Arterial spin labelling reveals multi-regional cerebral hypoperfusion in patients with transient ischemic attack that are unrelated to ischemia location: A proof-of-concept study

Meaghan Reid; George S. Tadros; Connor C. McDougall; Noaah Reaume; Brooklyn McDougall; Rani Gupta Sah; Meng Wang; Eric E. Smith; Richard Frayne; Shelagh B. Coutts; Tolulope Sajobi; R. Stewart Longman; Christopher D. d'Esterre; Philip Barber

Cerebral Circulation - Cognition and Behavior (Jan 2023)

Arterial spin labelling reveals multi-regional cerebral hypoperfusion in patients with transient ischemic attack that are unrelated to ischemia location: A proof-of-concept study

Meaghan Reid,
George S. Tadros,
Connor C. McDougall,
Noaah Reaume,
Brooklyn McDougall,
Rani Gupta Sah,
Meng Wang,
Eric E. Smith,
Richard Frayne,
Shelagh B. Coutts,
Tolulope Sajobi,
R. Stewart Longman,
Christopher D. d'Esterre,
Philip Barber

Affiliations

Meaghan Reid: Department of Medical Sciences, University of Calgary, Calgary, AB, Canada; Calgary Stroke Program, Department of Clinical Neurosciences, Foothills Medical Centre, Calgary, AB, Canada; Seaman Family MR Center, Foothills Medical Centre, Calgary, AB, Canada; Department of Radiology, University of Calgary, Calgary, AB, Canada
George S. Tadros: Seaman Family MR Center, Foothills Medical Centre, Calgary, AB, Canada; Department of Neurosciences, University of Calgary, Calgary, AB, Canada
Connor C. McDougall: Calgary Stroke Program, Department of Clinical Neurosciences, Foothills Medical Centre, Calgary, AB, Canada; Department of Mechanical Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB, Canada
Noaah Reaume: Calgary Stroke Program, Department of Clinical Neurosciences, Foothills Medical Centre, Calgary, AB, Canada; Seaman Family MR Center, Foothills Medical Centre, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Psychology, University of Calgary, Calgary, AB, Canada
Brooklyn McDougall: Calgary Stroke Program, Department of Clinical Neurosciences, Foothills Medical Centre, Calgary, AB, Canada; Seaman Family MR Center, Foothills Medical Centre, Calgary, AB, Canada
Rani Gupta Sah: Calgary Stroke Program, Department of Clinical Neurosciences, Foothills Medical Centre, Calgary, AB, Canada; Seaman Family MR Center, Foothills Medical Centre, Calgary, AB, Canada; Department of Neurosciences, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Radiology, University of Calgary, Calgary, AB, Canada
Meng Wang: Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
Eric E. Smith: Calgary Stroke Program, Department of Clinical Neurosciences, Foothills Medical Centre, Calgary, AB, Canada; Department of Neurosciences, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Radiology, University of Calgary, Calgary, AB, Canada
Richard Frayne: Seaman Family MR Center, Foothills Medical Centre, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Radiology, University of Calgary, Calgary, AB, Canada
Shelagh B. Coutts: Calgary Stroke Program, Department of Clinical Neurosciences, Foothills Medical Centre, Calgary, AB, Canada; Seaman Family MR Center, Foothills Medical Centre, Calgary, AB, Canada; Department of Neurosciences, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Radiology, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
Tolulope Sajobi: Calgary Stroke Program, Department of Clinical Neurosciences, Foothills Medical Centre, Calgary, AB, Canada; Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
R. Stewart Longman: Department of Psychology, University of Calgary, Calgary, AB, Canada; Neuropsychology Service, Foothills Medical Centre, Calgary, AB, Canada
Christopher D. d'Esterre: Calgary Stroke Program, Department of Clinical Neurosciences, Foothills Medical Centre, Calgary, AB, Canada; Seaman Family MR Center, Foothills Medical Centre, Calgary, AB, Canada; Department of Mechanical Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
Philip Barber: Calgary Stroke Program, Department of Clinical Neurosciences, Foothills Medical Centre, Calgary, AB, Canada; Seaman Family MR Center, Foothills Medical Centre, Calgary, AB, Canada; Department of Mechanical Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Radiology, University of Calgary, Calgary, AB, Canada; Correspond author at: Calgary Stroke Program, Departments of Clinical Neurosciences, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada

Journal volume & issue: Vol. 4
p. 100164

Abstract

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Background and Aims: Patients with transient ischemic attack (TIA) have a substantially increased risk of early dementia. In this exploratory study, we aim to determine whether patients with TIA have 1) measurable regional cerebral hypoperfusion unrelated to the location of ischemia, and 2) determine the relationship of regional cerebral blood flow (rCBF) with their cognitive profiles. Methods: Patients with TIA (N = 49) and seventy-nine (N = 79) age and sex matched controls underwent formal neuropsychological testing and MRI. Quantitative arterial spin labelling rCBF maps (mL/min/100 g) were registered to the corresponding high resolution T1-weighted image. Linear regression was used to determine the association between demographic, clinical and cognitive variables and rCBF. Results: Patients with TIA had significantly (p < 0.05) lower cognitive scores in the MMSE, MOCA, ACE-R, WAIS-IV DS Coding and Trail Making Tests A and B compared to controls. TIA patients had significantly lower rCBF in the left entorhinal cortex (p = 0.03), right posterior cingulate (p = 0.04), and right precuneus (p = 0.05), after adjusting for age and sex, that were unrelated to the regional anatomical volume and DWI positivity. Regional hypoperfusion in the right posterior cingulate and right precuneus was associated with impaired visual memory (BVMT total, p = 0.05 for both regions) and slower processing speed (TMT A, p = 0.04 and p = 0.01), respectively after adjusting for age and sex. Conclusions: TIA patients have patterns of regional hypoperfusion in multiple cortical regions unrelated to the parcellated regional anatomical volume or the presence of a DWI lesion. Regional hypoperfusion in patients with TIA may be an early marker conferring risk of future cognitive decline that needs to be confirmed by future studies.

Published in Cerebral Circulation - Cognition and Behavior

ISSN: 2666-2450 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine; Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry
Website: https://www.journals.elsevier.com/cerebral-circulation-cognition-and-behavior

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