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Cerebrospinal fluid and blood flow in mild cognitive impairment and Alzheimer's disease: a differential diagnosis from idiopathic normal pressure hydrocephalus.

El Sankari S, Gondry-Jouet C, Fichten A, Godefroy O, Serot JM, Deramond H, Meyer ME, Balédent O - Fluids Barriers CNS (2011)

Bottom Line: The patients' results were compared with those obtained for HEVs (n = 12), and for NPH patients (n = 13), using multivariate analysis.Arterial tCBF and the calculated pulsatility index were significantly greater in a-MCI patients than in HEVs.Our preliminary data show that a-MCI patients present with high systolic arterial peak flows, which are associated with higher mean total cerebral arterial flows.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Image Processing, Jules Verne University of Picardy and Amiens University Hospital, CHU d'Amiens, F-80054 Amiens cedex, France. olivier.baledent@chu-amiens.fr.

ABSTRACT

Background: Phase-contrast magnetic resonance imaging (PC-MRI) enables quantification of cerebrospinal fluid (CSF) flow and total cerebral blood (tCBF) flow and may be of value for the etiological diagnosis of neurodegenerative diseases. This investigation aimed to study CSF flow and intracerebral vascular flow in patients with Alzheimer's disease (AD) and patients with amnesic mild cognitive impairment (a-MCI) and to compare the results with patients with idiopathic normal pressure hydrocephalus (NPH) and with healthy elderly volunteers (HEV).

Methods: Ten a-MCI and 9 mild AD patients were identified in a comprehensive neurological and neuropsychological assessment. They underwent brain MRI; PC-MRI pulse sequence was performed with the following parameters: two views per segment; flip angle: 25° for vascular flow and 20° for CSF flow; field-of-view (FOV): 14 × 14 mm²; matrix: 256 × 128; slice thickness: 5 mm; with one excitation for exams on the 3 T machine, and 2 excitations for the 1.5 T machine exams. Velocity (encoding) sensitization was set to 80 cm/s for the vessels at the cervical level, 10 or 20 cm/s for the aqueduct and 5 cm/s for the cervical subarachnoid space (SAS). Dynamic flow images were analyzed with in-house processing software. The patients' results were compared with those obtained for HEVs (n = 12), and for NPH patients (n = 13), using multivariate analysis.

Results: Arterial tCBF and the calculated pulsatility index were significantly greater in a-MCI patients than in HEVs. In contrast, vascular parameters were lower in NPH patients. Cervical CSF flow analysis yielded similar values for all four populations. Aqueductal CSF stroke volumes (in μl per cardiac cycle) were similar in HEVs (34 ± 17) and AD patients (39 ± 18). In contrast, the aqueductal CSF was hyperdynamic in a-MCI patients (73 ± 33) and even more so in NPH patients (167 ± 89).

Conclusion: Our preliminary data show that a-MCI patients present with high systolic arterial peak flows, which are associated with higher mean total cerebral arterial flows. Aqueductal CSF oscillations are within normal range in AD and higher than normal in NPH. This study provides an original dynamic vision of cerebral neurodegenerative diseases, consistent with the vascular theory for AD, and supporting primary flow disturbances different from those observed in NPH.

No MeSH data available.


Related in: MedlinePlus

Arterial flow curves in the three groups of patients and in healthy volunteers. The mean arterial flow curve is plotted for each of the four populations over two successive cardiac cycles. In order to simplify the figure, the standard deviations have been intentionally omitted. The flow scale increases from top to bottom. Note the sharper, higher systolic arterial peak in MCI and (to a lesser extent) in AD patients, when compared with healthy elderly volunteers (HEVs) and NPH patients. There were significant differences between these curves (please refer to the values reported in Tables 1 and 2).
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Figure 3: Arterial flow curves in the three groups of patients and in healthy volunteers. The mean arterial flow curve is plotted for each of the four populations over two successive cardiac cycles. In order to simplify the figure, the standard deviations have been intentionally omitted. The flow scale increases from top to bottom. Note the sharper, higher systolic arterial peak in MCI and (to a lesser extent) in AD patients, when compared with healthy elderly volunteers (HEVs) and NPH patients. There were significant differences between these curves (please refer to the values reported in Tables 1 and 2).

Mentions: The mean arterial (tCBF) flow curves for each of the four populations are shown in Figure 3.


