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Zhang Q, Wang Q, He C, Fan D, Zhu Y, Zang F, Tan C, Zhang S, Shu H, Zhang Z, Feng H, Wang Z, Xie C. Altered Regional Cerebral Blood Flow and Brain Function Across the Alzheimer's Disease Spectrum: A Potential Biomarker. Front Aging Neurosci 2021; 13:630382. [PMID: 33692680 PMCID: PMC7937726 DOI: 10.3389/fnagi.2021.630382] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 01/20/2021] [Indexed: 12/14/2022] Open
Abstract
Objective: To investigate variation in the characteristics of regional cerebral blood flow (rCBF), brain activity, and intrinsic functional connectivity (FC) across the Alzheimer's disease spectrum (ADS). Methods: The study recruited 20 individuals in each of the following categories: Alzheimer's disease (AD), mild cognitive impairment (MCI), subjective cognitive decline (SCD), and healthy control (HC). All participants completed the 3.0T resting-state functional MRI (rs-fMRI) and arterial spin labeling scans in addition to neuropsychological tests. Additionally, the normalized CBF, regional homogeneity (ReHo), and amplitude of low-frequency fluctuation (ALFF) of individual subjects were compared in the ADS. Moreover, the changes in intrinsic FC were investigated across the ADS using the abnormal rCBF regions as seeds and behavioral correlations. Finally, a support-vector classifier model of machine learning was used to distinguish individuals with ADS from HC. Results: Compared to the HC subjects, patients with AD showed the poorest level of rCBF in the left precuneus (LPCUN) and right middle frontal gyrus (RMFG) among all participants. In addition, there was a significant decrease in the ALFF in the bilateral posterior cingulate cortex (PCC) and ReHo in the right PCC. Moreover, RMFG- and LPCUN-based FC analysis revealed that the altered FCs were primarily located in the posterior brain regions. Finally, a combination of altered rCBF, ALFF, and ReHo in posterior cingulate cortex/precuneus (PCC/PCUN) showed a better ability to differentiate ADS from HC, AD from SCD and MCI, but not MCI from SCD. Conclusions: The study demonstrated the significance of an altered rCBF and brain activity in the early stages of ADS. These findings, therefore, present a potential diagnostic neuroimaging-based biomarker in ADS. Additionally, the study provides a better understanding of the pathophysiology of AD.
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Affiliation(s)
- Qianqian Zhang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Qing Wang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Cancan He
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Dandan Fan
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yao Zhu
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Feifei Zang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Chang Tan
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Shaoke Zhang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Hao Shu
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zhijun Zhang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.,Neuropsychiatric Institute, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.,The Key Laboratory of Developmental Genes and Human Disease, Southeast University, Nanjing, China
| | - Haixia Feng
- Department of Nursing, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zan Wang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Chunming Xie
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.,Neuropsychiatric Institute, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.,The Key Laboratory of Developmental Genes and Human Disease, Southeast University, Nanjing, China
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Göttler J, Preibisch C, Riederer I, Pasquini L, Alexopoulos P, Bohn KP, Yakushev I, Beller E, Kaczmarz S, Zimmer C, Grimmer T, Drzezga A, Sorg C. Reduced blood oxygenation level dependent connectivity is related to hypoperfusion in Alzheimer's disease. J Cereb Blood Flow Metab 2019; 39:1314-1325. [PMID: 29431005 PMCID: PMC6668525 DOI: 10.1177/0271678x18759182] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Functional connectivity of blood oxygenation level dependent signal fluctuations (BOLD-FC) is decreased in Alzheimer's disease (AD), and suggested to reflect reduced coherence in neural population activity; however, as both neuronal and vascular-hemodynamic processes underlie BOLD signals, impaired perfusion might also contribute to reduced BOLD-FC; 42 AD patients and 27 controls underwent simultaneous PET/MR imaging. Resting-state functional MRI assessed BOLD co-activity to quantify BOLD-FC, pulsed arterial spin labeling (pASL) assessed cerebral blood flow (CBF) as proxy for vascular hemodynamics, and 18F-fluorodeoxyglucose PET assessed glucose metabolism (GluMet) to index neuronal activity. Patients' BOLD-FC, CBF, and GluMet were reduced within the same precuneal parietal regions. BOLD-FC was positively associated with mean CBF, specifically in patients and controlled for GluMet levels, suggesting that BOLD-FC reductions correlate with pASL-derived hypoperfusion in AD, independently from 18F-fluorodeoxyglucose PET-derived hypometabolism. Data indicate that impaired vascular hemodynamic processes contribute to reduced BOLD connectivity in AD.
