Decreased Vascular Pulsatility in Alzheimer’s Disease Dementia Measured by Transcranial Color-Coded Duplex Sonography

Decreased Vascular Pulsatility in Alzheimer’s Disease Dementia Measured by Transcranial Color-Coded Duplex Sonography

Marion Ortner,1 Christine Hauser,2 Christoph Schmaderer,2 Claudia Muggenthaler,1 Alexander Hapfelmeier,3 Christian Sorg,1,4 Janine Diehl-Schmid,1 Alexander Kurz,1 Hans Förstl,1 Benno Ikenberg,5 Konstantin Kotliar,6 Holger Poppert,5,7,* Timo Grimmer1,* 1Technical University of Munich, School...

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Autores principales: Ortner M, Hauser C, Schmaderer C, Muggenthaler C, Hapfelmeier A, Sorg C, Diehl-Schmid J, Kurz A, Förstl H, Ikenberg B, Kotliar K, Poppert H, Grimmer T
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2019
Materias:
pulsatility index (pi)
resistance index (ri)
biomarker
mild cognitive impairment (mci)
alzheimer’s dementia
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
Acceso en línea:https://doaj.org/article/49f043aa2d6c42e6882554ba4c0608fd
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id oai:doaj.org-article:49f043aa2d6c42e6882554ba4c0608fd
record_format dspace
institution DOAJ
collection DOAJ
language EN
topic pulsatility index (pi)
resistance index (ri)
biomarker
mild cognitive impairment (mci)
alzheimer’s dementia
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
spellingShingle pulsatility index (pi)
resistance index (ri)
biomarker
mild cognitive impairment (mci)
alzheimer’s dementia
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
Ortner M
Hauser C
Schmaderer C
Muggenthaler C
Hapfelmeier A
Sorg C
Diehl-Schmid J
Kurz A
Förstl H
Ikenberg B
Kotliar K
Poppert H
Grimmer T
Decreased Vascular Pulsatility in Alzheimer’s Disease Dementia Measured by Transcranial Color-Coded Duplex Sonography
description Marion Ortner,1 Christine Hauser,2 Christoph Schmaderer,2 Claudia Muggenthaler,1 Alexander Hapfelmeier,3 Christian Sorg,1,4 Janine Diehl-Schmid,1 Alexander Kurz,1 Hans Förstl,1 Benno Ikenberg,5 Konstantin Kotliar,6 Holger Poppert,5,7,* Timo Grimmer1,* 1Technical University of Munich, School of Medicine, Klinikum Rechts der Isar, Department of Psychiatry and Psychotherapy, Munich, Germany; 2Technical University of Munich, School of Medicine, Klinikum Rechts der Isar, Department of Nephrology, Munich, Germany; 3Technical University of Munich, School of Medicine, Klinikum Rechts der Isar, Institute for Medical Statistics and Epidemiology, Munich, Germany; 4Technical University of Munich, School of Medicine, Klinikum Rechts der Isar, Department of Diagnostic and Interventional Neuroradiology, Munich, Germany; 5Technical University of Munich, School of Medicine, Klinikum Rechts der Isar, Department of Neurology, Munich, Germany; 6Department of Medical Engineering and Technomathematics, FH Aachen, Jülich, Germany; 7Department of Neurology, Helios Dr. Horst Schmid Kliniken Wiesbaden, Wiesbaden, Germany*These authors contributed equally to this workCorrespondence: Marion OrtnerTechnical University of Munich, School of Medicine, Klinikum Rechts der Isar, Department of Psychiatry and Psychotherapy, Moehlstr. 26 81675, Muenchen, GermanyTel +49 89 4140 6463Fax +49 89 4140 4923Email marion.ortner@tum.dePurpose: Impaired paravascular drainage of β-Amyloid (Aβ) has been proposed as a contributing cause for sporadic Alzheimer’s disease (AD), as decreased cerebral blood vessel pulsatility and subsequently reduced propulsion in this pathway could lead to the accumulation and deposition of Aβ in the brain. Therefore, we hypothesized that there is an increased impairment in pulsatility across AD spectrum.Patients and Methods: Using transcranial color-coded duplex sonography (TCCS) the resistance and pulsatility index (RI; PI) of the middle cerebral artery (MCA) in healthy controls (HC, n=14) and patients with AD dementia (ADD, n=12) were measured. In a second step, we extended the sample by adding patients with mild cognitive impairment (MCI) stratified by the presence (MCI-AD, n=8) or absence of biomarkers (MCI-nonAD, n=8) indicative for underlying AD pathology, and compared RI and PI across the groups. To control for atherosclerosis as a confounder, we measured the arteriolar-venular-ratio of retinal vessels.Results: Left and right RI (p=0.020; p=0.027) and left PI (p=0.034) differed between HC and ADD controlled for atherosclerosis with AUCs of 0.776, 0.763, and 0.718, respectively. The RI and PI of MCI-AD tended towards ADD, of MCI-nonAD towards HC, respectively. RIs and PIs were associated with disease severity (p=0.010, p=0.023).Conclusion: Our results strengthen the hypothesis that impaired pulsatility could cause impaired amyloid clearance from the brain and thereby might contribute to the development of AD. However, further studies considering other factors possibly influencing amyloid clearance as well as larger sample sizes are needed.Keywords: pulsatility index, PI, resistance index, RI, biomarker, mild cognitive impairment, MCI, Alzheimer’s dementia
format article
author Ortner M
Hauser C
Schmaderer C
Muggenthaler C
Hapfelmeier A
Sorg C
Diehl-Schmid J
Kurz A
Förstl H
Ikenberg B
Kotliar K
Poppert H
Grimmer T
author_facet Ortner M
Hauser C
Schmaderer C
