scholarly journals Reduced parenchymal cerebral blood flow is associated with greater progression of brain atrophy: The SMART-MR study

2020 ◽  
pp. 0271678X2094861
Author(s):  
Rashid Ghaznawi ◽  
Maarten HT Zwartbol ◽  
Nicolaas PA Zuithoff ◽  
Jeroen de Bresser ◽  
Jeroen Hendrikse ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Brain Atrophy ◽  
Brain Volume ◽  
Arterial Disease ◽  
Cerebral Hypoperfusion ◽  
Intracranial Volume ◽  
Total Brain Volume ◽  
Brain Parenchymal ◽  
Mr Study

Global cerebral hypoperfusion may be involved in the aetiology of brain atrophy; however, long-term longitudinal studies on this relationship are lacking. We examined whether reduced cerebral blood flow was associated with greater progression of brain atrophy. Data of 1165 patients (61 ± 10 years) from the SMART-MR study, a prospective cohort study of patients with arterial disease, were used of whom 689 participated after 4 years and 297 again after 12 years. Attrition was substantial. Total brain volume and total cerebral blood flow were obtained from magnetic resonance imaging scans and expressed as brain parenchymal fraction (BPF) and parenchymal cerebral blood flow (pCBF). Mean decrease in BPF per year was 0.22% total intracranial volume (95% CI: –0.23 to –0.21). Mean decrease in pCBF per year was 0.24 ml/min per 100 ml brain volume (95% CI: –0.29 to –0.20). Using linear mixed models, lower pCBF at baseline was associated with a greater decrease in BPF over time ( p =  0.01). Lower baseline BPF, however, was not associated with a greater decrease in pCBF ( p =  0.43). These findings indicate that reduced cerebral blood flow is associated with greater progression of brain atrophy and provide further support for a role of cerebral blood flow in the process of neurodegeneration.

scholarly journals Total Cerebral Blood Flow, White Matter Lesions and Brain Atrophy: The SMART-MR Study

2007 ◽  
Vol 28 (3) ◽  
pp. 633-639 ◽  
Author(s):  
Auke PA Appelman ◽  
Yolanda van der Graaf ◽  
Koen L Vincken ◽  
Audrey M Tiehuis ◽  
Theo D Witkamp ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
White Matter ◽  
Magnetic Resonance ◽  
Brain Atrophy ◽  
Brain Volume ◽  
White Matter Lesions ◽  
Arterial Disease ◽  
Subcortical Brain ◽  
Mr Study

We investigated whether total cerebral blood flow (CBF) was associated with brain atrophy, and whether this relation was modified by white matter lesions (WML). Within the Second Manifestations of ARTerial disease-magnetic resonance (SMART-MR) study, a prospective cohort study among patients with arterial disease, cross-sectional analyses were performed in 828 patients (mean age 58±10 years, 81% male) with quantitative flow, atrophy, and WML measurements on magnetic resonance imaging (MRI). Total CBF was measured with MR angiography and was expressed per 100 mL brain volume. Total brain volume and ventricular volume were divided by intracranial volume to obtain brain parenchymal fraction (BPF) and ventricular fraction (VF). Lower BPF indicates more global brain atrophy, whereas higher VF indicates more subcortical brain atrophy. Mean CBF was 52.0±10.2 mL/min per 100 mL, mean BPF was 79.2±2.9%, and mean VF was 2.03±0.96%. Linear regression analyses showed that lower CBF was associated with more subcortical brain atrophy, after adjusting for age, sex, vascular risk factors, intima-media thickness, and lacunar infarcts, but only in patients with moderate to severe WML (upper quartile of WML): Change in VF per s.d. decrease in CBF 0.18%, 95% CI: 0.02 to 0.34%. Our findings suggest that cerebral hypoperfusion in the presence of WML may be associated with subcortical brain atrophy.

scholarly journals The Bidirectional Association between Reduced Cerebral Blood Flow and Brain Atrophy in the General Population

2015 ◽  
Vol 35 (11) ◽  
pp. 1882-1887 ◽  
Author(s):  
Hazel I Zonneveld ◽  
Elizabeth A Loehrer ◽  
Albert Hofman ◽  
Wiro J Niessen ◽  
Aad van der Lugt ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Brain Atrophy ◽  
Brain Volume ◽  
Brain Magnetic Resonance Imaging ◽  
Community Dwelling ◽  
Linear Regression Models ◽  
Total Brain Volume ◽  
Total Brain ◽  
Bidirectional Association

The question remains whether reduced cerebral blood flow (CBF) leads to brain atrophy or vice versa. We studied the longitudinal relation between CBF and brain volume in a community-dwelling population. In the Rotterdam Study, 3011 participants (mean age 59.6 years (s.d. 8.0)) underwent repeat brain magnetic resonance imaging to quantify brain volume and CBF at two time points. Adjusted linear regression models were used to investigate the bidirectional relation between CBF and brain volume. We found that smaller brain volume at baseline was associated with a steeper decrease in CBF in the whole population (standardized change per s.d. increase of total brain volume (TBV) = 0.296 (95% confidence interval (CI) 0.200; 0.393)). Only in persons aged ≥ 65 years, a lower CBF at baseline was associated with steeper decline of TBV (standardized change per s.d. increase of CBF = 0.003 (95% CI −0.004; 0.010) in the whole population and 0.020 (95% CI 0.004; 0.036) in those aged ≥65 years of age). Our results indicate that brain atrophy causes CBF to decrease over time, rather than vice versa. Only in persons aged >65 years of age did we find lower CBF to also relate to brain atrophy.

