Sven Haller MD, MSc, Presenter: Nothing to Disclose

Aikaterini XEKARDAKI, Abstract Co-Author: Nothing to Disclose

Cristelle RODRIGUEZ, Abstract Co-Author: Nothing to Disclose

Marie-Louise MONTANDON, Abstract Co-Author: Nothing to Disclose

Simona TOMA, Abstract Co-Author: Nothing to Disclose

Eline TOMBEUR, Abstract Co-Author: Nothing to Disclose

Francois Herrmann, Abstract Co-Author: Nothing to Disclose

Dina ZEKRY, Abstract Co-Author: Nothing to Disclose

Frederik Barkhof MD, PhD, Abstract Co-Author: Consultant, Biogen Idec Inc Consultant, Bayer AG Consultant, Merck KGaA Consultant, F. Hoffmann-La Roche Ltd Consultant, Novartis AG Consultant, Sanofi-aventis Group Consultant, General Electric Company Consultant, Teva Pharmaceutical Industries Ltd

Panteleimon Giannakopoulos, Abstract Co-Author: Nothing to Disclose

Karl-Olof Lovblad, Abstract Co-Author: Nothing to Disclose

To explore whether arterial spin labeling (ASL) imaging in cognitively intact elderly individuals may predict subsequent early neuropsychological decline.

The local ethics committee approved this prospective study and written informed consent was obtained from all participants. We included 148 consecutive controls, 75 of whom remained stable (sCON, mean age 75.9 ± 3.4 years, 43 females), and 73 who deteriorated cognitively at 18 months clinical follow-up (dCON, 76.8 ± 4.1 years, 44 females) and 65 mild cognitive impairment (MCI, 76.2 ± 6.1 years, 25 females). 2-D pulsed ASL was performed at baseline visit. Image analysis included voxel-wise analysis of the ASL relative cerebral blood flow (relCBF) data and receiver operator characteristics (ROC) analysis.

The voxel-wise comparison of ASL revealed decreased relCBF in dCON compared to sCON notably in the posterior cingulate cortex (PCC). MCI versus sCON revealed slightly more extensive decreased relCBF in PCC as well, while the comparison of dCON versus MCI revealed no significant differences. ROC analysis of the relCBF in the PCC discriminated dCON (p<0.001, area under curve AUC 0.66) and MCI (p<0.0001, AUC 0.71) from sCON.

Reduced ASL in PCC at baseline is associated with the development of subsequent subtle neuropsychological deficits in healthy elderly controls. At a group level, dCON display similar ASL patterns than MCI at baseline indicating that these cases may initially maintain their cognitive status via the mobilization of their neurocognitive reserve at baseline, yet are prone to develop subsequent subtle cognitive deficits.

Deteriorating controls and MCI have similar ASL patterns indicating that deteriorating controls already have perfusion alterations at baseline imaging despite apparent normal cognition, due to mobilization of the neurocognitive reserve. The cut-off value of 58.5 ml/100g/min in the posterior cingulate may predict subsequent very early cognitive with a sensitivity of 58.9 % and a specificity of 65.3 %.

Haller, S, XEKARDAKI, A, RODRIGUEZ, C, MONTANDON, M, TOMA, S, TOMBEUR, E, Herrmann, F, ZEKRY, D, Barkhof, F, Giannakopoulos, P, Lovblad, K, ASL Predicts Cognitive Deterioration in Healthy Elderly Individuals.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14005596.html