Cerebrovascular Hemodynamics in Cognitive Impairment and Dementia: A Systematic Review and Meta-Analysis of Transcranial Doppler Studies.

IF 2.2 4区医学 Q3 CLINICAL NEUROLOGY Dementia and Geriatric Cognitive Disorders Pub Date : 2023-01-01 Epub Date: 2023-11-26 DOI:10.1159/000535422

David Fresnais, Håkon Ihle-Hansen, Erik Lundström, Åsa G Andersson, Brynjar Fure

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Abstract

Introduction: Transcranial Doppler (TCD) sonography is a noninvasive tool for measuring cerebrovascular hemodynamics. Studies have reported alterations in cerebrovascular hemodynamics in normal aging, mild cognitive impairment (MCI), and dementia, as well as in different etiologies of dementia. This systematic review and meta-analysis was designed to investigate the relationship between cerebral blood velocity (CBv) and pulsatility index (PI) in the middle cerebral artery (MCA) in persons with MCI and dementia.

Methods: A systematic literature search was conducted in Pubmed, Embase, Cochrane Library, Epistemonikos, PsychINFO, and CINAHL. The search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. After screening of 33,439 articles, 86 were reviewed in full-text, and 35 fulfilled the inclusion criteria.

Results: CBv was significantly lower and PI significantly higher in MCA in vascular dementia (VaD) and Alzheimer's disease (AD) compared to cognitively normal (CN) older persons. Also, CBv was lower in MCI compared to CN. There were no significant differences in CBv in MCA in AD compared with VaD, although PI was higher in VaD compared to AD.

Conclusion: Alterations in cerebrovascular hemodynamics are seen in AD, VaD, and MCI. While PI was slightly higher in VaD compared to AD, the reduction in CBv appears to be equally pronounced across neurodegenerative and vascular etiologies of dementia.

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认知障碍和痴呆的脑血管血流动力学:经颅多普勒研究的系统回顾和荟萃分析。

简介:经颅多普勒超声(TCD)是一种测量脑血管血流动力学的无创工具。研究报道了正常衰老、轻度认知障碍(MCI)和痴呆以及不同病因的痴呆患者脑血管血流动力学的改变。本系统综述和荟萃分析旨在探讨MCI和痴呆患者大脑中动脉(MCA)的脑血流速度(CBv)和脉搏指数(PI)之间的关系。方法:系统检索Pubmed、Embase、Cochrane Library、Epistemonikos、PsychINFO和CINAHL的文献。根据系统评价和荟萃分析指南的首选报告项目进行搜索。筛选33439篇文献，86篇纳入全文，35篇符合纳入标准。结果:与认知正常(CN)的老年人相比，血管性痴呆(VaD)和阿尔茨海默病(AD)的MCA CBv显著降低，PI显著升高。此外，MCI患者的CBv较CN患者低。与VaD患者相比，AD患者MCA的CBv无显著差异，但VaD患者PI高于AD患者。结论:AD、VaD和MCI均存在脑血管血流动力学改变。虽然VaD的PI略高于AD，但CBv的降低似乎在痴呆的神经退行性和血管病因中同样明显。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Dementia and Geriatric Cognitive Disorders 医学-精神病学

CiteScore

4.70

自引率

0.00%

发文量

审稿时长

2 months

期刊介绍： As a unique forum devoted exclusively to the study of cognitive dysfunction, ''Dementia and Geriatric Cognitive Disorders'' concentrates on Alzheimer’s and Parkinson’s disease, Huntington’s chorea and other neurodegenerative diseases. The journal draws from diverse related research disciplines such as psychogeriatrics, neuropsychology, clinical neurology, morphology, physiology, genetic molecular biology, pathology, biochemistry, immunology, pharmacology and pharmaceutics. Strong emphasis is placed on the publication of research findings from animal studies which are complemented by clinical and therapeutic experience to give an overall appreciation of the field.