Abstract P61: Pulsatility Index Outperforms Conventional Imaging Markers in the Association With Cognition in Community Subjects

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Maggie L Lam ◽  
Vincent C Mok ◽  
Bonnie Y Lam
Keyword(s):  
Alzheimer’S Disease ◽  
Blood Pressure ◽  
Cognitive Decline ◽  
Pulsatility Index ◽  
Cerebral Microbleeds ◽  
Small Vessel ◽  
Conventional Imaging ◽  
Conventional Mri ◽  
Imaging Markers ◽  
Vessel Resistance

Increase in pulsatility index (PI), measured by the transcranial Doppler (TCD), correlates with cognitive impairment and is associated with progression of non-demented patients into Alzheimer’s disease (AD) with dementia, suggesting that increase in small vessel resistance is a critical marker of cognitive decline. No study compared PI and MRI markers for small vessel disease or AD that have been shown to be associated with worse cognitive functions. The objectives of this study include: (i) compare PI against conventional MRI markers in its association with cognition, and (ii) investigate the association of PI and cognition in the presence of vascular risk factors. We measured clinical data and PI in the middle cerebral artery in 331 stroke- and dementia-free community subjects. General cognition was assessed using Hong Kong-Montreal Cognitive Assessment. Conventional imaging markers (including lacunes, white matter hyperintensities (WMH), brain parenchymal fraction (BPF), cerebral microbleeds, Alzheimer’s Disease Resemblance Atrophy Index (ADRAI)) were assessed by MRI. Linear regression models were used to compare the sensitivity of PI against conventional MRI markers (including WMH, BPF, ADRAI, lacune and cerebral microbleeds count), with age and years of education entered as covariates. PI was negatively associated with cognition (standardised b=-0.122, p=0.01). PI outperformed (standardised b=-0.118, p=0.012) other imaging markers and contributes to 1.1% change in the variance. PI was associated with higher systolic blood pressure (standardised b=0.122, p=0.028), and level of triglyceride (standardised b = 0.126, p = 0.021). To conclude, PI is associated with cognition, higher levels of blood pressure and triglycerides, suggesting a vascular component in cognitive decline. PI outperforms conventional MRI markers in the association with cognition in community subjects without dementia. As TCD is non-invasive, portable with a lower cost than MRI, PI may serve as a simple marker in monitoring cerebral small vessel resistance and cognition in older people.

Blood pressure variability predicts cognitive decline in Alzheimer's disease patients

2014 ◽  
Vol 35 (10) ◽  
pp. 2282-2287 ◽  
Author(s):  
Simona Lattanzi ◽  
Simona Luzzi ◽  
Leandro Provinciali ◽  
Mauro Silvestrini
Keyword(s):  
Alzheimer’S Disease ◽  
Blood Pressure ◽  
Alzheimer's Disease ◽  
Cognitive Decline ◽  
Blood Pressure Variability

P4-054: Evaluation of neurodegeneration and cognitive decline in Alzheimer's disease by using combined techniques of non conventional MRI

2011 ◽  
Vol 7 ◽  
pp. S717-S717
Author(s):  
Elisabetta Giugni ◽  
Francesca Pezzella ◽  
Giuseppe Bomboi ◽  
Stefano Galletti ◽  
Orietta Picconi ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Decline ◽  
Conventional Mri

scholarly journals Changes in NfL Plasma Levels and Association with Cognitive and Imaging Markers of Alzheimer’s Disease

2021 ◽  
Author(s):  
Sumali Bajaj ◽  
Christoforos Hadjichrysanthou ◽  
Kevin McRae-McKee ◽  
Frank De Wolf ◽  
Roy M. Anderson
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Decline ◽  
Temporal Dynamics ◽  
Rate Of Change ◽  
Clinical Progression ◽  
Neurofilament Light Chain ◽  
Neurofilament Light ◽  
Brain Volumes ◽  
Imaging Markers

Abstract INTRODUCTION: We assessed the association of plasma neurofilament light chain (pNfL) with cognitive decline and neuroimaging markers, and investigated its potential relationship with the clinical progression to dementia due to Alzheimer’s disease (AD).METHODS: Individuals had evidence of amyloid beta accumulation. Linear and beta-regression models were developed to consider: i) the association between pNfL and cognition, ii) the association between the rate of change (ROC) of pNfL and that of imaging markers, iii) the temporal dynamics of pNfL before and after cognitive impairment as assessed by the Clinical Dementia Rating.RESULTS: Higher levels of pNfL were associated with declining cognition. The ROC of pNfL was associated with the ROC of ventricular, hippocampal and whole brain volumes, but not with PET amyloid. pNfL levels did not reflect the clinical progression of AD.DISCUSSION: pNfL is associated with cognitive decline and brain imaging markers. However, it is not specific to AD clinical diagnosis.

scholarly journals Longitudinal decline in structural networks predicts dementia in cerebral small vessel disease

Neurology ◽  
2018 ◽  
Vol 90 (21) ◽  
pp. e1898-e1910 ◽  
Author(s):  
Andrew J. Lawrence ◽  
Eva A. Zeestraten ◽  
Philip Benjamin ◽  
Christian P. Lambert ◽  
Robin G. Morris ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Vessel Disease ◽  
Conventional Mri ◽  
Global Efficiency ◽  
Structural Network ◽  
Structural Networks ◽  
Network Disruption

