Ultrasound and dynamic functional imaging in vascular cognitive impairment and Alzheimer's disease

Research output: Contribution to journalReview article

Branko Malojcic, Panteleimon Giannakopoulos, Farzaneh A. Sorond, Elsa Azevedo, Marina Diomedi, Janja Pretnar Oblak, Nicola Carraro, Marina Boban, Laszlo Olah, Stephan J. Schreiber, Aleksandra Pavlovic, Zsolt Garami, Nantan M. Bornstein, Bernhard Rosengarten

Background: The vascular contributions to neurodegeneration and neuroinflammation may be assessed by magnetic resonance imaging (MRI) and ultrasonography (US). This review summarises the methodology for these widely available, safe and relatively low cost tools and analyses recent work highlighting their potential utility as biomarkers for differentiating subtypes of cognitive impairment and dementia, tracking disease progression and evaluating response to treatment in various neurocognitive disorders. Methods: At the 9th International Congress on Vascular Dementia (Ljubljana, Slovenia, October 2015) a writing group of experts was formed to review the evidence on the utility of US and arterial spin labelling (ASL) as neurophysiological markers of normal ageing, vascular cognitive impairment (VCI) and Alzheimer's disease (AD). Original articles, systematic literature reviews, guidelines and expert opinions published until September 2016 were critically analysed to summarise existing evidence, indicate gaps in current knowledge and, when appropriate, suggest standards of use for the most widely used US and ASL applications. Results: Cerebral hypoperfusion has been linked to cognitive decline either as a risk or an aggravating factor. Hypoperfusion as a consequence of microangiopathy, macroangiopathy or cardiac dysfunction can promote or accelerate neurodegeneration, blood-brain barrier disruption and neuroinflammation. US can evaluate the cerebrovascular tree for pathological structure and functional changes contributing to cerebral hypoperfusion. Microvascular pathology and hypoperfusion at the level of capillaries and small arterioles can also be assessed by ASL, an MRI signal. Despite increasing evidence supporting the utility of these methods in detection of microvascular pathology, cerebral hypoperfusion, neurovascular unit dysfunction and, most importantly, disease progression, incomplete standardisation and missing validated cut-off values limit their use in daily routine. Conclusions: US and ASL are promising tools with excellent temporal resolution, which will have a significant impact on our understanding of the vascular contributions to VCI and AD and may also be relevant for assessing future prevention and therapeutic strategies for these conditions. Our work provides recommendations regarding the use of non-invasive imaging techniques to investigate the functional consequences of vascular burden in dementia.

Original languageEnglish (US)
Article number27
JournalBMC Medicine
Volume15
Issue number1
DOIs
StatePublished - Feb 9 2017

PMID: 28178960

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Ultrasound and dynamic functional imaging in vascular cognitive impairment and Alzheimer's disease. / Malojcic, Branko; Giannakopoulos, Panteleimon; Sorond, Farzaneh A.; Azevedo, Elsa; Diomedi, Marina; Oblak, Janja Pretnar; Carraro, Nicola; Boban, Marina; Olah, Laszlo; Schreiber, Stephan J.; Pavlovic, Aleksandra; Garami, Zsolt; Bornstein, Nantan M.; Rosengarten, Bernhard.

In: BMC Medicine, Vol. 15, No. 1, 27, 09.02.2017.

Research output: Contribution to journalReview article

Harvard

Malojcic, B, Giannakopoulos, P, Sorond, FA, Azevedo, E, Diomedi, M, Oblak, JP, Carraro, N, Boban, M, Olah, L, Schreiber, SJ, Pavlovic, A, Garami, Z, Bornstein, NM & Rosengarten, B 2017, 'Ultrasound and dynamic functional imaging in vascular cognitive impairment and Alzheimer's disease' BMC Medicine, vol. 15, no. 1, 27. https://doi.org/10.1186/s12916-017-0799-3

APA

Malojcic, B., Giannakopoulos, P., Sorond, F. A., Azevedo, E., Diomedi, M., Oblak, J. P., ... Rosengarten, B. (2017). Ultrasound and dynamic functional imaging in vascular cognitive impairment and Alzheimer's disease. BMC Medicine, 15(1), [27]. https://doi.org/10.1186/s12916-017-0799-3

Vancouver

Malojcic B, Giannakopoulos P, Sorond FA, Azevedo E, Diomedi M, Oblak JP et al. Ultrasound and dynamic functional imaging in vascular cognitive impairment and Alzheimer's disease. BMC Medicine. 2017 Feb 9;15(1). 27. https://doi.org/10.1186/s12916-017-0799-3

Author

Malojcic, Branko ; Giannakopoulos, Panteleimon ; Sorond, Farzaneh A. ; Azevedo, Elsa ; Diomedi, Marina ; Oblak, Janja Pretnar ; Carraro, Nicola ; Boban, Marina ; Olah, Laszlo ; Schreiber, Stephan J. ; Pavlovic, Aleksandra ; Garami, Zsolt ; Bornstein, Nantan M. ; Rosengarten, Bernhard. / Ultrasound and dynamic functional imaging in vascular cognitive impairment and Alzheimer's disease. In: BMC Medicine. 2017 ; Vol. 15, No. 1.

