Jae-Sung Lim1, Jee Young Lee2, Hyung-Min Kwon2, Yong-Seok Lee3. 1. Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea. 2. Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Hospital, Seoul, Republic of Korea. 3. Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Hospital, Seoul, Republic of Korea. Electronic address: mercades@snu.ac.kr.
Abstract
BACKGROUND: Potential role of vascular dysfunction has been suggested in the pathogenesis of Alzheimer's disease (AD). Previous cross-sectional studies have demonstrated relations between abnormal transcranial Doppler (TCD) parameters and cognitive impairment. We aimed to investigate the associations between longitudinal changes of TCD parameters and cognitive decline in patients with AD. METHODS: We have enrolled patients with mild to moderate AD who aged 60 to 79years. Mean flow velocity and pulsatility index (PI) of anterior (ACA), middle (MCA), and posterior (PCA) cerebral arteries were evaluated. Cognitive functions were assessed using mini-mental state examination (MMSE), clinical dementia rating sum of boxes (SOB), and Alzheimer's Disease Assessment Scale (ADAS-cog), which was further categorized as praxis, language, and memory subscores. TCD and cognitive assessments were followed up 1year later, and the longitudinal changes (Δ) between the baseline and follow-up measurements were evaluated. RESULTS: A total of 51 patients completed the follow-up evaluations (baseline age 71.5years, MMSE 21.2). In the baseline evaluations, high PI values of ACA and MCA were associated with poor MMSE score, ADAS-cog total, memory, and praxis subscores. After 1year, the increases of ACA and MCA PI were correlated with the aggravation of ADAS language subscore, and ΔACA PI was also correlated with ΔSOB. The decrease in mean flow velocity of ACA was associated with aggravation of ADAS-cog praxis score. CONCLUSIONS: There was significant correlation between longitudinal changes of TCD parameters and cognitive dysfunction in patients with mild to moderate AD. Serial assessment of TCD may provide useful information regarding to the disease progression.
BACKGROUND: Potential role of vascular dysfunction has been suggested in the pathogenesis of Alzheimer's disease (AD). Previous cross-sectional studies have demonstrated relations between abnormal transcranial Doppler (TCD) parameters and cognitive impairment. We aimed to investigate the associations between longitudinal changes of TCD parameters and cognitive decline in patients with AD. METHODS: We have enrolled patients with mild to moderate AD who aged 60 to 79years. Mean flow velocity and pulsatility index (PI) of anterior (ACA), middle (MCA), and posterior (PCA) cerebral arteries were evaluated. Cognitive functions were assessed using mini-mental state examination (MMSE), clinical dementia rating sum of boxes (SOB), and Alzheimer's Disease Assessment Scale (ADAS-cog), which was further categorized as praxis, language, and memory subscores. TCD and cognitive assessments were followed up 1year later, and the longitudinal changes (Δ) between the baseline and follow-up measurements were evaluated. RESULTS: A total of 51 patients completed the follow-up evaluations (baseline age 71.5years, MMSE 21.2). In the baseline evaluations, high PI values of ACA and MCA were associated with poor MMSE score, ADAS-cog total, memory, and praxis subscores. After 1year, the increases of ACA and MCA PI were correlated with the aggravation of ADAS language subscore, and ΔACA PI was also correlated with ΔSOB. The decrease in mean flow velocity of ACA was associated with aggravation of ADAS-cog praxis score. CONCLUSIONS: There was significant correlation between longitudinal changes of TCD parameters and cognitive dysfunction in patients with mild to moderate AD. Serial assessment of TCD may provide useful information regarding to the disease progression.
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