ObjectiveTo determine whether longitudinal change in white matter structural network integrity predicts dementia and future cognitive decline in cerebral small vessel disease (SVD). To investigate whether network disruption has a causal role in cognitive decline and mediates the association between conventional MRI markers of SVD with both cognitive decline and dementia.MethodsIn the prospective longitudinal SCANS (St George's Cognition and Neuroimaging in Stroke) Study, 97 dementia-free individuals with symptomatic lacunar stroke were followed with annual MRI for 3 years and annual cognitive assessment for 5 years. Conversion to dementia was recorded. Structural networks were constructed from diffusion tractography using a longitudinal registration pipeline, and network global efficiency was calculated. Linear mixed-effects regression was used to assess change over time.ResultsSeventeen individuals (17.5%) converted to dementia, and significant decline in global cognition occurred (p = 0.0016). Structural network measures declined over the 3-year MRI follow-up, but the degree of change varied markedly between individuals. The degree of reductions in network global efficiency was associated with conversion to dementia (B = −2.35, odds ratio = 0.095, p = 0.00056). Change in network global efficiency mediated much of the association of conventional MRI markers of SVD with cognitive decline and progression to dementia.ConclusionsNetwork disruption has a central role in the pathogenesis of cognitive decline and dementia in SVD. It may be a useful disease marker to identify that subgroup of patients with SVD who progress to dementia.

scholarly journals Orthostatic Blood Pressure Recovery Is Associated With the Rate of Cognitive Decline and Mortality in Clinical Alzheimer’s Disease

2020 ◽  
Vol 75 (11) ◽  
pp. 2169-2176
Author(s):  
Rianne A A de Heus ◽  
Daan L K de Jong ◽  
Anne Rijpma ◽  
Brian A Lawlor ◽  
Marcel G M Olde Rikkert ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Blood Pressure ◽  
Alzheimer's Disease ◽  
Confidence Interval ◽  
Cognitive Decline ◽  
Controlled Trial ◽  
Intervention Group ◽  
Disease Assessment ◽  
Progression Rate ◽  
Initial Drop

Abstract Background Impaired recovery of blood pressure (BP) after standing has been shown to be related to cognitive function and mortality in people without dementia, but its role in people with Alzheimer’s disease (AD) is unknown. The aim of this study was to investigate the association of the orthostatic BP response with cognitive decline and mortality in AD. Methods In this post hoc analysis of a randomized controlled trial (Nilvad), we measured the beat-to-beat response of BP upon active standing in mild-to-moderate AD. This included the initial drop (nadir within 40 seconds) and recovery after 1 minute, both expressed relative to resting values. We examined the relationship between a small or large initial drop (median split) and unimpaired (≥100%) or impaired recovery (<100%) with 1.5-year change in Alzheimer’s Disease Assessment—cognitive subscale (ADAS-cog) scores and all-cause mortality. Results We included 55 participants (age 73.1 ± 6.2 years). Impaired BP recovery was associated with higher increases in ADAS-cog scores (systolic: β [95% confidence interval] = 5.6 [0.4–10.8], p = .035; diastolic: 7.6 [2.3–13.0], p = .006). During a median follow-up time of 49 months, 20 participants died. Impaired BP recovery was associated with increased mortality (systolic: HR [95% confidence interval] = 2.9 [1.1–7.8], p = .039; diastolic: HR [95% confidence interval] = 5.5 [1.9–16.1], p = .002). The initial BP drop was not associated with any outcome. Results were adjusted for age, sex, and intervention group. Conclusions Failure to fully recover BP after 1 minute of standing is associated with cognitive decline and mortality in AD. As such, BP recovery can be regarded as an easily obtained marker of progression rate of AD.

scholarly journals Structural network changes in cerebral small vessel disease

2019 ◽  
Vol 91 (2) ◽  
pp. 196-203 ◽  
Author(s):  
Anil M Tuladhar ◽  
Jonathan Tay ◽  
Esther van Leijsen ◽  
Andrew J Lawrence ◽  
Ingeborg Wilhelmina Maria van Uden ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Psychomotor Speed ◽  
Network Efficiency ◽  
Vessel Disease ◽  
Global Efficiency ◽  
Structural Network ◽  
Imaging Markers

ObjectivesTo investigate whether longitudinal structural network efficiency is associated with cognitive decline and whether baseline network efficiency predicts mortality in cerebral small vessel disease (SVD).MethodsA prospective, single-centre cohort consisting of 277 non-demented individuals with SVD was conducted. In 2011 and 2015, all participants were scanned with MRI and underwent neuropsychological assessment. We computed network properties using graph theory from probabilistic tractography and calculated changes in psychomotor speed and overall cognitive index. Multiple linear regressions were performed, while adjusting for potential confounders. We divided the group into mild-to-moderate white matter hyperintensities (WMH) and severe WMH group based on median split on WMH volume.ResultsThe decline in global efficiency was significantly associated with a decline in psychomotor speed in the group with severe WMH (β=0.18, p=0.03) and a trend with change in cognitive index (β=0.14, p=0.068), which diminished after adjusting for imaging markers for SVD. Baseline global efficiency was associated with all-cause mortality (HR per decrease of 1 SD 0.43, 95% CI 0.23 to 0.80, p=0.008, C-statistic 0.76).ConclusionDisruption of the network efficiency, a metric assessing the efficiency of network information transfer, plays an important role in explaining cognitive decline in SVD, which was however not independent of imaging markers of SVD. Furthermore, baseline network efficiency predicts risk of mortality in SVD that may reflect the global health status of the brain in SVD. This emphasises the importance of structural network analysis in the context of SVD research and the use of network measures as surrogate markers in research setting.

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