Entorhinal Perfusion Predicts Future Memory Decline, Neurodegeneration, and White Matter Hyperintensity Progression in Older Adults.

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  • Additional Information
    • Corporate Authors:
      Alzheimer’s Disease Neuroimaging Initiative
    • Source:
      Publisher: IOS Press Country of Publication: Netherlands NLM ID: 9814863 Publication Model: Print Cited Medium: Internet ISSN: 1875-8908 (Electronic) Linking ISSN: 13872877 NLM ISO Abbreviation: J Alzheimers Dis Subsets: MEDLINE
    • Publication Information:
      Original Publication: Amsterdam ; Washington : IOS Press, c1998-
    • Subject Terms:
      Entorhinal Cortex/*diagnostic imaging ; Memory Disorders/*diagnostic imaging ; Neurodegenerative Diseases/*diagnostic imaging ; White Matter/*diagnostic imaging; Aged ; Aged, 80 and over ; Cerebrovascular Circulation/physiology ; Disease Progression ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neuroimaging ; Neuropsychological Tests
    • Abstract:
      Background: Altered cerebral blood flow (CBF) has been linked to increased risk for Alzheimer's disease (AD). However, whether altered CBF contributes to AD risk by accelerating cognitive decline remains unclear. It also remains unclear whether reductions in CBF accelerate neurodegeneration and development of small vessel cerebrovascular disease.
      Objective: To examine associations between CBF and trajectories of memory performance, regional brain atrophy, and global white matter hyperintensity (WMH) volume.
      Method: 147 Alzheimer's Disease Neuroimaging Initiative participants free of dementia underwent arterial spin labeling (ASL) magnetic resonance imaging (MRI) to measure CBF and serial neuropsychological and structural MRI examinations. Linear mixed effects models examined 5-year rate of change in memory and 4-year rate of change in regional brain atrophy and global WMH volumes as a function of baseline regional CBF. Entorhinal and hippocampal CBF were examined in separate models.
      Results: Adjusting for demographic characteristics, pulse pressure, apolipoprotein E ɛ4 positivity, cerebrospinal fluid p-tau/Aβ ratio, and neuronal metabolism (i.e., fluorodeoxyglucose standardized uptake value ratio), lower baseline entorhinal CBF predicted faster rates of decline in memory as well as faster entorhinal thinning and WMH progression. Hippocampal CBF did not predict cognitive or brain structure trajectories.
      Conclusion: Findings highlight the importance of early cerebrovascular dysfunction in AD risk and suggest that entorhinal CBF as measured by noninvasive ASL MRI is a useful biomarker predictive of future cognitive decline and of risk of both.
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    • Grant Information:
      IK2 CX001415 United States CX CSRD VA; R01 AG054049 United States AG NIA NIH HHS; I01 CX001842 United States CX CSRD VA; R01 AG049810 United States AG NIA NIH HHS; U01 AG024904 United States AG NIA NIH HHS; R01 AG063782 United States AG NIA NIH HHS; R25 AG043364 United States AG NIA NIH HHS; IK2 CX001865 United States CX CSRD VA
    • Contributed Indexing:
      Keywords: Aging; Alzheimer’s disease; cognition; entorhinal cortex regional blood flow; magnetic resonance imaging; neuropsychology; perfusion; white matter hyperintensities
    • Publication Date:
      Date Created: 20210510 Date Completed: 20210920 Latest Revision: 20220912
    • Publication Date:
      20221213
    • Accession Number:
      PMC9462657
    • Accession Number:
      10.3233/JAD-201474
    • Accession Number:
      33967041