Mohammed Alwatban1, Daniel L Murman2, Greg Bashford1. 1. Department of Biological Systems Engineering, University of Nebraska-Lincoln, Lincoln, NE. 2. Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE.
Abstract
BACKGROUND AND PURPOSE: A substantial overlap exists between declines in cerebral vasoreactivity (CVR) and symptomatic Alzheimer's disease (AD). CVR can be quantified using transcranial Doppler (TCD) measurement of cerebral blood flow velocities (CBFV) in the middle cerebral artery (MCA) with CO2 as a vasodilatory stimulus. The breath-hold acceleration index (BHAI) is a new, more reliable measure of CVR developed recently in our laboratory. Our primary goal is to explore the possibility of using TCD for asymptomatic AD screening. METHODS: A pilot study population was divided into three groups: 9 healthy control subjects, 8 subjects identified as preclinical AD, and 10 patients diagnosed with prodromal or mild AD. Control subjects had a Clinical Dementia Rating (CDR) score of 0 without elevated amyloid-β (Aβ) on amyloid positron emission tomography (PET) imaging, preclinical AD subjects had CDR = 0 with elevated Aβ, and prodromal to mild AD subjects had CDR scores ≥.5 and elevated Aβ. CVR was calculated using two indices: the conventional breath-holding index (BHI) and the new BHAI. TCD parameters between the three groups were compared. RESULTS: BHAI was able to distinguish between 9 normal control subjects and 8 preclinical-AD subjects with high statistical significance (P < .001). BHI and pulsatility index were able only to distinguish AD from healthy and preclinical subjects (P < .001). CONCLUSIONS: In this exploratory pilot study, CVR was significantly decreased in preclinical, prodromal, and mild AD subjects as compared to the healthy group. Lower CVR in the preclinical AD group was detected using the new BHAI index but not the conventional BHI index.
BACKGROUND AND PURPOSE: A substantial overlap exists between declines in cerebral vasoreactivity (CVR) and symptomatic Alzheimer's disease (AD). CVR can be quantified using transcranial Doppler (TCD) measurement of cerebral blood flow velocities (CBFV) in the middle cerebral artery (MCA) with CO2 as a vasodilatory stimulus. The breath-hold acceleration index (BHAI) is a new, more reliable measure of CVR developed recently in our laboratory. Our primary goal is to explore the possibility of using TCD for asymptomatic AD screening. METHODS: A pilot study population was divided into three groups: 9 healthy control subjects, 8 subjects identified as preclinical AD, and 10 patients diagnosed with prodromal or mild AD. Control subjects had a Clinical Dementia Rating (CDR) score of 0 without elevated amyloid-β (Aβ) on amyloid positron emission tomography (PET) imaging, preclinical AD subjects had CDR = 0 with elevated Aβ, and prodromal to mild AD subjects had CDR scores ≥.5 and elevated Aβ. CVR was calculated using two indices: the conventional breath-holding index (BHI) and the new BHAI. TCD parameters between the three groups were compared. RESULTS: BHAI was able to distinguish between 9 normal control subjects and 8 preclinical-AD subjects with high statistical significance (P < .001). BHI and pulsatility index were able only to distinguish AD from healthy and preclinical subjects (P < .001). CONCLUSIONS: In this exploratory pilot study, CVR was significantly decreased in preclinical, prodromal, and mild AD subjects as compared to the healthy group. Lower CVR in the preclinical AD group was detected using the new BHAI index but not the conventional BHI index.
Authors: Sana Suri; Daniel Bulte; Scott T Chiesa; Klaus P Ebmeier; Peter Jezzard; Sebastian W Rieger; Jemma E Pitt; Ludovica Griffanti; Thomas W Okell; Martin Craig; Michael A Chappell; Nicholas P Blockley; Mika Kivimäki; Archana Singh-Manoux; Ashraf W Khir; Alun D Hughes; John E Deanfield; Daria E A Jensen; Sebastian F Green; Veronika Sigutova; Michelle G Jansen; Enikő Zsoldos; Clare E Mackay Journal: Front Physiol Date: 2021-03-31 Impact factor: 4.566
Authors: Andrew E Beaudin; Cheryl R McCreary; Erin L Mazerolle; Myrlene Gee; Breni Sharma; Arsenije Subotic; Angela M Zwiers; Emily Cox; Krista Nelles; Anna Charlton; Richard Frayne; Zahinoor Ismail; Christian Beaulieu; Glen C Jickling; Richard M Camicioli; G Bruce Pike; Eric E Smith Journal: Neurology Date: 2022-02-24 Impact factor: 11.800
Authors: Lidia Glodzik; Henry Rusinek; Tracy Butler; Yi Li; Pippa Storey; Elizabeth Sweeney; Ricardo S Osorio; Adrienne Biskaduros; Emily Tanzi; Patrick Harvey; Christopher Woldstad; Thomas Maloney; Mony J de Leon Journal: Front Aging Neurosci Date: 2022-09-07 Impact factor: 5.702