TY - JOUR
T1 - Gray matter hypoperfusion is a late pathological event in the course of Alzheimer’s disease
AU - Ahmadi, Khazar
AU - Pereira, Joana B.
AU - Berron, David
AU - Vogel, Jacob
AU - Ingala, Silvia
AU - Strandberg, Olof T.
AU - Janelidze, Shorena
AU - Barkhof, Frederik
AU - Pfeuffer, Josef
AU - Knutsson, Linda
AU - van Westen, Danielle
AU - Palmqvist, Sebastian
AU - Mutsaerts, Henk J.M.M.
AU - Hansson, Oskar
N1 - Publisher Copyright:
© The Author(s) 2022.
PY - 2023/4
Y1 - 2023/4
N2 - Several studies have shown decreased cerebral blood flow (CBF) in Alzheimer’s disease (AD). However, the role of hypoperfusion in the disease pathogenesis remains unclear. Combining arterial spin labeling MRI, PET, and CSF biomarkers, we investigated the associations between gray matter (GM)-CBF and the key mechanisms in AD including amyloid-β (Aβ) and tau pathology, synaptic and axonal degeneration. Further, we applied a disease progression modeling to characterize the temporal sequence of different AD biomarkers. Lower perfusion was observed in temporo-occipito-parietal cortex in the Aβ-positive cognitively impaired compared to both Aβ-negative and Aβ-positive cognitively unimpaired individuals. In participants along the AD spectrum, GM-CBF was associated with tau, synaptic and axonal dysfunction, but not Aβ in similar cortical regions. Axonal degeneration was further associated with hypoperfusion in cognitively unimpaired individuals. Disease progression modeling revealed that GM-CBF disruption Followed the abnormality of biomarkers of Aβ, tau and brain atrophy. These findings indicate that tau tangles and neurodegeneration are more closely connected with GM-CBF changes than Aβ pathology. Although subjected to the sensitivity of the employed neuroimaging techniques and the modeling approach, these findings suggest that hypoperfusion might not be an early event associated with the build-up of Aβ in preclinical phase of AD.
AB - Several studies have shown decreased cerebral blood flow (CBF) in Alzheimer’s disease (AD). However, the role of hypoperfusion in the disease pathogenesis remains unclear. Combining arterial spin labeling MRI, PET, and CSF biomarkers, we investigated the associations between gray matter (GM)-CBF and the key mechanisms in AD including amyloid-β (Aβ) and tau pathology, synaptic and axonal degeneration. Further, we applied a disease progression modeling to characterize the temporal sequence of different AD biomarkers. Lower perfusion was observed in temporo-occipito-parietal cortex in the Aβ-positive cognitively impaired compared to both Aβ-negative and Aβ-positive cognitively unimpaired individuals. In participants along the AD spectrum, GM-CBF was associated with tau, synaptic and axonal dysfunction, but not Aβ in similar cortical regions. Axonal degeneration was further associated with hypoperfusion in cognitively unimpaired individuals. Disease progression modeling revealed that GM-CBF disruption Followed the abnormality of biomarkers of Aβ, tau and brain atrophy. These findings indicate that tau tangles and neurodegeneration are more closely connected with GM-CBF changes than Aβ pathology. Although subjected to the sensitivity of the employed neuroimaging techniques and the modeling approach, these findings suggest that hypoperfusion might not be an early event associated with the build-up of Aβ in preclinical phase of AD.
KW - Alzheimer’s disease
KW - arterial spin labeling
KW - cerebral blood flow
KW - neurodegeneration
KW - tau
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U2 - 10.1177/0271678X221141139
DO - 10.1177/0271678X221141139
M3 - Article
C2 - 36412244
AN - SCOPUS:85142634560
SN - 0271-678X
VL - 43
SP - 565
EP - 580
JO - Journal of Cerebral Blood Flow and Metabolism
JF - Journal of Cerebral Blood Flow and Metabolism
IS - 4
ER -