Abstract
Many studies have applied arterial spin labeling (ASL) to characterize cerebral perfusion patterns of Alzheimer's disease (AD). However, findings across studies are not conclusive. A quantitatively voxel-wise meta-analysis to pool the resting-state ASL studies that measure regional cerebral blood flow (rCBF) alterations in AD was conducted to identify the most consistent and replicable perfusion pattern using seed-based d mapping. The meta-analysis, including 17 ASL studies encompassing 327 AD patients and 357 healthy controls, demonstrated that decreased rCBF in AD patients relative to healthy controls were consistently identified in the bilateral posterior cingulate cortices (PCC)/precuneus, bilateral inferior parietal lobules (IPLs), and left dorsolateral prefrontal cortex. The meta-regression analysis showed that more severe cognitive impairment in the AD samples correlated with greater decreases of rCBF in the bilateral PCC and left IPL. This study characterizes an aberrant ASL-rCBF perfusion pattern of AD involving the posterior default mode network and executive network, which are implicated in its pathophysiology and hold promise for developing imaging biomarkers.
Highlights
Alzheimer’s disease (AD), the most prevalent type of dementia in the aging population [1,2,3], is featured by memory disturbance, attentional and executive deficits, and visuospatial and perceptual impairments [4]
The meta-analysis, including 17 arterial spin labeling (ASL) studies encompassing 327 AD patients and 357 healthy controls, demonstrated that decreased regional cerebral blood flow (rCBF) in AD patients relative to healthy controls were consistently identified in the bilateral posterior cingulate cortices (PCC)/precuneus, bilateral inferior parietal lobules (IPLs), and left dorsolateral prefrontal cortex
Besides the areas of rCBF changes observed in the default mode network (DMN) in AD patients compared with healthy controls, we identified the regions of decreased rCBF belonging to the central executive network (CEN), such as the dorsolateral prefrontal cortex (DLPFC) and posterior parietal areas [77, 78]
Summary
Alzheimer’s disease (AD), the most prevalent type of dementia in the aging population [1,2,3], is featured by memory disturbance, attentional and executive deficits, and visuospatial and perceptual impairments [4]. The underlying neurobiology is far from being complete and no effective medications are available today for AD to slow or halt the damage and destruction of neurons [2]. This disorder has caused a substantial burden on the patients and their caregivers and on the socioeconomic system [6]. Regional CBF is recognized as a reflection of intrinsic neural activity and brain physiology, which has been validated in normal aging and neuropsychiatric disorders [13,14,15]. Owing to its ease of acquisition, non-invasiveness, non-radiation, and reliability, ASL is increasingly proposed as an alternative to PET and holds promise for developing imaging biomarkers [13, 15, 22]
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