pCASL CBF analysis in Alzheimer’s disease spectrum patients: a prospective MRI study

Backround: CBF has been demonstrated to be reduced in many area in AD spectrum disease but data on longitudinal patients, especially in SCD, are lacking. Aim: to analyze, by means of pCASL technique, the CBF in prospectively enrolled healthy subjects and AD spectrum and its relationship with cognitive function at each stage in specific domains. Investigate on the relation between CBF and brain atrophy in each group. Our hypothesis is that CBF represent an early sign of disease and can be used as a valid biomarker in both disease identification and prediction of performance. Results: as the disease advanced in stage, a progressive CBF reduction has been observed in PCC and perietal lobule, which could be translated in posterior DMN dysfunction. CBF is positively correlated with memory domain functions at early stage of the disease, while negative correlation are encountered in later phases, when more consistent structural damage is present. Progressive atrophy in core areas, such hippocampus and parahippocampal gyrus, as the disease becomes more severe, was observed. Gray matter volume is associated more with better clinical performances in MCI and AD, while SCD and HS rely more on synaptic pruning to achieve better performances. Conclusions: CBF could be used as a non-invasive clinical biomarker for monitoring clinical progression, since it could anticipate visible structural damage, in particular at early stages of disease.