scholarly journals Total Cerebral Blood Flow in Relation to Cognitive Function: The Rotterdam Scan Study

2008 ◽  
Vol 28 (10) ◽  
pp. 1652-1655 ◽  
Author(s):  
Mariëlle MF Poels ◽  
Mohammad Arfan Ikram ◽  
Meike W Vernooij ◽  
Gabriel P Krestin ◽  
Albert Hofman ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Cognitive Function ◽  
Brain Atrophy ◽  
Brain Volume ◽  
Population Based ◽  
Cerebral Hypoperfusion ◽  
Information Processing Speed ◽  
Future Studies ◽  
Global Cognition

Cerebral hypoperfusion has been associated with worse cognitive function. We investigated the association between cerebral blood flow and cognition and whether this association is independent of brain volume. In 892 participants, aged 60 to 91 years, of the population-based Rotterdam Scan study, we measured total cerebral blood flow (tCBF) and brain volume using magnetic resonance imaging. Lower tCBF was associated with worse information-processing speed, executive function, and global cognition. However, after correcting tCBF for brain volume, these associations disappeared. The association between tCBF and cognition may be mediated or confounded by brain atrophy. Future studies on tCBF should take into account brain atrophy.

scholarly journals Contributions of Cerebral Blood Flow to Associations Between Blood Pressure Levels and Cognition

Hypertension ◽  
2021 ◽  
Author(s):  
Justine E. Moonen ◽  
Behnam Sabayan ◽  
Sigurdur Sigurdsson ◽  
Mark A. van Buchem ◽  
Vilmundur Gudnason ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Working Memory ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Late Life ◽  
Cerebral Hypoperfusion ◽  
Total Brain Volume ◽  
Total Brain

Cerebral hypoperfusion leads to adverse sequalae including dementia. Midlife higher blood pressure (BP) can lead to low cerebral blood flow (CBF), but older persons may need higher BP to maintain cerebral perfusion. We investigated the associations among late-life BP, CBF, and cognition. Data are from 2498 participants with a mean age of 79.8 (SD, 4.7) years of the second exam of the AGES (Age, Gene/Environment Susceptibility)–Reykjavik Study. BP was measured, and phase-contrast (PC) magnetic resonance imaging was acquired to estimate total brain CBF PC . Cognitive outcomes included verbal and working memory, processing speed, mild cognitive impairment, and all-cause dementia. Relationships among late-life BP, CBF PC , and cognition were assessed with regression models, controlling for socio-demographics, BP level at midlife (at a mean age of 49.6 [SD, 5.9] years), cardiovascular factors, and total brain volume. In fully adjusted models, each mm Hg increase in late-life diastolic BP was associated with a −0.082 mL/min per 100 mL (95% CI −0.123 to −0.041) lower CBF PC . In contrast, each mm Hg increase in late-life systolic BP or pulse pressure was associated with a 0.027 mL/min per 100 mL (95% CI, 0.0065–0.048) and 0.061 mL/min per 100 mL (95% CI, 0.038–0.084) higher late-life CBF PC , respectively. Higher CBF PC was significantly related to higher cognitive scores for psychomotor speed, verbal, and working memory and to a lower odd of mild cognitive impairment or dementia, irrespective of late-life BP level. Higher late-life diastolic BP and systolic BP were differentially associated with CBF PC . Our findings suggest CBF is an important correlate of late-life cognition, independent of BP level.

Hemoglobin, hematocrit, and changes in cerebral blood flow: the Second Manifestations of ARTerial disease-Magnetic Resonance study

2015 ◽  
Vol 36 (3) ◽  
pp. 1417-1423 ◽  
Author(s):  
Pieternella H. van der Veen ◽  
Majon Muller ◽  
Koen L. Vincken ◽  
Jan Westerink ◽  
Willem P.T.M. Mali ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Magnetic Resonance ◽  
Arterial Disease ◽  
Magnetic Resonance Study

scholarly journals Dynamic Regional Brain Atrophy Rates in the First Year After Ischemic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (9) ◽  
Author(s):  
Amy Brodtmann ◽  
Mohamed Salah Khlif ◽  
Natalia Egorova ◽  
Michele Veldsman ◽  
Laura J. Bird ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cortical Thickness ◽  
Brain Atrophy ◽  
Brain Volume ◽  
Linear Mixed Effect Model ◽  
First Year ◽  
Intracranial Volume ◽  
Mixed Effect ◽  
Time Points ◽  
Regional Brain

