Abstract
There is emerging evidence suggesting that Alzheimer's disease is a vascular disorder, caused by impaired cerebral perfusion, which may be promoted by cardiovascular risk factors that are strongly influenced by lifestyle. In order to develop an understanding of the exact nature of such a hypothesis, a biomechanical understanding of the influence of lifestyle factors is pursued. An extended poroelastic model of perfused parenchymal tissue coupled with separate workflows concerning subject-specific meshes, permeability tensor maps and cerebral blood flow variability is used. The subject-specific datasets used in the modelling of this paper were collected as part of prospective data collection. Two cases were simulated involving male, non-smokers (control and mild cognitive impairment (MCI) case) during two states of activity (high and low). Results showed a marginally reduced clearance of cerebrospinal fluid (CSF)/interstitial fluid (ISF), elevated parenchymal tissue displacement and CSF/ISF accumulation and drainage in the MCI case. The peak perfusion remained at 8 mm s−1 between the two cases.
Highlights
Alzheimer’s diseaseAlzheimer’s disease (AD) may present itself as mild cognitive impairment (MCI), an intermediate state between normal ageing and dementia [5,6]
For the MCI case, the flow rate is higher in the right internal carotid artery (ICA) during high and low activity
The lower flow rate in the ICA and vertebral artery (VA) associated with the MCI case may hint to a subtle underlying hypoperfusion that could develop further in this patient
Summary
Alzheimer’s disease (AD) is the most common form of dementia, a clinical syndrome of progressive deterioration of cognitive abilities and ordinary daily functioning [1]. It is characterized by the excessive accumulation of neurotoxic amyloid-b (Ab) into parenchymal senile plaques or within the walls of arteries and capillaries in addition to the aggregation of hyperphosphorylated t into intracellular neurofibrillary tangles and neuropil threads [2,3]. AD may present itself as mild cognitive impairment (MCI), an intermediate state between normal ageing and dementia [5,6]. It is estimated that 46% of people with MCI develop dementia within 3 years, compared with 3% of the age-matched population [8]
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