Research Article

Longitudinal Changes in Global Cerebral Blood Flow in Cognitively Normal Older Adults: A Phase-Contrast MRI Study

Hualu Han BS

orcid.org/0000-0002-4144-5722

Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China

The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

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Zixuan Lin PhD,

Zixuan Lin PhD

The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

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Anja Soldan PhD, MA,

Anja Soldan PhD, MA

Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

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Corinne Pettigrew PhD,

Corinne Pettigrew PhD

Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

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Joshua F. Betz MS,

Joshua F. Betz MS

Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA

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Kumiko Oishi PhD,

Kumiko Oishi PhD

Center for Imaging Science, Johns Hopkins University, Whiting School of Engineering, Baltimore, Maryland, USA

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Yang Li PhD,

Yang Li PhD

The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

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Peiying Liu PhD,

Peiying Liu PhD

The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

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Marilyn Albert PhD,

Marilyn Albert PhD

Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

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Hanzhang Lu PhD,

Corresponding Author

Hanzhang Lu PhD

[email protected]

orcid.org/0000-0003-3871-1564

The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

F.M. Kirby Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA

Address reprint requests to: H.L., 600 N. Wolfe Street, Park 322, Baltimore, MD 21287, USA. Email: [email protected]

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Hualu Han BS,

Hualu Han BS

orcid.org/0000-0002-4144-5722

Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China

The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Search for more papers by this author

Zixuan Lin PhD,

Zixuan Lin PhD

The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

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Anja Soldan PhD, MA,

Anja Soldan PhD, MA

Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

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Corinne Pettigrew PhD,

Corinne Pettigrew PhD

Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

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Joshua F. Betz MS,

Joshua F. Betz MS

Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA

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Kumiko Oishi PhD,

Kumiko Oishi PhD

Center for Imaging Science, Johns Hopkins University, Whiting School of Engineering, Baltimore, Maryland, USA

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Yang Li PhD,

Yang Li PhD

The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

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Peiying Liu PhD,

Peiying Liu PhD

The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

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Marilyn Albert PhD,

Marilyn Albert PhD

Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

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Hanzhang Lu PhD,

Corresponding Author

Hanzhang Lu PhD

[email protected]

orcid.org/0000-0003-3871-1564

The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

F.M. Kirby Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA

Address reprint requests to: H.L., 600 N. Wolfe Street, Park 322, Baltimore, MD 21287, USA. Email: [email protected]

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First published: 26 February 2022

https://doi.org/10.1002/jmri.28133

Citations: 4

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Abstract

Background

Characterization of blood supply changes in older individuals is important in understanding brain aging and diseases. However, prior studies largely focused on cross-sectional design, thus change in cerebral blood flow (CBF) could not be assessed on an individual level.

Purpose

To evaluate longitudinal short-term changes in global CBF in cognitively normal older adults.

Study Type

Prospective, longitudinal, and cohort.

Population

One-hundred twenty-seven cognitive-normal participants (mean age 69 ± 7 years, 47 males) underwent serial MRI with an average follow-up time of 2.1 years.

Field Strength/Sequence

3 T phase-contrast (PC), three-dimensional magnetization-prepared-rapid-acquisition-of-gradient-echo (MPRAGE) and fluid-attenuated inversion recovery (FLAIR) MRI.

Assessment

Total CBF was measured with PC MRI allowing assessment of quantitative flow in four major feeding arteries by a trained radiologist with >3 years' experience (O.K.). Brain volume was obtained from MPRAGE MRI and measured by T1-MultiAtlas MRICloud tool. The ratio between total CBF and brain volume yielded global CBF in mL/100 g/min. White matter hyperintensity (WMH) was measured automatically using a Bayesian probability approach on FLAIR.

Statistical Tests

Linear mixed effect model was used to simultaneously assess cross-sectional age-differences and longitudinal age-changes in CBF. Spearman rank correlation was used to evaluate the relationship between CBF change and WMH progression. A P-value of <0.05 (two-tailed) was considered significant.

Results

Global CBF decreased with age at a longitudinal rate of −0.56 mL/100 g/min/year (95% confidence interval [CI]: −1.09, −0.03), compared to a cross-sectional rate of −0.26 mL/100 g/min/year (95% CI: −0.41, −0.11). Changes in CBF were significantly associated with progression of WMH (Spearman rank correlation r = −0.25), as those participants who had a more rapid CBF reduction had greater increases in WMH volumes and the relationship remained significant when adjusting for baseline vascular risk scores. Additionally, age-related changes in whole-brain volume were found to be −0.151%/year (95% CI: −0.186, −0.116).

Data Conclusion

These findings suggest that brain aging in older adults is accompanied by a rapid longitudinal reduction in CBF, the rate of which is associated with white matter damage.

Level of Evidence

Technical Efficacy Stage

Supporting Information

References

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Citing Literature

Volume56, Issue5

November 2022

Pages 1538-1545

Longitudinal Changes in Global Cerebral Blood Flow in Cognitively Normal Older Adults: A Phase-Contrast MRI Study

Abstract

Background

Purpose

Study Type

Population

Field Strength/Sequence

Assessment

Statistical Tests

Results

Data Conclusion

Level of Evidence

Technical Efficacy Stage

Supporting Information

References

Citing Literature

References

Information

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Longitudinal Changes in Global Cerebral Blood Flow in Cognitively Normal Older Adults: A Phase-Contrast MRI Study

Abstract

Background

Purpose

Study Type

Population

Field Strength/Sequence

Assessment

Statistical Tests

Results

Data Conclusion

Level of Evidence

Technical Efficacy Stage

Supporting Information

References

Citing Literature

References

Related

Information