLUSIONS
Our results suggest that CBF may have potential as a functional marker of disease severity.
Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: a.leeuwis@vumc.nl.
Anna E
AE
Leeuwis
Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands.
Marije R
MR
Benedictus
Department of Physics and Medical Technology, VU University Medical Center, Amsterdam, The Netherlands.
Joost P A
JPA
Kuijer
Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands; Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands.
Maja A A
MAA
Binnewijzend
Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands; Department of Clinical Neuropsychology, Vrije Universiteit, Amsterdam, The Netherlands.
Astrid M
AM
Hooghiemstra
Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands; Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands.
Sander C J
SCJ
Verfaillie
Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands.
Teddy
T
Koene
Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands.
Philip
P
Scheltens
Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands; Institutes of Neurology and Healthcare Engineering, UCL, London, United Kingdom.
Frederik
F
Barkhof
Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands.
Niels D
ND
Prins
Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.
Wiesje M
WM
van der Flier
D000544:Alzheimer Disease / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D013113:Spin Labels
D013113:Spin Labels
Alzheimer's disease; Arterial spin labeling; Brain perfusion; Cognition; Dementia