AUTHOR=Neumann Katja , Günther Matthias , Düzel Emrah , Schreiber Stefanie 

TITLE=Microvascular Impairment in Patients With Cerebral Small Vessel Disease Assessed With Arterial Spin Labeling Magnetic Resonance Imaging: A Pilot Study

JOURNAL=Frontiers in Aging Neuroscience

VOLUME=Volume 14 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2022.871612

DOI=10.3389/fnagi.2022.871612

ISSN=1663-4365

ABSTRACT=In this pilot study we investigated microvascular impairment in cerebral small vessel disease (CSVD) patients using non-invasive arterial spin labeling (ASL) magnetic resonance imaging (MRI). This method enabled us to measure the perfusion parameters cerebral blood flow (CBF) and arterial transit time (ATT), and the effective T1-relaxation time (T1eff) to research a novel approach of assessing perivascular clearance. CSVD severity was characterized using the Standards for Reporting Vascular Changes on Neuroimaging (STRIVE) and included a rating of white matter hyperintensities (WMH), lacunes, enlarged perivascular spaces (EPVS) and cerebral microbleeds (CMB). Here we found, that CBF decreases and ATT increases with increasing CSVD severity in patients, most prominent for a white matter (WM) region-of-interest, whereas this relation was almost equally driven by WMH, lacunes, EPVS and CMB. Additionally, we observed a longer mean T1eff of grey matter and WM in CSVD patients compared to elderly controls, providing an indication of impaired clearance in patients. Mainly T1eff of WM was associated to CSVD burden, whereas lobar lacunes and CMB contributed primary to this relation compared to EPVS of the centrum semiovale.
Our results complement previous findings of CSVD related hypoperfusion by the observation of retarded arterial blood arrival times in brain tissue, and by an increased T1eff as potential indication of impaired clearance rates using ASL.