Association of arterial spin labeling parameters with cognitive decline, vascular events and mortality in a memory-clinic sample
Association of arterial spin labeling parameters with cognitive decline, vascular events and mortality in a memory-clinic sample
Gyanwali, B.; Mutsaerts, H. J. M. M.; Seng Tan, C.; Rajab Kaweilh, O.; Petr, J.; Chen, C.; Hilal, S.
Background: Cognitive decline in older adults has been attributed to reduced cerebral blood flow (CBF). Recently, the spatial coefficient of variation (sCoV) of ASL has been proposed as a proxy marker of cerebrovascular insufficiency. We investigated the association between baseline ASL parameters with cognitive decline, incident cerebrovascular disease and risk of vascular events and mortality.
Design, Setting and Participants: 368 memory-clinic patients underwent three-annual neuropsychological assessments and brain MRI scans at baseline and follow-up. MRIs were graded for white matter hyperintensities (WMH), lacunes, cerebral microbleeds (CMBs), cortical infarcts and intracranial stenosis. Baseline gray (GM) and white matter (WM) CBF and GM-sCoV were obtained with ExploreASL from 2D-EPI pseudo-continuous ASL images. Cognitive assessment was done using a validated neuropsychological battery. Data on incident vascular events (heart disease, stroke, transient ischemic attack) and mortality were obtained.
Results: Higher baseline GM-sCoV was associated with decline in the memory domain over three years of follow-up. Furthermore, higher GM-sCoV was associated with a decline in the memory domain only in participants without dementia. Higher baseline GM-sCoV was associated with progression of WMH and incident CMBs. During a mean follow-up of 3 years, 29 (7.8%) participants developed vascular events and 18 (4.8%) died. Participants with higher baseline mean GM-sCoV were at increased risk of vascular events.
Conclusions: Higher baseline GM-sCoV of ASL was associated with a decline in memory and risk of incident cerebrovascular disease and vascular events, suggesting that cerebrovascular insufficiency may contribute to accelerated cognitive decline and worse clinical outcomes in memory clinic participants.
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American Journal of Geriatric Psychiatry 30(2022)12, 1298-1309
Online First (2022) DOI: 10.1016/j.jagp.2022.06.007
Cited 2 times in Scopus
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Publ.-Id: 33847