Background and Purpose: Brain atrophy can be regarded as an end-organ effect of cumulative cardiovascular risk factors. Accelerated brain atrophy is described following ischemic stroke, but it is not known whether atrophy rates vary over the poststroke period. Examining rates of brain atrophy allows the identification of potential therapeutic windows for interventions to prevent poststroke brain atrophy. Methods: We charted total and regional brain volume and cortical thickness trajectories, comparing atrophy rates over 2 time periods in the first year after ischemic stroke: within 3 months (early period) and between 3 and 12 months (later period). Patients with first-ever or recurrent ischemic stroke were recruited from 3 Melbourne hospitals at 1 of 2 poststroke time points: within 6 weeks (baseline) or 3 months. Whole-brain 3T magnetic resonance imaging was performed at 3 time points: baseline, 3 months, and 12 months. Eighty-six stroke participants completed testing at baseline; 125 at 3 months (76 baseline follow-up plus 49 delayed recruitment); and 113 participants at 12 months. Their data were compared with 40 healthy control participants with identical testing. We examined 5 brain measures: hippocampal volume, thalamic volume, total brain and hemispheric brain volume, and cortical thickness. We tested whether brain atrophy rates differed between time points and groups. A linear mixed-effect model was used to compare brain structural changes, including age, sex, years of education, a composite cerebrovascular risk factor score, and total intracranial volume as covariates. Results: Atrophy rates were greater in stroke than control participants. Ipsilesional hemispheric, hippocampal, and thalamic atrophy rates were 2 to 4 times greater in the early versus later period. Conclusions: Regional atrophy rates vary over the first year after stroke. Rapid brain volume loss in the first 3 months after stroke may represent a potential window for intervention. Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT02205424.

scholarly journals Total Cerebral Blood Flow and Total Brain Perfusion in the General Population: The Rotterdam Scan Study

2007 ◽  
Vol 28 (2) ◽  
pp. 412-419 ◽  
Author(s):  
Meike W Vernooij ◽  
Aad van der Lugt ◽  
Mohammad Arfan Ikram ◽  
Piotr A Wielopolski ◽  
Henri A Vrooman ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
General Population ◽  
Cerebral Perfusion ◽  
Brain Volume ◽  
Measurement Techniques ◽  
White Matter Lesions ◽  
Brain Perfusion ◽  
Linear Regression Models ◽  
Total Brain

Reduced cerebral perfusion may contribute to the development of cerebrovascular and neurodegenerative diseases. Little is known on cerebral perfusion in the general population, as most measurement techniques are too invasive for application in large groups of healthy individuals. Total cerebral blood flow (tCBF) can be noninvasively measured by magnetic resonance imaging (MRI) but is highly correlated with brain volume. We calculated total brain perfusion by dividing tCBF by brain volume, and we investigated determinants of total brain perfusion in comparison with tCBF. Secondly, we studied whether persons with a low tCBF or low total brain perfusion have a larger volume of white matter lesions (WML). This study is based on 892 persons aged 60 to 91 years from the Rotterdam Study, a population-based cohort study. We performed two-dimensional (2D) phase-contrast MRI for tCBF measurement. Brain volume and WML volume were quantitatively assessed. Cardiovascular determinants were assessed by interview and physical examination. We assessed associations between cardiovascular determinants and flow measures with linear regression models, adjusted for age and sex. Associations between tCBF or total brain perfusion and WML volume were assessed using general linear models. We found that determinants of tCBF and total brain perfusion differed largely due to the large influence of brain volume on tCBF values. Persons with low total brain perfusion had a significantly larger WML volume compared with those with high total brain perfusion. Prospective studies are required to unravel whether hypoperfusion contributes to WML formation or that tissue damage, manifested by WML, leads to brain hypoperfusion.

Case 29: Hypocapnic Cerebral Hypoperfusion

2019 ◽  
pp. 185-188
Author(s):  
Peter Novak
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Flow Velocity ◽  
Autonomic Dysfunction ◽  
Blood Flow Velocity ◽  
Cerebral Blood Flow Velocity ◽  
Cerebral Hypoperfusion ◽  
Tilt Test ◽  
Excessive Sleepiness ◽  
End Tidal

This case presents a patient with extreme fatigue and excessive sleepiness. The tilt test provoked decline in cerebral blood flow velocity (CBFv) associated with decline in end tidal CO2, indicative of hypocapnic cerebral hypoperfusion (HYCH). There was also mild small fiber neuropathy affecting predominantly autonomic fibers associated with mild autonomic dysfunction.

Case 24: Orthostatic Cerebral Hypoperfusion Syndrome with Vision Loss

2019 ◽  
pp. 157-162
Author(s):  
Peter Novak
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Orthostatic Hypotension ◽  
Flow Velocity ◽  
Blood Flow Velocity ◽  
Vision Loss ◽  
Cerebral Blood Flow Velocity ◽  
Cerebral Hypoperfusion ◽  
Tilt Test

The tilt test showed orthostatic cerebral hypoperfusion syndrome (OCHOS) with intermittent reduction in cerebral blood flow velocity and vision loss. OCHOS is associated with reduced orthostatic cerebral blood flow velocity without orthostatic hypotension or arrhythmia.

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