Cerebroarterial pulsatility and resistivity indices are associated with cognitive impairment and white matter hyperintensity in elderly subjects: A phase-contrast MRI study

Soroush H. Pahlavian; Xinhui Wang; Samantha Ma; Hong Zheng; Marlena Casey; Lina M. D’Orazio; Xingfeng Shao; John M. Ringman; Helena Chui; Danny J.J. Wang; Lirong Yan

doi:10.1177/0271678X20927101

Cerebroarterial pulsatility and resistivity indices are associated with cognitive impairment and white matter hyperintensity in elderly subjects: A phase-contrast MRI study

Soroush H. Pahlavian, Xinhui Wang, Samantha Ma, Hong Zheng, Marlena Casey, Lina M. D’Orazio, Xingfeng Shao, John M. Ringman, Helena Chui, Danny J.J. Wang, Lirong Yan^*

^*Corresponding author for this work

Radiology

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17 Scopus citations

Abstract

Increased cerebroarterial pulsations are thought to be contributing factors in microvascular damage and cognitive impairment. In this study, we assessed the utility of two-dimensional (2D) phase-contrast MRI (PC-MRI) in quantifying cerebroarterial pulsations and evaluated the associations of pulsatile and non-pulsatile hemodynamic measures with cognitive performance and white matter hyperintensities (WMH). Neurocognitive assessments on 50 elderly subjects were performed using clinical dementia rating (CDR) and Montreal cognitive assessment (MoCA). An electrocardiogram-gated 2D PC-MRI sequence was used to calculate mean flow rate, pulsatility index (PI), and resistivity index (RI) of the internal carotid artery. For each subject, whole brain global cerebral blood flow (gCBF) and relative WMH volume were also quantified. Elevated RI was significantly associated with reduced cognitive performance quantified using MoCA (p = 0.04) and global CDR (p = 0.02). PI and RI were both significantly associated with relative WMH volume (p = 0.01, p < 0.01, respectively). However, non-pulsatile hemodynamic measures were not associated with cognitive impairment or relative WMH volume. This study showed that the cerebroarterial pulsatile measures obtained using PC-MRI have stronger association with the measures of cognitive impairment compared to global blood flow measurement and as such, might be useful as potential biomarkers of cerebrovascular dysfunction in preclinical populations.

Original language	English (US)
Pages (from-to)	670-683
Number of pages	14
Journal	Journal of Cerebral Blood Flow and Metabolism
Volume	41
Issue number	3
DOIs	https://doi.org/10.1177/0271678X20927101
State	Published - Mar 2021

Funding

The authors thank Katherin Martin and Kai Wang for assistance with data collection, Dr. Kay Jann for assistance with ASL processing, and Giuseppe Barisano for evaluation of WMH. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by National Institute of Health (NIH) grants UH2-NS100614, K25-AG056594 and R01-EB028297. This work was also supported by American Heart Association (AHA) grant 16SDG29630013 and Alzheimer’s disease research center (ADRC) grant NIA AG P50-AG05142.

Keywords

Cerebroarterial pulsations
cognitive impairment
phase-contrast MRI
pulsatility index
resistivity index
white matter hyperintensity

ASJC Scopus subject areas

Neurology
Clinical Neurology
Cardiology and Cardiovascular Medicine

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10.1177/0271678X20927101

Cite this

Pahlavian, S. H., Wang, X., Ma, S., Zheng, H., Casey, M., D’Orazio, L. M., Shao, X., Ringman, J. M., Chui, H., Wang, D. J. J., & Yan, L. (2021). Cerebroarterial pulsatility and resistivity indices are associated with cognitive impairment and white matter hyperintensity in elderly subjects: A phase-contrast MRI study. Journal of Cerebral Blood Flow and Metabolism, 41(3), 670-683. https://doi.org/10.1177/0271678X20927101

