Abstract #1107

Identifying Cerebrovascular Versus Parenchymal Disease Components in Dementia with Rest-Stress CASL MRI

Georg Deutsch¹, David G. Clark², Amol Pednekar³, Beverly Corbitt¹, Jan den Hollander⁴

¹Radiology, University of Alabama at Birmingham, Birmingham, AL, USA; ²Neurology, University of Alabama at Birmingham, Birmingham, AL, USA; ³Philips Medical Systems NA, Bothell, WA, USA; ⁴Vascular Cardiology, University of Alabama at Birmngham, Birmingham, AL, USA

The role of vascular disease in dementia, including in patients diagnosed with Alzheimers disease (AD), has become more controversial lately, with growing evidence that vascular disease is present among many subjects with pathologically proved AD. Some new models propose that subclinical vascular disease may provide an environment conducive to AD or that there may even be a more causal relationship. We have shown that regions of reduced metabolic activity show more substantial increases in rCBF during CO2 or Diamox stress compared to healthy tissue. We now provide preliminary data using CASL MRI based measurement of quantitative rCBF on 7 dementia cases, that cerebrovascular stress procedures can help confirm the diagnosis of a primary degenerative dementia and help discriminate between vascular disease and primary degenerative processes through an almost paradoxical effect on cerebrovascular reactivity.