Ultrasound and dynamic functional imaging in vascular cognitive impairment and Alzheimer's disease

Malojčić, Branko and Giannakopoulos, Panteleimon and Sorond, Farzaneh A. and Azevedo, Elsa and Diomedi, Marina and Pretnar Oblak, Janja and Carraro, Nicola and Boban, Marina and Olah, Laszlo and Schreiber, Stephan J. and Pavlović, Aleksandra and Garami, Zsolt and Bornstein, Nantan M. and Rosengarten, Bernhard (2017) Ultrasound and dynamic functional imaging in vascular cognitive impairment and Alzheimer's disease. BMC Medicine, 15 (1). p. 27. ISSN 1741-7015

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BACKGROUND: The vascular contributions to neurodegeneration and neuroinflammation may be assessed by magnetic resonance imaging (MRI) and ultrasonography (US). This review summarises the methodology for these widely available, safe and relatively low cost tools and analyses recent work highlighting their potential utility as biomarkers for differentiating subtypes of cognitive impairment and dementia, tracking disease progression and evaluating response to treatment in various neurocognitive disorders. ----- METHODS: At the 9th International Congress on Vascular Dementia (Ljubljana, Slovenia, October 2015) a writing group of experts was formed to review the evidence on the utility of US and arterial spin labelling (ASL) as neurophysiological markers of normal ageing, vascular cognitive impairment (VCI) and Alzheimer's disease (AD). Original articles, systematic literature reviews, guidelines and expert opinions published until September 2016 were critically analysed to summarise existing evidence, indicate gaps in current knowledge and, when appropriate, suggest standards of use for the most widely used US and ASL applications. ----- RESULTS: Cerebral hypoperfusion has been linked to cognitive decline either as a risk or an aggravating factor. Hypoperfusion as a consequence of microangiopathy, macroangiopathy or cardiac dysfunction can promote or accelerate neurodegeneration, blood-brain barrier disruption and neuroinflammation. US can evaluate the cerebrovascular tree for pathological structure and functional changes contributing to cerebral hypoperfusion. Microvascular pathology and hypoperfusion at the level of capillaries and small arterioles can also be assessed by ASL, an MRI signal. Despite increasing evidence supporting the utility of these methods in detection of microvascular pathology, cerebral hypoperfusion, neurovascular unit dysfunction and, most importantly, disease progression, incomplete standardisation and missing validated cut-off values limit their use in daily routine. ----- CONCLUSIONS: US and ASL are promising tools with excellent temporal resolution, which will have a significant impact on our understanding of the vascular contributions to VCI and AD and may also be relevant for assessing future prevention and therapeutic strategies for these conditions. Our work provides recommendations regarding the use of non-invasive imaging techniques to investigate the functional consequences of vascular burden in dementia.

Item Type: Article
Additional Information: © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
MeSH: Alzheimer Disease/diagnostic imaging ; Alzheimer Disease/pathology ; Cognitive Dysfunction/diagnostic imaging ; Humans
Departments: Katedra za neurologiju
Depositing User: Martina Žužak
Status: Published
Malojčić, BrankoUNSPECIFIED
Giannakopoulos, PanteleimonUNSPECIFIED
Sorond, Farzaneh A.UNSPECIFIED
Diomedi, MarinaUNSPECIFIED
Pretnar Oblak, JanjaUNSPECIFIED
Carraro, NicolaUNSPECIFIED
Schreiber, Stephan J.UNSPECIFIED
Pavlović, AleksandraUNSPECIFIED
Bornstein, Nantan M.UNSPECIFIED
Rosengarten, BernhardUNSPECIFIED
Date: 9 February 2017
Date Deposited: 02 Mar 2018 10:28
Last Modified: 20 Aug 2020 07:35
Related URLs:
URI: http://medlib.mef.hr/id/eprint/2830

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