Assessment of vascular stiffness in the internal carotid artery proximal to the carotid canal in Alzheimer’s disease using pulse wave velocity from low rank reconstructed 4D flow MRI

Abstract

Clinical evidence shows vascular factors may co-occur and complicate the expression of Alzheimer’s disease (AD); yet, the pathologic mechanisms and involvement of different compartments of the vascular network are not well understood. Diseases such as arteriosclerosis diminish vascular compliance and will lead to arterial stiffness, a well-established risk factor for cardiovascular morbidity. Arterial stiffness can be assessed using pulse wave velocity (PWV); however, this is usually done from carotid-to-femoral artery ratios. To probe the brain vasculature, intracranial PWV measures would be ideal. In this study, high temporal resolution 4D flow MRI was used to assess transcranial PWV in 160 subjects including AD, mild cognitive impairment (MCI), healthy controls, and healthy subjects with apolipoprotein ɛ4 positivity (APOE4+) and parental history of AD dementia (FH+). High temporal resolution imaging was achieved by high temporal binning of retrospectively gated data using a local-low rank approach. Significantly higher transcranial PWV in AD dementia and MCI subjects was found when compared to old-age-matched controls (AD vs. old-age-matched controls: P <0.001, AD vs. MCI: P = 0.029, MCI vs. old-age-matched controls P = 0.013). Furthermore, vascular changes were found in clinically healthy middle-age adults with APOE4+ and FH+ indicating significantly higher transcranial PWV compared to controls ( P <0.001).

Vasculo-Neuronal Coupling and Neurovascular Coupling at the Neurovascular Unit: Impact of Hypertension

“…In older adults, arterial stiffness is positively correlated with an increased incidence of cerebral small vessel disease (Hughes et al, 2015;Chirinos et al, 2019). Rivera-Rivera et al (2020) showed that cerebrovascular stiffness was increased in middle-aged AD patients. In this work, the authors employed high temporal resolution 4D flow magnetic resonance imaging (MRI) to assess transcranial PWV in 160 participants classified according to cognitive function.…”

Utilisation of advanced MRI techniques to understand neurovascular complications of PHACE syndrome: a case of arterial stenosis and dissection

“…By measuring the flow velocity field, 4D flow MRI allows the characterisation of haemodynamic parameters including average blood flow rates, PIs, PWV, pressure gradients, wall shear stress, vessel tracking and other parameters. 9 4D flow MRI has been used to detect alterations in intracranial blood flow in multiple types as vascular lesions including aneurysms, 20 21 dural arteriovenous fistulas, 22 vein of Galen malformations 23 and arteriovenous malformations 24 as well as more diffuse neurological disease such as Alzheimer’s disease 10 25 26 ; however, to the best of our knowledge, this is the first case of PHACE syndrome evaluated with this advanced technique. As expected, we found decreased blood flow through the stenotic left ICA and increased blood flow through the prominent left PCOMM artery.…”

“…The PI in the basilar artery was 1.03±0.09 and 1.02±0.05 in the left PCOMM artery. By estimating the temporal shift of the cardiac waveform along the arteries, PWV was quantified as previously described 10 using the relationship PWV = Δx/Δt, where Δx is the distance travelled by the pulse wave and Δt is the time of traversal. The PWV in the left cervical ICA was 2.9 m/s and 7.3 m/s in the right cervical ICA.…”

Intracranial vascular flow oscillations in Alzheimer’s disease from 4D flow MRI

“…To compare hemodynamic response between groups, mean PSD were estimated. Measurements of transcranial pulse wave velocity (PWV) were included as described previously ( Rivera-Rivera et al, 2020 ) in order to compare with LFO analysis.…”

“…Time-resolved, three-dimensional, phase contrast velocimetry measurements, well known as 4D flow MRI, can be accelerated using 3D radial sampling to enable high spatial resolution and field-of-view needed to provide whole brain coverage and the quantification of blood velocities in the brain’s feeding arteries and draining veins ( Johnson et al, 2008 , Rivera-Rivera et al, 2016 , Vikner et al, 2019 ). 4D flow MRI has also been used to probe transcranial vascular stiffness in AD subjects by means of pulse wave velocity (PWV), the gold standard non-invasive biomarker of arterial stiffness ( Laurent et al, 2006 , Rivera-Rivera et al, 2020 ). Higher PWV was measured in AD dementia clinical syndrome when compared to age-matched controls.…”