BibTeX

@article{5f621bdee7e94d7495d1649ebbd63608,
title = "Ultrasound and dynamic functional imaging in vascular cognitive impairment and Alzheimer's disease",
abstract = "Background: The vascular contributions to neurodegeneration and neuroinflammation may be assessed by magnetic resonance imaging (MRI) and ultrasonography (US). This review summarises the methodology for these widely available, safe and relatively low cost tools and analyses recent work highlighting their potential utility as biomarkers for differentiating subtypes of cognitive impairment and dementia, tracking disease progression and evaluating response to treatment in various neurocognitive disorders. Methods: At the 9th International Congress on Vascular Dementia (Ljubljana, Slovenia, October 2015) a writing group of experts was formed to review the evidence on the utility of US and arterial spin labelling (ASL) as neurophysiological markers of normal ageing, vascular cognitive impairment (VCI) and Alzheimer's disease (AD). Original articles, systematic literature reviews, guidelines and expert opinions published until September 2016 were critically analysed to summarise existing evidence, indicate gaps in current knowledge and, when appropriate, suggest standards of use for the most widely used US and ASL applications. Results: Cerebral hypoperfusion has been linked to cognitive decline either as a risk or an aggravating factor. Hypoperfusion as a consequence of microangiopathy, macroangiopathy or cardiac dysfunction can promote or accelerate neurodegeneration, blood-brain barrier disruption and neuroinflammation. US can evaluate the cerebrovascular tree for pathological structure and functional changes contributing to cerebral hypoperfusion. Microvascular pathology and hypoperfusion at the level of capillaries and small arterioles can also be assessed by ASL, an MRI signal. Despite increasing evidence supporting the utility of these methods in detection of microvascular pathology, cerebral hypoperfusion, neurovascular unit dysfunction and, most importantly, disease progression, incomplete standardisation and missing validated cut-off values limit their use in daily routine. Conclusions: US and ASL are promising tools with excellent temporal resolution, which will have a significant impact on our understanding of the vascular contributions to VCI and AD and may also be relevant for assessing future prevention and therapeutic strategies for these conditions. Our work provides recommendations regarding the use of non-invasive imaging techniques to investigate the functional consequences of vascular burden in dementia.",
keywords = "Alzheimer disease, Arterial spin labelling, Cerebral small vessel disease, Transcranial Doppler sonography, Ultrasonography, Vascular cognitive impairment, Vascular dementia",
author = "Branko Malojcic and Panteleimon Giannakopoulos and Sorond, {Farzaneh A.} and Elsa Azevedo and Marina Diomedi and Oblak, {Janja Pretnar} and Nicola Carraro and Marina Boban and Laszlo Olah and Schreiber, {Stephan J.} and Aleksandra Pavlovic and Zsolt Garami and Bornstein, {Nantan M.} and Bernhard Rosengarten",
year = "2017",
month = "2",
day = "9",
doi = "10.1186/s12916-017-0799-3",
language = "English (US)",
volume = "15",
journal = "BMC Medicine",
issn = "1741-7015",
publisher = "BioMed Central",
number = "1",

}

RIS

TY - JOUR

T1 - Ultrasound and dynamic functional imaging in vascular cognitive impairment and Alzheimer's disease

AU - Malojcic, Branko

AU - Giannakopoulos, Panteleimon

AU - Sorond, Farzaneh A.

AU - Azevedo, Elsa

AU - Diomedi, Marina

AU - Oblak, Janja Pretnar

AU - Carraro, Nicola

AU - Boban, Marina

AU - Olah, Laszlo

AU - Schreiber, Stephan J.

AU - Pavlovic, Aleksandra

AU - Garami, Zsolt

AU - Bornstein, Nantan M.

