Altered BOLD signal variation in Alzheimer’s disease and frontotemporal dementia

Recently discovered glymphatic brain clearance mechanisms utilizing physiological pulsations have been shown to fail at removing waste materials such as amyloid and tau plaques in neurodegenerative diseases. Since cardiovascular pulsations are a main driving force of the clearance, this research investigates if commonly available blood oxygen level-dependent (BOLD) signals at 1.5 and 3 T could detect abnormal physiological pulsations in neurodegenerative diseases. Coefficient of variation in BOLD signal (CVBOLD) was used to estimate contribution of physiological signals in Alzheimer’s disease (AD) and behavioural variant frontotemporal dementia (bvFTD). 17 AD patients and 18 bvFTD patients were compared to 24 control subjects imaged with a 1.5 T setup from a local institute. AD results were further verified with 3 T data from the Alzheimer’s disease neuroimaging initiative (ADNI) repository with 30 AD patients and 40 matched controls. Effect of motion and gray matter atrophy was evaluated and receiver operating characteristic (ROC) analyses was performed.The CVBOLD was higher in both AD and bvFTD groups compared to controls (p < 0.0005). The difference was not explained by head motion or gray matter atrophy. In AD patients, the CVBOLD alterations were localized in overlapping structures in both 1.5 T and 3 T data. Localization of the CVBOLD alterations was different in AD than in bvFTD. Areas where CVBOLD is higher in patient groups than in control group involved periventricular white matter, basal ganglia and multiple cortical structures. Notably, a robust difference between AD and bvFTD groups was found in the CVBOLD of frontal poles. In the analysis of diagnostic accuracy, the CVBOLD metrics area under the ROC for detecting disease ranged 0.85 – 0.96.ConclusionsThe analysis of brain physiological pulsations measured using CVBOLD reveals disease-specific alterations in both AD and bvFTD.