Increased pulsatility indices in the circle of Willis were significantly associated with the presence of Alzheimer's disease (OR ranging from 1.8 to 48; p<0.005).
Case-Control (n=55)
Are pulsatility indices and mean flow velocities measured by transcranial Doppler ultrasonography altered in patients with Alzheimer's disease compared to non-demented elderly subjects?
Higher pulsatility indices in the circle of Willis are strongly associated with Alzheimer's disease, suggesting intracranial atherosclerosis may be a risk factor for neurodegeneration.
Effect estimate: OR 1.8 to 48
p-value: p=<0.005
OBJECTIVE: Recent post-mortem studies have reported that the severity of atheromatous deposits in the circle of Willis is significantly greater, relative to non-demented (ND) elderly persons, in subjects with neuropathologically diagnosed Alzheimer's disease (AD). Additionally, the severity of intracranial atherosclerosis correlates significantly with the densities of neuritic plaques and neurofibrillary tangles. In this study, we examine the arteries of the circle of Willis by transcranial Doppler (TCD) ultrasonography. METHODS: TCD was used to measure, in 25 AD patients and 30 ND elderly subjects, mean flow velocities and pulsatility indices in 16 different segments of the circle of Willis. The data were compared with and without adjustment for age, gender and systolic blood pressure. RESULTS: The AD patients had systematically higher pulsatility indices (p<0.005) than the ND group. Incremental increases of pulsatility indices in these segments had odds ratios ranging from 1.8 to 48 for the presence of AD when adjusted for age, gender and systolic blood pressure. The left internal carotid artery siphon and the left posterior cerebral artery were the two vessels that were strongly associated with AD diagnosis. Mean flow velocities were generally lower in patients with AD but the differences did not reach the significance level. DISCUSSION: The pulsatility indices of the arteries of AD patients were generally greater than those of similarly-aged ND subjects. This difference is most likely due to increased arterial wall rigidity imposed by atherosclerotic changes. Atherosclerotic disease of intracranial arteries may be a risk factor for AD.
Roher et al. (Thu,) conducted a case-control in Alzheimer's disease (n=55). Increased pulsatility indices in the circle of Willis vs. Lower pulsatility indices was evaluated on Presence of Alzheimer's disease (OR 1.8 to 48, p=<0.005). Increased pulsatility indices in the circle of Willis were significantly associated with the presence of Alzheimer's disease (OR ranging from 1.8 to 48; p<0.005).
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