Cerebrospinal fluid and blood flow in mild cognitive impairment and Alzheimer's disease: a differential diagnosis from idiopathic normal pressure hydrocephalus.

El Sankari S, Gondry-Jouet C, Fichten A, Godefroy O, Serot JM, Deramond H, Meyer ME, Balédent O - Fluids Barriers CNS (2011)

Arterial flow curves in the three groups of patients and in healthy volunteers. The mean arterial flow curve is plotted for each of the four populations over two successive cardiac cycles. In order to simplify the figure, the standard deviations have been intentionally omitted. The flow scale increases from top to bottom. Note the sharper, higher systolic arterial peak in MCI and (to a lesser extent) in AD patients, when compared with healthy elderly volunteers (HEVs) and NPH patients. There were significant differences between these curves (please refer to the values reported in Tables 1 and 2).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3045982&req=5

Figure 3: Arterial flow curves in the three groups of patients and in healthy volunteers. The mean arterial flow curve is plotted for each of the four populations over two successive cardiac cycles. In order to simplify the figure, the standard deviations have been intentionally omitted. The flow scale increases from top to bottom. Note the sharper, higher systolic arterial peak in MCI and (to a lesser extent) in AD patients, when compared with healthy elderly volunteers (HEVs) and NPH patients. There were significant differences between these curves (please refer to the values reported in Tables 1 and 2).
Mentions: The mean arterial (tCBF) flow curves for each of the four populations are shown in Figure 3.

Bottom Line: The patients' results were compared with those obtained for HEVs (n = 12), and for NPH patients (n = 13), using multivariate analysis.Arterial tCBF and the calculated pulsatility index were significantly greater in a-MCI patients than in HEVs.Our preliminary data show that a-MCI patients present with high systolic arterial peak flows, which are associated with higher mean total cerebral arterial flows.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Image Processing, Jules Verne University of Picardy and Amiens University Hospital, CHU d'Amiens, F-80054 Amiens cedex, France. olivier.baledent@chu-amiens.fr.

ABSTRACT

Background: Phase-contrast magnetic resonance imaging (PC-MRI) enables quantification of cerebrospinal fluid (CSF) flow and total cerebral blood (tCBF) flow and may be of value for the etiological diagnosis of neurodegenerative diseases. This investigation aimed to study CSF flow and intracerebral vascular flow in patients with Alzheimer's disease (AD) and patients with amnesic mild cognitive impairment (a-MCI) and to compare the results with patients with idiopathic normal pressure hydrocephalus (NPH) and with healthy elderly volunteers (HEV).

Methods: Ten a-MCI and 9 mild AD patients were identified in a comprehensive neurological and neuropsychological assessment. They underwent brain MRI; PC-MRI pulse sequence was performed with the following parameters: two views per segment; flip angle: 25° for vascular flow and 20° for CSF flow; field-of-view (FOV): 14 × 14 mm²; matrix: 256 × 128; slice thickness: 5 mm; with one excitation for exams on the 3 T machine, and 2 excitations for the 1.5 T machine exams. Velocity (encoding) sensitization was set to 80 cm/s for the vessels at the cervical level, 10 or 20 cm/s for the aqueduct and 5 cm/s for the cervical subarachnoid space (SAS). Dynamic flow images were analyzed with in-house processing software. The patients' results were compared with those obtained for HEVs (n = 12), and for NPH patients (n = 13), using multivariate analysis.

Results: Arterial tCBF and the calculated pulsatility index were significantly greater in a-MCI patients than in HEVs. In contrast, vascular parameters were lower in NPH patients. Cervical CSF flow analysis yielded similar values for all four populations. Aqueductal CSF stroke volumes (in μl per cardiac cycle) were similar in HEVs (34 ± 17) and AD patients (39 ± 18). In contrast, the aqueductal CSF was hyperdynamic in a-MCI patients (73 ± 33) and even more so in NPH patients (167 ± 89).

Conclusion: Our preliminary data show that a-MCI patients present with high systolic arterial peak flows, which are associated with higher mean total cerebral arterial flows. Aqueductal CSF oscillations are within normal range in AD and higher than normal in NPH. This study provides an original dynamic vision of cerebral neurodegenerative diseases, consistent with the vascular theory for AD, and supporting primary flow disturbances different from those observed in NPH.

No MeSH data available.


Related in: MedlinePlus