Document Detail

Neurovascular decoupling is associated with severity of cerebral amyloid angiopathy.
MedLine Citation:
PMID:  24097810     Owner:  NLM     Status:  MEDLINE    
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.
Stefano Peca; Cheryl R McCreary; Emily Donaldson; Gopukumar Kumarpillai; Nandavar Shobha; Karla Sanchez; Anna Charlton; Craig D Steinback; Andrew E Beaudin; Daniela Flück; Neelan Pillay; Gordon H Fick; Marc J Poulin; Richard Frayne; Bradley G Goodyear; Eric E Smith
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2013-10-04
Journal Detail:
Title:  Neurology     Volume:  81     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2013 Nov 
Date Detail:
Created Date:  2013-11-05     Completed Date:  2013-12-23     Revised Date:  2014-05-07    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1659-65     Citation Subset:  AIM; IM    
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MeSH Terms
Brain / blood supply*,  drug effects,  pathology*
Carbon Dioxide / administration & dosage
Cerebral Amyloid Angiopathy / diagnosis,  physiopathology*
Cerebral Arteries / physiology,  ultrasonography
Cohort Studies
Cross-Sectional Studies
Evoked Potentials, Visual / drug effects,  physiology*
Image Processing, Computer-Assisted
Magnetic Resonance Imaging
Middle Aged
Oxygen / blood
Photic Stimulation
Ultrasonography, Doppler, Transcranial
Grant Support
R01 NS062028/NS/NINDS NIH HHS; //Canadian Institutes of Health Research
Reg. No./Substance:
142M471B3J/Carbon Dioxide; S88TT14065/Oxygen

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