Muggenthaler C
Hapfelmeier A
Sorg C
Diehl-Schmid J
Kurz A
Förstl H
Ikenberg B
Kotliar K
Poppert H
Grimmer T
author_sort Ortner M
title Decreased Vascular Pulsatility in Alzheimer’s Disease Dementia Measured by Transcranial Color-Coded Duplex Sonography
title_short Decreased Vascular Pulsatility in Alzheimer’s Disease Dementia Measured by Transcranial Color-Coded Duplex Sonography
title_full Decreased Vascular Pulsatility in Alzheimer’s Disease Dementia Measured by Transcranial Color-Coded Duplex Sonography
title_fullStr Decreased Vascular Pulsatility in Alzheimer’s Disease Dementia Measured by Transcranial Color-Coded Duplex Sonography
title_full_unstemmed Decreased Vascular Pulsatility in Alzheimer’s Disease Dementia Measured by Transcranial Color-Coded Duplex Sonography
title_sort decreased vascular pulsatility in alzheimer’s disease dementia measured by transcranial color-coded duplex sonography
publisher Dove Medical Press
publishDate 2019
url https://doaj.org/article/49f043aa2d6c42e6882554ba4c0608fd
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AT schmadererc decreasedvascularpulsatilityinalzheimerrsquosdiseasedementiameasuredbytranscranialcolorcodedduplexsonography
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spelling oai:doaj.org-article:49f043aa2d6c42e6882554ba4c0608fd2021-12-02T10:57:06ZDecreased Vascular Pulsatility in Alzheimer’s Disease Dementia Measured by Transcranial Color-Coded Duplex Sonography1178-2021https://doaj.org/article/49f043aa2d6c42e6882554ba4c0608fd2019-12-01T00:00:00Zhttps://www.dovepress.com/decreased-vascular-pulsatility-in-alzheimerrsquos-disease-dementia-mea-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Marion Ortner,1 Christine Hauser,2 Christoph Schmaderer,2 Claudia Muggenthaler,1 Alexander Hapfelmeier,3 Christian Sorg,1,4 Janine Diehl-Schmid,1 Alexander Kurz,1 Hans Förstl,1 Benno Ikenberg,5 Konstantin Kotliar,6 Holger Poppert,5,7,* Timo Grimmer1,* 1Technical University of Munich, School of Medicine, Klinikum Rechts der Isar, Department of Psychiatry and Psychotherapy, Munich, Germany; 2Technical University of Munich, School of Medicine, Klinikum Rechts der Isar, Department of Nephrology, Munich, Germany; 3Technical University of Munich, School of Medicine, Klinikum Rechts der Isar, Institute for Medical Statistics and Epidemiology, Munich, Germany; 4Technical University of Munich, School of Medicine, Klinikum Rechts der Isar, Department of Diagnostic and Interventional Neuroradiology, Munich, Germany; 5Technical University of Munich, School of Medicine, Klinikum Rechts der Isar, Department of Neurology, Munich, Germany; 6Department of Medical Engineering and Technomathematics, FH Aachen, Jülich, Germany; 7Department of Neurology, Helios Dr. Horst Schmid Kliniken Wiesbaden, Wiesbaden, Germany*These authors contributed equally to this workCorrespondence: Marion OrtnerTechnical University of Munich, School of Medicine, Klinikum Rechts der Isar, Department of Psychiatry and Psychotherapy, Moehlstr. 26 81675, Muenchen, GermanyTel +49 89 4140 6463Fax +49 89 4140 4923Email marion.ortner@tum.dePurpose: Impaired paravascular drainage of β-Amyloid (Aβ) has been proposed as a contributing cause for sporadic Alzheimer’s disease (AD), as decreased cerebral blood vessel pulsatility and subsequently reduced propulsion in this pathway could lead to the accumulation and deposition of Aβ in the brain. Therefore, we hypothesized that there is an increased impairment in pulsatility across AD spectrum.Patients and Methods: Using transcranial color-coded duplex sonography (TCCS) the resistance and pulsatility index (RI; PI) of the middle cerebral artery (MCA) in healthy controls (HC, n=14) and patients with AD dementia (ADD, n=12) were measured. In a second step, we extended the sample by adding patients with mild cognitive impairment (MCI) stratified by the presence (MCI-AD, n=8) or absence of biomarkers (MCI-nonAD, n=8) indicative for underlying AD pathology, and compared RI and PI across the groups. To control for atherosclerosis as a confounder, we measured the arteriolar-venular-ratio of retinal vessels.Results: Left and right RI (p=0.020; p=0.027) and left PI (p=0.034) differed between HC and ADD controlled for atherosclerosis with AUCs of 0.776, 0.763, and 0.718, respectively. The RI and PI of MCI-AD tended towards ADD, of MCI-nonAD towards HC, respectively. RIs and PIs were associated with disease severity (p=0.010, p=0.023).Conclusion: Our results strengthen the hypothesis that impaired pulsatility could cause impaired amyloid clearance from the brain and thereby might contribute to the development of AD. However, further studies considering other factors possibly influencing amyloid clearance as well as larger sample sizes are needed.Keywords: pulsatility index, PI, resistance index, RI, biomarker, mild cognitive impairment, MCI, Alzheimer’s dementiaOrtner MHauser CSchmaderer CMuggenthaler CHapfelmeier ASorg CDiehl-Schmid JKurz AFörstl HIkenberg BKotliar KPoppert HGrimmer TDove Medical Pressarticlepulsatility index (pi)resistance index (ri)biomarkermild cognitive impairment (mci)alzheimer’s dementiaNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 15, Pp 3487-3499 (2019)

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