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首页> 外文期刊>Journal of neurology >Arterial spin labeling perfusion predicts longitudinal decline in semantic variant primary progressive aphasia
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Arterial spin labeling perfusion predicts longitudinal decline in semantic variant primary progressive aphasia

机译：动脉自旋标记灌注预测语义变异的原发性进行性失语症的纵向下降

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The objective of the study was to evaluate the prognostic value of regional cerebral blood flow (CBF) measured by arterial spin labeled (ASL) perfusion MRI in patients with semantic variant primary progressive aphasia (svPPA). We acquired pseudo-continuous ASL (pCASL) MRI and whole-brain T1-weighted structural MRI in svPPA patients (N = 13) with cerebrospinal fluid biomarkers consistent with frontotemporal lobar degeneration pathology. Follow-up T1-weighted MRI was available in a subset of patients (N = 8). We performed whole-brain comparisons of partial volume-corrected CBF and cortical thickness between svPPA and controls, and compared baseline and follow-up cortical thickness in regions of significant hypoperfusion and hyperperfusion. Patients with svPPA showed partial volume-corrected hypoperfusion relative to controls in left temporal lobe and insula. svPPA patients also had typical cortical thinning in anterior temporal, insula, and inferior frontal regions at baseline. Volume-corrected hypoperfusion was seen in areas of significant cortical thinning such as the left temporal lobe and insula. Additional regions of hypoperfusion corresponded to areas without cortical thinning. We also observed regions of hyperperfusion, some associated with cortical thinning and others without cortical thinning, including right superior temporal, inferior parietal, and orbitofrontal cortices. Regions of hypoperfusion and hyperperfusion near cortical thinning at baseline had significant longitudinal thinning between baseline and follow-up scans, but perfusion changes in distant areas did not show progressive thinning. Our findings suggest ASL MRI may be sensitive to functional changes not readily apparent in structural MRI, and specific changes in perfusion may be prognostic markers of disease progression in a manner consistent with cell-to-cell spreading pathology.
机译：这项研究的目的是评估通过动脉自旋标记（ASL）灌注MRI测量的区域性脑血流（CBF）对语义变异性原发性失语症（svPPA）患者的预后价值。我们在具有脑脊液生物标志物且符合额颞叶变性病理学特征的svPPA患者（N = 13）中，获得了伪连续ASL（pCASL）MRI和全脑T1加权结构MRI。一部分患者可获得随访T1加权MRI（N = 8）。我们对svPPA和对照之间的部分体积校正的CBF和皮质厚度进行了全脑比较，并比较了明显的低灌注和高灌注区域的基线和后续皮质厚度。 svPPA患者相对于左颞叶和岛状岛的对照显示部分体积校正的灌注不足。 svPPA患者在基线时颞前，岛状和额下下部也有典型的皮质变薄。在明显的皮质变薄的区域（例如左颞叶和岛状）中看到了体积校正的灌注不足。灌注不足的其他区域对应于没有皮质变薄的区域。我们还观察到了过度灌注区域，其中一些区域与皮质变薄相关，而其他区域与皮质变薄无关，包括右侧颞上叶，顶下壁和眶额皮质。基线时皮层变薄附近的低灌注和高灌注区域在基线和随访扫描之间有明显的纵向变薄，但远处区域的灌注变化并未显示出进行性变薄。我们的发现表明，ASL MRI可能对结构性MRI中不易发现的功能变化敏感，并且灌注的特定变化可能以与细胞间扩散病理学一致的方式成为疾病进展的预后标志。

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