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Affiliation(s)
- Jens Göttler
- 1 Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.,2 TUM Neuroimaging Center (TUM-NIC), Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Christine Preibisch
- 1 Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.,2 TUM Neuroimaging Center (TUM-NIC), Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.,3 Clinic for Neurology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Isabelle Riederer
- 1 Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.,2 TUM Neuroimaging Center (TUM-NIC), Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Lorenzo Pasquini
- 2 TUM Neuroimaging Center (TUM-NIC), Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.,4 Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, USA
| | - Panagiotis Alexopoulos
- 5 Department of Psychiatry and Psychotherapy, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Karl Peter Bohn
- 6 Department of Nuclear Medicine, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Igor Yakushev
- 2 TUM Neuroimaging Center (TUM-NIC), Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.,6 Department of Nuclear Medicine, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Ebba Beller
- 7 Department of Radiology, Klinikum Großhadern, Ludwig-Maximilans-Universität München, Munich, Germany
| | - Stephan Kaczmarz
- 1 Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.,2 TUM Neuroimaging Center (TUM-NIC), Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Claus Zimmer
- 1 Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Timo Grimmer
- 2 TUM Neuroimaging Center (TUM-NIC), Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.,5 Department of Psychiatry and Psychotherapy, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Alexander Drzezga
- 6 Department of Nuclear Medicine, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.,8 Department of Nuclear Medicine, University of Cologne, Cologne, Germany
| | - Christian Sorg
- 1 Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.,2 TUM Neuroimaging Center (TUM-NIC), Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.,5 Department of Psychiatry and Psychotherapy, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
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Riederer I, Bohn KP, Preibisch C, Wiedemann E, Zimmer C, Alexopoulos P, Förster S. Alzheimer Disease and Mild Cognitive Impairment: Integrated Pulsed Arterial Spin-Labeling MRI and 18F-FDG PET. Radiology 2018; 288:198-206. [DOI: 10.1148/radiol.2018170575] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Isabelle Riederer
- From the Department of Diagnostic and Interventional Neuroradiology (I.R., C.P., C.Z.), Department of Diagnostic and Interventional Radiology (I.R.), Department of Nuclear Medicine (K.P.B., E.W., S.F.), TUM Neuroimaging Center (TUM-NIC) (C.P., S.F.), and Departments of Psychiatry and Psychotherapy (P.A.), Klinikum Rechts der Isar, Technische Universität München, Ismaninger Str 22, 81675 Munich, Germany
| | - Karl Peter Bohn
- From the Department of Diagnostic and Interventional Neuroradiology (I.R., C.P., C.Z.), Department of Diagnostic and Interventional Radiology (I.R.), Department of Nuclear Medicine (K.P.B., E.W., S.F.), TUM Neuroimaging Center (TUM-NIC) (C.P., S.F.), and Departments of Psychiatry and Psychotherapy (P.A.), Klinikum Rechts der Isar, Technische Universität München, Ismaninger Str 22, 81675 Munich, Germany
| | - Christine Preibisch
- From the Department of Diagnostic and Interventional Neuroradiology (I.R., C.P., C.Z.), Department of Diagnostic and Interventional Radiology (I.R.), Department of Nuclear Medicine (K.P.B., E.W., S.F.), TUM Neuroimaging Center (TUM-NIC) (C.P., S.F.), and Departments of Psychiatry and Psychotherapy (P.A.), Klinikum Rechts der Isar, Technische Universität München, Ismaninger Str 22, 81675 Munich, Germany
| | - Eva Wiedemann
- From the Department of Diagnostic and Interventional Neuroradiology (I.R., C.P., C.Z.), Department of Diagnostic and Interventional Radiology (I.R.), Department of Nuclear Medicine (K.P.B., E.W., S.F.), TUM Neuroimaging Center (TUM-NIC) (C.P., S.F.), and Departments of Psychiatry and Psychotherapy (P.A.), Klinikum Rechts der Isar, Technische Universität München, Ismaninger Str 22, 81675 Munich, Germany
| | - Claus Zimmer
- From the Department of Diagnostic and Interventional Neuroradiology (I.R., C.P., C.Z.), Department of Diagnostic and Interventional Radiology (I.R.), Department of Nuclear Medicine (K.P.B., E.W., S.F.), TUM Neuroimaging Center (TUM-NIC) (C.P., S.F.), and Departments of Psychiatry and Psychotherapy (P.A.), Klinikum Rechts der Isar, Technische Universität München, Ismaninger Str 22, 81675 Munich, Germany
| | - Panagiotis Alexopoulos
- From the Department of Diagnostic and Interventional Neuroradiology (I.R., C.P., C.Z.), Department of Diagnostic and Interventional Radiology (I.R.), Department of Nuclear Medicine (K.P.B., E.W., S.F.), TUM Neuroimaging Center (TUM-NIC) (C.P., S.F.), and Departments of Psychiatry and Psychotherapy (P.A.), Klinikum Rechts der Isar, Technische Universität München, Ismaninger Str 22, 81675 Munich, Germany
| | - Stefan Förster
- From the Department of Diagnostic and Interventional Neuroradiology (I.R., C.P., C.Z.), Department of Diagnostic and Interventional Radiology (I.R.), Department of Nuclear Medicine (K.P.B., E.W., S.F.), TUM Neuroimaging Center (TUM-NIC) (C.P., S.F.), and Departments of Psychiatry and Psychotherapy (P.A.), Klinikum Rechts der Isar, Technische Universität München, Ismaninger Str 22, 81675 Munich, Germany
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