Altered Cerebral Blood Flow in Alzheimer's Disease With Depression

Runzhi Li; Yanling Zhang; Zhizheng Zhuo; Yanli Wang; Ziyan Jia; Mengfan Sun; Yuan Zhang; Wenyi Li; Yunyun Duan; Zeshan Yao; Haoyi Weng; Juan Wei; Yaou Liu; Jun Xu

doi:10.3389/fpsyt.2021.687739

Altered Cerebral Blood Flow in Alzheimer's Disease With Depression

Front Psychiatry. 2021 Jul 8:12:687739. doi: 10.3389/fpsyt.2021.687739. eCollection 2021.

Authors

Runzhi Li^{1

2}, Yanling Zhang², Zhizheng Zhuo², Yanli Wang¹, Ziyan Jia¹, Mengfan Sun¹, Yuan Zhang¹, Wenyi Li¹, Yunyun Duan², Zeshan Yao³, Haoyi Weng⁴, Juan Wei⁵, Yaou Liu², Jun Xu^{1

6}

Affiliations

¹ Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
² Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
³ AnImage Technology (Beijing) Co., Ltd., Beijing, China.
⁴ Bioinformatics Department, Shenzhen WeGene Clinical Laboratory, Shenzhen, China.
⁵ GE Healthcare, MR Research China, Beijing, China.
⁶ Department of Cognitive Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Abstract

Background: Depression is common in Alzheimer's disease (AD) with an unclear neural mechanism. This study aimed to investigate the underlying cerebral perfusion associated with depression in AD and evaluate its clinical significance. Method: Twenty-one AD patients and 21 healthy controls (HCs) were enrolled in this study. The depressive symptom was defined according to the Hamilton Depression Rating Scale (HAMD). Nine patients were diagnosed as AD with depression symptoms (HAMD >7). Three-dimensional pseudocontinuous arterial spin labeling MR imaging was conducted to measure regional cerebral blood flow (CBF). Neuropsychological tests covered cognition and depressive scores. Between-group comparisons on clinical variables and regional CBFs, relationship between regional CBF and depressive score, and identification of AD patients with depression were performed using covariance analysis, linear regression, and receiver operating characteristic (ROC) analysis, respectively. Results: Compared with HCs, AD patients without depression exhibited lower gray matter CBF (p = 0.016); compared with AD patients without depression, AD patients with depression had higher CBF in the right supplementary motor area (39.23 vs. 47.91 ml/100 g/min, p = 0.017) and right supramarginal gyrus (35.54 vs. 43.85 ml/100 g/min, p = 0.034). CBF in the right supplementary motor area was correlated with depressive score (β = 0.46, p = 0.025). The combination of CBF in the right supplementary motor area and supramarginal gyrus and age could identify AD patients with depression from those without depression with a specificity of 100%, sensitivity of 66.67%, accuracy of 85.71%, and area under the curve of 0.87. Conclusions: Our findings suggested that hyperperfusion of the right supplementary motor area and right supramarginal gyrus were associated with depression syndrome in AD, which could provide a potential neuroimaging marker to evaluate the depression state in AD.

Keywords: Alzheimer's disease; arterial spin label; cerebral blood blow; depressive symptom; neuroimaging marker.