Neurovascular decoupling is associated with severity of cerebral amyloid angiopathy.

Abstract:

OBJECTIVES:We used functional MRI (fMRI), transcranial Doppler ultrasound, and visual evoked potentials (VEPs) to determine the nature of blood flow responses to functional brain activity and carbon dioxide (CO2) inhalation in patients with cerebral amyloid angiopathy (CAA), and their association with markers of CAA severity. METHODS:In a cross-sectional prospective cohort study, fMRI, transcranial Doppler ultrasound CO2 reactivity, and VEP data were compared between 18 patients with probable CAA (by Boston criteria) and 18 healthy controls, matched by sex and age. Functional MRI consisted of a visual task (viewing an alternating checkerboard pattern) and a motor task (tapping the fingers of the dominant hand). RESULTS:Patients with CAA had lower amplitude of the fMRI response in visual cortex compared with controls (p = 0.01), but not in motor cortex (p = 0.22). In patients with CAA, lower visual cortex fMRI amplitude correlated with higher white matter lesion volume (r = -0.66, p = 0.003) and more microbleeds (r = -0.78, p < 0.001). VEP P100 amplitudes, however, did not differ between CAA and controls (p = 0.45). There were trends toward reduced CO2 reactivity in the middle cerebral artery (p = 0.10) and posterior cerebral artery (p = 0.08). CONCLUSIONS:Impaired blood flow responses in CAA are more evident using a task to activate the occipital lobe than the frontal lobe, consistent with the gradient of increasing vascular amyloid severity from frontal to occipital lobe seen in pathologic studies. Reduced fMRI responses in CAA are caused, at least partly, by impaired vascular reactivity, and are strongly correlated with other neuroimaging markers of CAA severity.

journal_name

Neurology

journal_title

Neurology

authors

Peca S,McCreary CR,Donaldson E,Kumarpillai G,Shobha N,Sanchez K,Charlton A,Steinback CD,Beaudin AE,Flück D,Pillay N,Fick GH,Poulin MJ,Frayne R,Goodyear BG,Smith EE

doi

10.1212/01.wnl.0000435291.49598.54

subject

Has Abstract

pub_date

2013-11-05 00:00:00

pages

1659-65

issue

19

eissn

0028-3878

issn

1526-632X

pii

01.wnl.0000435291.49598.54

journal_volume

81

pub_type

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