AU - Rosengarten, Bernhard

PY - 2017/2/9

Y1 - 2017/2/9

N2 - Background: The vascular contributions to neurodegeneration and neuroinflammation may be assessed by magnetic resonance imaging (MRI) and ultrasonography (US). This review summarises the methodology for these widely available, safe and relatively low cost tools and analyses recent work highlighting their potential utility as biomarkers for differentiating subtypes of cognitive impairment and dementia, tracking disease progression and evaluating response to treatment in various neurocognitive disorders. Methods: At the 9th International Congress on Vascular Dementia (Ljubljana, Slovenia, October 2015) a writing group of experts was formed to review the evidence on the utility of US and arterial spin labelling (ASL) as neurophysiological markers of normal ageing, vascular cognitive impairment (VCI) and Alzheimer's disease (AD). Original articles, systematic literature reviews, guidelines and expert opinions published until September 2016 were critically analysed to summarise existing evidence, indicate gaps in current knowledge and, when appropriate, suggest standards of use for the most widely used US and ASL applications. Results: Cerebral hypoperfusion has been linked to cognitive decline either as a risk or an aggravating factor. Hypoperfusion as a consequence of microangiopathy, macroangiopathy or cardiac dysfunction can promote or accelerate neurodegeneration, blood-brain barrier disruption and neuroinflammation. US can evaluate the cerebrovascular tree for pathological structure and functional changes contributing to cerebral hypoperfusion. Microvascular pathology and hypoperfusion at the level of capillaries and small arterioles can also be assessed by ASL, an MRI signal. Despite increasing evidence supporting the utility of these methods in detection of microvascular pathology, cerebral hypoperfusion, neurovascular unit dysfunction and, most importantly, disease progression, incomplete standardisation and missing validated cut-off values limit their use in daily routine. Conclusions: US and ASL are promising tools with excellent temporal resolution, which will have a significant impact on our understanding of the vascular contributions to VCI and AD and may also be relevant for assessing future prevention and therapeutic strategies for these conditions. Our work provides recommendations regarding the use of non-invasive imaging techniques to investigate the functional consequences of vascular burden in dementia.

AB - Background: The vascular contributions to neurodegeneration and neuroinflammation may be assessed by magnetic resonance imaging (MRI) and ultrasonography (US). This review summarises the methodology for these widely available, safe and relatively low cost tools and analyses recent work highlighting their potential utility as biomarkers for differentiating subtypes of cognitive impairment and dementia, tracking disease progression and evaluating response to treatment in various neurocognitive disorders. Methods: At the 9th International Congress on Vascular Dementia (Ljubljana, Slovenia, October 2015) a writing group of experts was formed to review the evidence on the utility of US and arterial spin labelling (ASL) as neurophysiological markers of normal ageing, vascular cognitive impairment (VCI) and Alzheimer's disease (AD). Original articles, systematic literature reviews, guidelines and expert opinions published until September 2016 were critically analysed to summarise existing evidence, indicate gaps in current knowledge and, when appropriate, suggest standards of use for the most widely used US and ASL applications. Results: Cerebral hypoperfusion has been linked to cognitive decline either as a risk or an aggravating factor. Hypoperfusion as a consequence of microangiopathy, macroangiopathy or cardiac dysfunction can promote or accelerate neurodegeneration, blood-brain barrier disruption and neuroinflammation. US can evaluate the cerebrovascular tree for pathological structure and functional changes contributing to cerebral hypoperfusion. Microvascular pathology and hypoperfusion at the level of capillaries and small arterioles can also be assessed by ASL, an MRI signal. Despite increasing evidence supporting the utility of these methods in detection of microvascular pathology, cerebral hypoperfusion, neurovascular unit dysfunction and, most importantly, disease progression, incomplete standardisation and missing validated cut-off values limit their use in daily routine. Conclusions: US and ASL are promising tools with excellent temporal resolution, which will have a significant impact on our understanding of the vascular contributions to VCI and AD and may also be relevant for assessing future prevention and therapeutic strategies for these conditions. Our work provides recommendations regarding the use of non-invasive imaging techniques to investigate the functional consequences of vascular burden in dementia.

KW - Alzheimer disease

KW - Arterial spin labelling

KW - Cerebral small vessel disease

KW - Transcranial Doppler sonography

KW - Ultrasonography

KW - Vascular cognitive impairment

KW - Vascular dementia

UR - http://www.scopus.com/inward/record.url?scp=85012072470&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85012072470&partnerID=8YFLogxK

U2 - 10.1186/s12916-017-0799-3

DO - 10.1186/s12916-017-0799-3

M3 - Review article

VL - 15

JO - BMC Medicine

T2 - BMC Medicine

JF - BMC Medicine

SN - 1741-7015

IS - 1

M1 - 27

ER -

ID: 38748795