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title = "Cerebroarterial pulsatility and resistivity indices are associated with cognitive impairment and white matter hyperintensity in elderly subjects: A phase-contrast MRI study",

abstract = "Increased cerebroarterial pulsations are thought to be contributing factors in microvascular damage and cognitive impairment. In this study, we assessed the utility of two-dimensional (2D) phase-contrast MRI (PC-MRI) in quantifying cerebroarterial pulsations and evaluated the associations of pulsatile and non-pulsatile hemodynamic measures with cognitive performance and white matter hyperintensities (WMH). Neurocognitive assessments on 50 elderly subjects were performed using clinical dementia rating (CDR) and Montreal cognitive assessment (MoCA). An electrocardiogram-gated 2D PC-MRI sequence was used to calculate mean flow rate, pulsatility index (PI), and resistivity index (RI) of the internal carotid artery. For each subject, whole brain global cerebral blood flow (gCBF) and relative WMH volume were also quantified. Elevated RI was significantly associated with reduced cognitive performance quantified using MoCA (p = 0.04) and global CDR (p = 0.02). PI and RI were both significantly associated with relative WMH volume (p = 0.01, p < 0.01, respectively). However, non-pulsatile hemodynamic measures were not associated with cognitive impairment or relative WMH volume. This study showed that the cerebroarterial pulsatile measures obtained using PC-MRI have stronger association with the measures of cognitive impairment compared to global blood flow measurement and as such, might be useful as potential biomarkers of cerebrovascular dysfunction in preclinical populations.",

keywords = "Cerebroarterial pulsations, cognitive impairment, phase-contrast MRI, pulsatility index, resistivity index, white matter hyperintensity",

author = "Pahlavian, {Soroush H.} and Xinhui Wang and Samantha Ma and Hong Zheng and Marlena Casey and D{\textquoteright}Orazio, {Lina M.} and Xingfeng Shao and Ringman, {John M.} and Helena Chui and Wang, {Danny J.J.} and Lirong Yan",

note = "Funding Information: The authors thank Katherin Martin and Kai Wang for assistance with data collection, Dr. Kay Jann for assistance with ASL processing, and Giuseppe Barisano for evaluation of WMH. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by National Institute of Health (NIH) grants UH2-NS100614, K25-AG056594 and R01-EB028297. This work was also supported by American Heart Association (AHA) grant 16SDG29630013 and Alzheimer{\textquoteright}s disease research center (ADRC) grant NIA AG P50-AG05142. Publisher Copyright: {\textcopyright} The Author(s) 2020.",

year = "2021",

month = mar,

doi = "10.1177/0271678X20927101",

language = "English (US)",

volume = "41",

pages = "670--683",

journal = "Journal of Cerebral Blood Flow and Metabolism",

issn = "0271-678X",

publisher = "Nature Publishing Group",

number = "3",

}

Pahlavian, SH, Wang, X, Ma, S, Zheng, H, Casey, M, D’Orazio, LM, Shao, X, Ringman, JM, Chui, H, Wang, DJJ & Yan, L 2021, 'Cerebroarterial pulsatility and resistivity indices are associated with cognitive impairment and white matter hyperintensity in elderly subjects: A phase-contrast MRI study', Journal of Cerebral Blood Flow and Metabolism, vol. 41, no. 3, pp. 670-683. https://doi.org/10.1177/0271678X20927101

Cerebroarterial pulsatility and resistivity indices are associated with cognitive impairment and white matter hyperintensity in elderly subjects: A phase-contrast MRI study. / Pahlavian, Soroush H.; Wang, Xinhui; Ma, Samantha et al.
In: Journal of Cerebral Blood Flow and Metabolism, Vol. 41, No. 3, 03.2021, p. 670-683.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Cerebroarterial pulsatility and resistivity indices are associated with cognitive impairment and white matter hyperintensity in elderly subjects

T2 - A phase-contrast MRI study

AU - Pahlavian, Soroush H.

