AbstractBackgroundThis work characterized cerebrovascular health in human subjects spanning the cognitive spectrum with and without presence of Aβ using different neuroimaging techniques (Fig1).MethodsSubjects (n=70) were clinically characterized into four groups: cognitively unimpaired (CU), CU‐Declining (at‐risk of progressing to clinical mild MCI based on traditional neuropsychological data), clinical MCI, and clinical dementia (Fig2). MRI: Vascular imaging: Whole‐brain 4D‐Flow data were acquired to characterize cerebrovascular health. pCASL with three post labeling delays was used to provide transit time corrected CBF maps. Structural imaging: T1‐weighted and T2‐FLAIR images were also collected for quantification of intracranial, hippocampal and white matter hyperintensity volumes. Hemodynamic measurements were extracted from intracranial arteries including the petrous ICAs, BA, MCAs, and veins SSS. Quantified flow parameters included: total cerebral blood flow, trans‐capillary pulse wave delay, and flow pulsatility index (PI). Trans‐capillary pulse wave delay was defined as the time shift between arterial and venous cardiac waveforms. PET: Aβ burden was assessed using 11C‐PiB PET imaging. Amyloid positivity (A‐, A+) was established as mean cortical PiB DVR >1.16. For A+ participants, amyloid time (i.e., estimated duration A+) was estimated using the sampled iterative local approximation algorithm. Differences were assessed using ANOVA followed by post‐hoc analysis (P<0.05 significance).ResultsMicro‐vascular tissue perfusion was statically higher in A+/CU when compared to other A+ groups in the GM, WM, and hippocampus (Fig3 and 4). Trans‐capillary pulse wave delay was statistically longer in A+/CU when compared to A+/CU‐Declining, A+/MCI, and A+/dementia (Fig5A). For A‐ groups trans‐capillary pulse wave delay was similar; yet, flow PI was statistically higher in A‐/CU‐Declining and A‐/MCI when compared to A‐/CU in the ICAs and MCAs (Fig5 C, D). Flow PI in A+/CU was higher than in A‐/CU.ConclusionsDecreased micro‐vascular tissue perfusion and shorter trans‐capillary pulse wave delay in A+ subjects with cognitive alterations (e.g. CU‐Declining, MCI, Dementia) compared to A+/CU indicates decreased metabolism and increased small vessel stiffness may contribute to cognitive decline and/or are induced by amyloidosis. In contrast, for A‐ subjects significant differences in arterial flow pulsatility index between A‐/CU, CU‐Declining, and MCI suggests macro‐vascular arterial stiffness contributes to cognitive decline.
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