Test–retest reliability of arterial spin labelling for cerebral blood flow in older adults with small vessel disease
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Cerebral small vessel disease (SVD) is common in older people and is associated with lacunar stroke, white matter hyperintensities (WMH) and vascular cognitive impairment. Cerebral blood flow (CBF) is reduced in SVD, particularly within white matter. Here we quantified test–retest reliability in CBF measurements using pseudo-continuous arterial spin labelling (pCASL) in older adults with clinical and radiological evidence of SVD (N=54, mean (SD): 66.9 (8.7) years, 15 females/39 males). We generated whole-brain CBF maps on two visits at least 7 days apart (mean (SD): 20 (19), range 7-117 days). Test–retest reliability for CBF was high in all tissue types, with intra-class correlation coefficient [95%CI]: 0.758 [0.616, 0.852] for whole brain, 0.842 [0.743, 0.905] for total grey matter, 0.771 [0.636, 0.861] for deep grey matter (caudate-putamen and thalamus), 0.872 [0.790, 0.923] for normal-appearing white matter (NAWM) and 0.780 [0.650, 0.866] for WMH (all p<0.001). ANCOVA models indicated significant decline in CBF in total grey matter, deep grey matter and NAWM with increasing age and diastolic blood pressure (all p<0.001). CBF was lower in males relative to females (p=0.013 for total grey matter, p=0.004 for NAWM). We conclude that pCASL has high test–retest reliability as a quantitative measure of CBF in older adults with SVD. These findings support the use of pCASL in routine clinical imaging and as a clinical trial endpoint. All data come from the PASTIS trial, prospectively registered at: https://eudract.ema.europa.eu (2015-001235-20, registered 13/05/2015), http://www.clinicaltrials.gov (NCT02450253, registered 21/05/2015).
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Translational Stroke Research |
| Vol/bind | 13 |
| Udgave nummer | 4 |
| Sider (fra-til) | 583-594 |
| Antal sider | 12 |
| ISSN | 1868-4483 |
| DOI | |
| Status | Udgivet - 2022 |
Bibliografisk note
Funding Information:
We are very grateful to our colleagues in the Department of Neuroradiology, St George’s Hospital, the St George’s Stroke service, the South London CRN Stroke Research Network and St George’s Clinical Research Facility. We thank Dr Robin Young of the Robertson Centre for Biostatistics, University of Glasgow, for helpful comments on statistics. We dedicate this paper to our friend and colleague Debbie Rolfe (1967-2019).
Funding Information:
LRB and MMHP were employed as part of the PASTIS trial, JDI was Principal Investigator, and AHH was Chief Investigator. CK is a PI on clinical trials with Bristol-Myers-Squibb and Bayer and has received funding from Novo Nordisk, Bayer and Bristol-Myers-Squibb, all not relevant to the present trial. JDI has been a PI on clinical trials funded by Roche, Merck and Lupin Pharmaceuticals and has received funds from Biogen and Roche, none relevant to the present trial. AHH has received honoraria from Eli-Lilly and from NIA, he chairs the Vascular Cognitive Disorders PIA within ISTAART, and he leads MRC-Dementias Platform UK Vascular Experimental Medicine group. All other authors report no relevant disclosures.
Funding Information:
The PASTIS trial was joint-funded by UK Alzheimer’s Society and Alzheimer’s Drug Discovery Foundation (Grant Ref. 20140901). The funding sources had no involvement in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. The sponsor was St George’s University of London (contact: sponsor@sgul.ac.uk). Mr Anan Shtaya was supported by a NIHR Clinical Lectureship [CL-2015-16-001].
Publisher Copyright:
© 2021, The Author(s).
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