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Cerebral blood flow by arterial spin labeling in poststroke dementia

Lookup NU author(s): Dr Michael FirbankORCiD, Dr Jiabao He, Professor Andrew BlamireORCiD, Professor Raj KalariaORCiD, Professor John O'Brien


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Objective: To investigate the relationship between cerebral blood flow and dementia in older stroke survivors and subjects with Alzheimer disease (AD). Methods: This cohort study used arterial spin labeling MRI at 3T to examine cerebral blood flow (CBF). We scanned 39 patients 6 years after stroke. They were older than 75 years at the time of stroke and free of dementia 3 months poststroke, with 8 subsequently developing dementia. We also scanned 17 subjects with AD and 29 healthy control subjects. We determined the perfusion in regions of interest (ROIs). Hippocampal volume was also measured using a previously validated automated procedure. Results: The gray matter/white matter CBF ratio was reduced globally in the poststroke dementia (PSD) group (1.55 SD = 0.12) relative to control subjects (1.78 SD = 0.18; p = 0.03). The CBF ratio in a parietal ROI was reduced in the AD (1.34 SD = 0.31; p = 0.003), PSD (1.32 SD = 0.22; p = 0.041), and poststroke no-dementia (PSND) (1.44 SD = 0.34; p = 0.014) groups relative to that of control subjects (1.70 SD = 0.32). In subjects without stroke, the best predictor of dementia was hippocampus volume, whereas in the stroke group, it was the global CBF gray matter/white matter ratio. Hippocampus volume was not significantly different between the AD and PSD groups, and both had reduced hippocampi relative to those of control subjects and the PSND group. Conclusions: We found evidence for both vascular and AD pathology in PSD, suggesting that both the direct impact of the stroke and subsequent development of AD-type changes play a role in the etiology of PSD. Neurology (R) 2011;76:1478-1484

Publication metadata

Author(s): Firbank MJ, He J, Blamire AM, Singh B, Danson P, Kalaria RN, O'Brien JT

Publication type: Article

Publication status: Published

Journal: Neurology

Year: 2011

Volume: 76

Issue: 17

Pages: 1478-1484

Print publication date: 26/04/2011

ISSN (print): 0028-3878

ISSN (electronic): 1526-632X

Publisher: Lippincott Williams & Wilkins


DOI: 10.1212/WNL.0b013e318217e76a


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Funder referenceFunder name
Alzheimer's Research Trust
Cancer Research UK
Medical Research Council UK
NHS Trust
Parkinson's Disease Society
Sir Jules Thorn Charitable Trust
Alzheimer's Research Trust (UK)
British Heart Foundation
UK National Institute for Health Research Biomedical Research Centre for Ageing and Age Related Diseases
Wellcome Trust
G0500247Medical Research Council (UK)