AU - Wang, Xinhui

AU - Ma, Samantha

AU - Zheng, Hong

AU - Casey, Marlena

AU - D’Orazio, Lina M.

AU - Shao, Xingfeng

AU - Ringman, John M.

AU - Chui, Helena

AU - Wang, Danny J.J.

AU - Yan, Lirong

N1 - Funding Information: The authors thank Katherin Martin and Kai Wang for assistance with data collection, Dr. Kay Jann for assistance with ASL processing, and Giuseppe Barisano for evaluation of WMH. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by National Institute of Health (NIH) grants UH2-NS100614, K25-AG056594 and R01-EB028297. This work was also supported by American Heart Association (AHA) grant 16SDG29630013 and Alzheimer’s disease research center (ADRC) grant NIA AG P50-AG05142. Publisher Copyright: © The Author(s) 2020.

PY - 2021/3

Y1 - 2021/3

N2 - Increased cerebroarterial pulsations are thought to be contributing factors in microvascular damage and cognitive impairment. In this study, we assessed the utility of two-dimensional (2D) phase-contrast MRI (PC-MRI) in quantifying cerebroarterial pulsations and evaluated the associations of pulsatile and non-pulsatile hemodynamic measures with cognitive performance and white matter hyperintensities (WMH). Neurocognitive assessments on 50 elderly subjects were performed using clinical dementia rating (CDR) and Montreal cognitive assessment (MoCA). An electrocardiogram-gated 2D PC-MRI sequence was used to calculate mean flow rate, pulsatility index (PI), and resistivity index (RI) of the internal carotid artery. For each subject, whole brain global cerebral blood flow (gCBF) and relative WMH volume were also quantified. Elevated RI was significantly associated with reduced cognitive performance quantified using MoCA (p = 0.04) and global CDR (p = 0.02). PI and RI were both significantly associated with relative WMH volume (p = 0.01, p < 0.01, respectively). However, non-pulsatile hemodynamic measures were not associated with cognitive impairment or relative WMH volume. This study showed that the cerebroarterial pulsatile measures obtained using PC-MRI have stronger association with the measures of cognitive impairment compared to global blood flow measurement and as such, might be useful as potential biomarkers of cerebrovascular dysfunction in preclinical populations.

AB - Increased cerebroarterial pulsations are thought to be contributing factors in microvascular damage and cognitive impairment. In this study, we assessed the utility of two-dimensional (2D) phase-contrast MRI (PC-MRI) in quantifying cerebroarterial pulsations and evaluated the associations of pulsatile and non-pulsatile hemodynamic measures with cognitive performance and white matter hyperintensities (WMH). Neurocognitive assessments on 50 elderly subjects were performed using clinical dementia rating (CDR) and Montreal cognitive assessment (MoCA). An electrocardiogram-gated 2D PC-MRI sequence was used to calculate mean flow rate, pulsatility index (PI), and resistivity index (RI) of the internal carotid artery. For each subject, whole brain global cerebral blood flow (gCBF) and relative WMH volume were also quantified. Elevated RI was significantly associated with reduced cognitive performance quantified using MoCA (p = 0.04) and global CDR (p = 0.02). PI and RI were both significantly associated with relative WMH volume (p = 0.01, p < 0.01, respectively). However, non-pulsatile hemodynamic measures were not associated with cognitive impairment or relative WMH volume. This study showed that the cerebroarterial pulsatile measures obtained using PC-MRI have stronger association with the measures of cognitive impairment compared to global blood flow measurement and as such, might be useful as potential biomarkers of cerebrovascular dysfunction in preclinical populations.

KW - Cerebroarterial pulsations

KW - cognitive impairment

KW - phase-contrast MRI

KW - pulsatility index

KW - resistivity index

KW - white matter hyperintensity

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Cerebroarterial pulsatility and resistivity indices are associated with cognitive impairment and white matter hyperintensity in elderly subjects: A phase-contrast MRI study

Abstract

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