Increased cerebral blood flow is associated with higher baseline amyloid burden in a cognitively unimpaired population

Background:

Decreased cerebral blood flow (CBF) and deterioration of blood-brain barrier (BBB) are suggested to be precursor conditions of cognitive impairment. Using a novel multi-echo-time arterial spin labelling (ASL) protocol, we examined the time of exchange (Tex) of water across the BBB as a measurement of BBB permeability. We further examined the association of cardiovascular risk factors with Tex in an ongoing cohort study.
Method:
Data (n=29, mean age: 55.9±6.1years, 69% women) were drawn from Neurological biomarkers of Blood, MRI and Cognition (NEURO-BMC) study performed at National University of Singapore. NEURO-BMC is an ongoing prospective cohort study (age: 45-65 years) on brain changes in a subclinical phase of cognitive impairment. A multi-echo, Hadamard-encoded multi-post-labelling-delay pseudo-continuous ASL (PCASL) protocol was used on a 3T scanner. ExploreASL was used with a modified version of FSL FABBER(4) to quantify cerebral blood flow (CBF), arterial transit time (ATT), and Tex. ASL-extracted parameters were compared with cardiovascular risk parameters such as blood pressure (BP), BMI and smoking status.
Result:
High systolic and diastolic BP were associated with significantly reduced Tex (Fig 1). Additionally, higher systolic and diastolic BP showed a trend of increased ATT and reduced CBF, though the associations were not statistically significant (Table 1). High BMI had a significant association with increased ATT and reduced CBF. However, no trend was observed between BMI and Tex. Participants who ever smoked were observed to have a reduced Tex and CBF and increased ATT, but statistical significance was only found for CBF (Fig 1).
Conclusion:
In this pilot study, we showed that BBB-ASL-derived parameters - ATT, CBF, and Tex - were associated with BP, BMI, and smoking status. While the sample size for this preliminary analysis was too small to make a definitive conclusion as not all associations were statistically significant, all studied cardiovascular risk factors showed their potential in increasing the risk of BBB deterioration. Further investigation with a larger sample size and other health risk factors to assess these observations is warranted.