Decreased Vasomotor Reactivity in Alzheimer’s Disease
1
조회
0
다운로드
2
인용
0
참고문헌
초록
Abstract
Background: Reduced cerebral blood flow and microvascular abnormalities have been suggested as the vascular pathogenesis of Alzheimer’s disease (AD). Transcranial Doppler sonography (TCD) can be used as a noninvasive method for measuring cerebral vasomotor reactivity (VMR) which represent the capability of arterioles to dilate and constrict in order to maintain cerebral blood flow. Objective: The objective of this study was to determine whether VMR is decreased in AD patients. Methods: Seventeen consecutive patients who met NINDS-ADRDA criteria for AD, and 17 age- and sex- matched controls were included in this study. MRI and MRA were performed for the grading of white-matter lesions. Patients with cerebral infarct or stenosis of the middle cerebral artery (MCA) were excluded. The fixed TCD probe was used to monitor the mean flow velocity (MFV) in the MCA. A 6-L rebreathing bag was applied to patients for at least 5 minutes to elevate the CO2 concentration, which was continuously monitored with a capnometer. VMR was calculated as the percentage change in the MFV. Results: Baseline characteristics - including cerebrovascular risk factors, grades of white-matter lesions, baseline MFV, and pulsatility index - did not differ between the two groups. Mini-Mental State Examination score was significantly low in AD group (20.5 vs. 27.5, p<0.05). VMR was significantly reduced in AD group both in the right- side (24.5% vs. 36.6%, p<0.05) and left-side (20.7% vs. 34.1%, p<0.05) MCAs. Conclusions: Our finding that VMR is reduced in AD may be suggestive of underlying microangiopathic mechanism in AD patients. Future studies should check the validity of these experimental and hypothesis-generating pilot results.
참고문헌 (21)
- Breteler MMB, "Vascular risk factors for Alzheimer’s disease: an epidemiologic perspective", 21, pp.153~160 (2000)
- Launer LJ, "Demonstrating the case that AD is a vascular disease: epidemiologic evidence", 1, pp.61~77 (2002)
- Ruitenberg A, "Cerebral hypoperfusion and clinical onset of dementia: the Rotterdam Study", 57, pp.789~794 (2005)
- Silvestrini M, "Cerebrovascular reactivity and cognitive decline in patients with Alzheimer disease", 37, pp.1010~1015 (2006)
- Hetzel A, "CO2 reactivity testing without blood pressure monitoring?", 30, pp.398~401 (1999)
- Katzman R, "Stadlan EM. Clinical diagnosis of Alzheimer’s disease report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 1984", pp.939~944
- Sander K, "Improved cerebral vasoreactivity after statin administration in healthy adults", 15, pp.266~270 (2005)
- Walters M, "Lees K. Effect of perindopril on cerebral vasomotor reactivity in patients with lacunar infarction. Stroke 2004" (1899)
- de Leeuw FE, "Prevalence of cerebral white matter lesions in elderly people: a population based magnetic resonance imaging study", 70, pp.9~14 (2001)
- Heo JH, "Measurement of cerebral vasomotor reactivity with semi-closed rebreathing method: validation study and normal reference values", 238(supp 1), pp.A414~ (2005)
- Ries F, "Solymosi L. Differentiation of multi-infarct and Alzheimer dementia by intracranial hemodynamic parameters. Stroke 1993", pp.228~235
- Reed BR, "Ober BA. Memory and regional cerebral blood flow in mildly symptomatic Alzheimer’s disease. Neurology 1989", pp.1537~1539
- Terborg C, "Reduced vasomotor reactivity in cerebral microangiopathy: a study with near-infrared spectroscopy and transcranial Doppler sonography", 31, pp.924~929 (2000)
- Kidwell CS, "Transcranial Doppler pulsatility indices as a measure of diffuse small-vessel disease", 11, pp.229~235 (2001)
- de la Torre JC, "Is Alzheimer’s disease a neurodegenerative or a vascular disorder? Data, dogma, and dialectics", 3, pp.184~190 (2004)
- Rodriguez G, "Hippocampal perfusion in mild Alzheimer’s disease", 100, pp.65~74 (2000)
- J Nucl Med, "Is Alzheimer’s disease preceded by neurodegeneration or cerebral hypoperfusion?", 57, pp.783~784 (2005)
- Kogure D, "Longitudinal evaluation of early Alzheimer’s disease using brain perfusion SPECT", 41, pp.1155~1162 (2000)
- Johnson KA, "Perfusion abnormalities in prodromal AD", 21, pp.289~292 (2000)
- Guo Z, "Blood pressure and dementia in persons 75+ years old: 3-year follow-up results from the Kungsholmen Project", 3, pp.585~591 (2001)
- Hofman A, "Atherosclerosis, apolipoprotein E, and prevalence of dementia and Alzheimer’s disease in the Rotterdam Study", 349, pp.151~154 (1997)