Carotid Artery Ultrasound and Echocardiography Testing to Lower the Prevalence of Alzheimer's Disease

Torre, Jack C. de la

doi:10.1016/j.jstrokecerebrovasdis.2008.11.014

Cited by 33 publications

(17 citation statements)

References 115 publications

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“…Brain hypoperfusion can be triggered or complicated by cardiovascular-related diseases, including stroke, cerebral infarction, hypertension, hypotension, coronary artery disease, myocardial infarction, valvulopathy, arrhythmia, cardiomyopathy, atherosclerosis, arteriosclerosis, diabetes, obesity, and smoking 4,5,55–60. The presence of lacunar infarcts and strokes may prompt the onset of dementia or worsen the clinical course of AD,61–64 clearly demonstrating that deficiencies in cerebral blood flow are involved in the global pathogenesis of cognitive decline.…”

Section: Discussionmentioning

confidence: 99%

Cerebral blood flow in Alzheimer’s disease

Roher¹,

Debbins²,

Malek-Ahmadi³

et al. 2012

VHRM

175

127

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BackgroundAlzheimer’s disease (AD) dementia is a consequence of heterogeneous and complex interactions of age-related neurodegeneration and vascular-associated pathologies. Evidence has accumulated that there is increased atherosclerosis/arteriosclerosis of the intracranial arteries in AD and that this may be additive or synergistic with respect to the generation of hypoxia/ischemia and cognitive dysfunction. The effectiveness of pharmacologic therapies and lifestyle modification in reducing cardiovascular disease has prompted a reconsideration of the roles that cardiovascular disease and cerebrovascular function play in the pathogenesis of dementia.MethodsUsing two-dimensional phase-contrast magnetic resonance imaging, we quantified cerebral blood flow within the internal carotid, basilar, and middle cerebral arteries in a group of individuals with mild to moderate AD (n = 8) and compared the results with those from a group of age-matched nondemented control (NDC) subjects (n = 9). Clinical and psychometric testing was performed on all individuals, as well as obtaining their magnetic resonance imaging-based hippocampal volumes.ResultsOur experiments reveal that total cerebral blood flow was 20% lower in the AD group than in the NDC group, and that these values were directly correlated with pulse pressure and cognitive measures. The AD group had a significantly lower pulse pressure (mean AD 48, mean NDC 71; P = 0.0004). A significant group difference was also observed in their hippocampal volumes. Composite z-scores for clinical, psychometric, hippocampal volume, and hemodynamic data differed between the AD and NDC subjects, with values in the former being significantly lower (t = 12.00, df = 1, P = 0.001) than in the latter.ConclusionThese results indicate an association between brain hypoperfusion and the dementia of AD. Cardiovascular disease combined with brain hypoperfusion may participate in the pathogenesis/pathophysiology of neurodegenerative diseases. Future longitudinal and larger-scale confirmatory investigations measuring multidomain parameters are warranted.

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Section: Discussionmentioning

confidence: 99%

Cerebral blood flow in Alzheimer’s disease

Roher¹,

Debbins²,

Malek-Ahmadi³

et al. 2012

VHRM

175

127

View full text Add to dashboard Cite

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“…Special risk is indicated by studies associating elevated CV responses among older adults with poorer cognition (Brown et al, 2009) and greater cerebrovascular pathology (Waldstein et al, 2004). Some have even hypothesized that cerebrovascular dysfunction is directly involved in the neuropathogenesis of Alzheimer's disease pathology (de la Torre, 2005(de la Torre, , 2009(de la Torre, , 2010de la Torre and Mussivand, 1993). Insofar as elevated CV responses contribute to declines in cognition or the accumulation of neuropathology, they might hasten the progression from cognitive health to MCI and/or the progression from MCI to dementia.…”

Section: Present Researchmentioning

confidence: 99%

Difficulty, effort and cardiovascular response to a working memory challenge: Older adults with and without mild cognitive impairment

Stewart

Wright

Griffith

2016

International Journal of Psychophysiology

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“…We have previously discussed the application and benefits of CAUSE in the prevention-by-detection of severe cognitive impairment from cardiac-carotid pathology [23,24] , and for brevity's sake will only refer to this technology in a clinical flowchart ( fig. 1 ).…”

Section: Beyond the Bedsidementioning

confidence: 99%

“…For these reasons, a feasibility study such as we have proposed [23,24] , needs to be done to test the merit and practicality of CAUSE screening in cognitively intact individuals. On the other hand, if nothing is done, or if clinical trials can only repeat past clinical failures, progress in dementia research will continue at a glacial pace.…”

Section: Beyond the Bedsidementioning

confidence: 99%

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The Vascular Hypothesis of Alzheimer’s Disease: Bench to Bedside and Beyond

Torre¹

2010

Neurodegener Dis

Self Cite

141

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The vascular hypothesis of Alzheimer’s disease (AD) which we first proposed in 1993, has become a useful concept in identifying vascular risk factors for AD or vascular dementia that can be modified through appropriate treatment to prevent, reduce or delay the onset of cognitive impairment and dementia onset. Among the more than two dozen vascular risk factors already identified for AD, are cardiovascular disease and carotid artery atherosclerosis, which may exert their pathology by chronically lowering cerebral hypoperfusion during aging. We propose and plan to initiate a clinical study to screen middle-aged, cognitively intact individuals, with carotid artery ultrasound and echocardiography to identify potentially progressive pathology in the heart and carotid artery that is considered modifiable with optimal medical treatment. This clinical strategy, if found effective in preventing pathologic conditions suspected of contributing to severe cognitive impairment, could significantly reduce AD prevalence if applied on a wide scale and help promote healthier mental and physical aging while providing a compelling economic benefit to society.

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Carotid Artery Ultrasound and Echocardiography Testing to Lower the Prevalence of Alzheimer's Disease

Cited by 33 publications

References 115 publications

Cerebral blood flow in Alzheimer’s disease

Cerebral blood flow in Alzheimer’s disease

Difficulty, effort and cardiovascular response to a working memory challenge: Older adults with and without mild cognitive impairment

The Vascular Hypothesis of Alzheimer’s Disease: Bench to Bedside and Beyond

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Carotid Artery Ultrasound and Echocardiography Testing to Lower the Prevalence of Alzheimer's Disease

Cited by 33 publications

References 115 publications

Cerebral blood flow in Alzheimer&rsquo;s disease

Cerebral blood flow in Alzheimer&rsquo;s disease

Difficulty, effort and cardiovascular response to a working memory challenge: Older adults with and without mild cognitive impairment

The Vascular Hypothesis of Alzheimer’s Disease: Bench to Bedside and Beyond

Contact Info

Product

Resources

About

Cerebral blood flow in Alzheimer’s disease

Cerebral blood flow in Alzheimer’s disease