Document Detail


Autoregulation of cerebral blood flow to changes in arterial pressure in mild Alzheimer's disease.
MedLine Citation:
PMID:  20736966     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Studies in transgenic mice overexpressing amyloid precursor protein (APP) demonstrate impaired autoregulation of cerebral blood flow (CBF) to changes in arterial pressure and suggest that cerebrovascular dysfunction may be critically important in the development of pathological Alzheimer's disease (AD). Given the relevance of such a finding for guiding hypertension treatment in the elderly, we assessed autoregulation in individuals with AD. Twenty persons aged 75±6 years with very mild or mild symptomatic AD (Clinical Dementia Rating 0.5 or 1.0) underwent (15)O-positron emission tomography (PET) CBF measurements before and after mean arterial pressure (MAP) was lowered from 107±13 to 92±9 mm Hg with intravenous nicardipine; (11)C-PIB-PET imaging and magnetic resonance imaging (MRI) were also obtained. There were no significant differences in mean CBF before and after MAP reduction in the bilateral hemispheres (-0.9±5.2 mL per 100 g per minute, P=0.4, 95% confidence interval (CI)=-3.4 to 1.5), cortical borderzones (-1.9±5.0 mL per 100 g per minute, P=0.10, 95% CI=-4.3 to 0.4), regions of T2W-MRI-defined leukoaraiosis (-0.3±4.4 mL per 100 g per minute, P=0.85, 95% CI=-3.3 to 3.9), or regions of peak (11)C-PIB uptake (-2.5±7.7 mL per 100 g per minute, P=0.30, 95% CI=-7.7 to 2.7). The absence of significant change in CBF with a 10 to 15 mm Hg reduction in MAP within the normal autoregulatory range demonstrates that there is neither a generalized nor local defect of autoregulation in AD.
Authors:
Allyson R Zazulia; Tom O Videen; John C Morris; William J Powers
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-08-25
Journal Detail:
Title:  Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism     Volume:  30     ISSN:  1559-7016     ISO Abbreviation:  J. Cereb. Blood Flow Metab.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-02     Completed Date:  2010-11-29     Revised Date:  2011-09-26    
Medline Journal Info:
Nlm Unique ID:  8112566     Medline TA:  J Cereb Blood Flow Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1883-9     Citation Subset:  IM    
Affiliation:
Department of Neurology, Washington University, St Louis, Missouri 63110, USA. zazuliaa@neuro.wustl.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Alzheimer Disease / diagnosis,  physiopathology*
Blood Pressure*
Cerebrovascular Circulation*
Female
Homeostasis*
Humans
Leukoaraiosis / diagnosis
Magnetic Resonance Imaging
Male
Positron-Emission Tomography
Severity of Illness Index
Grant Support
ID/Acronym/Agency:
K23 NS044885-05/NS/NINDS NIH HHS; NS006833/NS/NINDS NIH HHS; NS044885/NS/NINDS NIH HHS; P01 AG003991/AG/NIA NIH HHS; P01 AG003991-28/AG/NIA NIH HHS; P50 AG005681/AG/NIA NIH HHS; P50 AG005681-25/AG/NIA NIH HHS; P50 NS006833-43/NS/NINDS NIH HHS
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