Cerebral Blood Flow in White Matter Is Correlated with Systolic Blood Pressure and EEG in Senile Dementia of the Alzheimer Type

Abstract

The presence and functional significance of white matter lesions in the ageing brain and in dementia as well as their relation to blood pressure are often discussed. The aim of this study was to evaluate cerebral blood flow in white matter (WMCBF) and its relation to systemic blood pressure and multichannel EEG. WMCBF was measured in 24 elderly women with senile dementia of Alzheimer’s type (SDAT, median age 85.5, range 68–93) and 20 age-matched controls (median age 86.0, range 79–93) using ^99mTc-HMPAO single photon emission CT. A significant low WMCBF could be observed in all analysed regions in SDAT subjects compared to controls, with the greatest decline in the posterior region (parietotemporo-occipital area). Correlations between quantified EEG from the posterior regions and WMCBF were seen. Systolic blood pressure was significantly lower in the SDAT group and was positively correlated with WMCBF in the posterior and anterior brain regions. Whether low systemic blood pressure is the result of cerebral dysfunction is unclear.

Effect of White Matter Lesions on Brain Perfusion in Alzheimer’s Disease

“…On the other hand, another study using xenon-enhanced CT reported no significant correlation between rCBF and WMLs [30]. Moreover, some previous SPECT studies in AD patients have failed to find a relation between the presence of WMLs and regional or global CBF [14,15], whereas other studies showed a correlation between WMLs and hypoperfusion in the cerebral white matter or hippocampal regions [16,17]. Our results showed decreased rCBF associated with the limbic system.…”

Hypertension in patients with Alzheimer's disease—prevalence, characteristics, and impact on clinical outcome. Experience of one neurology center in Poland

“…The results of several studies are consistent, finding a relationship between low BP and low MMSE scores, indicating that lower BP predicts reduced neuropsychological functioning [16][17][18][19][20][21][22][23][24][25][26][27][28].…”

Impact of the Type and Severity of Dementia on Hospitalization and Survival of the Elderly

“…In our study, an increased use of neuroradiological examinations in the hospital might have favored a diagnosis of VaD. On the other hand, it is plausible that AD cases are representative of 'pure' forms, and that the coexistence of white matter lacunes was considered as the expression of vascular lesions [49,53,54]. Yet, the correlation between white matter lesions and cognitive tests or SPECT abnormalities remains equivocal among AD patients [55].…”