Cerebral blood flow is diminished in asymptomatic middle-aged adults with maternal history of Alzheimer’s disease

Ozioma C. Okonkwo, Guofan Xu, Jennifer M. Oh, N. Maritza Dowling, Cynthia M. Carlsson, Catherine L. Gallagher, Alex C. Birdsill, Matthew Palotti, Whitney Wharton, Bruce P. Hermann, Asenath LaRue, Barbara B. Bendlin, Howard A. Rowley, Sanjay Asthana, Mark A. Sager, Sterling C. Johnson

Cereb Cortex. 2014 Apr;24(4):978-88. Epub 2012 Dec 12.


Cerebral blood flow (CBF) provides an indication of the metabolic status of the cortex and may have utility in understanding preclinical brain changes in persons at risk for Alzheimer’s disease (AD) and related diseases. In this study, we investigated CBF in 327 well-characterized adults including patients with AD (n=28), patients with amnestic mild cognitive impairment (aMCI, n=23), older cognitively-normal adults (OCN, n=24), and asymptomatic middle-aged adults (n=252) with and without family history (FH) of AD. Compared to the asymptomatic cohort, AD patients displayed significant hypoperfusion in the precuneus, posterior cingulate, lateral parietal cortex, and the hippocampal region. Patients with aMCI exhibited a similar but less marked pattern of hypoperfusion. Perfusion deficits within the OCN adults were primarily localized to the inferior parietal lobules. Asymptomatic participants with a maternal FH of AD showed hypoperfusion in hippocampal and parietofrontal regions compared to those without a FH of AD or those with only a paternal FH of AD. These observations persisted when gray matter volume was included as a voxel-wise covariate. Our findings suggest that having a mother with AD might confer particular risk for AD-related cerebral hypoperfusion in midlife. In addition, they provide further support for the potential utility of arterial spin labeling for measurement of AD-related neurometabolic dysfunction, especially in situations where [18F]fluorodeoxyglucose imaging is infeasible or clinically contraindicated.


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