Cascade of Perfusion and Brain Atrophy in Alzheimer’s Disease: A Longitudinal Study

We conducted a longitudinal study to determine if reduced temporoparietal and frontal cerebral blood flow (CBF) in elderly population leads to reduced gray matter volumes (GMVs) in the temporal lobe, or vice versa. We observed smaller GMVs in the temporal pole (TP) region in Alzheimer’s disease (AD) patients. We also found associations of: (1) the TP GMVs with subsequent temporoparietal CBF declines; (2) the TP CBF with its own subsequent GMV changes; and (3) the hippocampal GMVs with longitudinal frontal CBF declines. Hypoperfusion in the temporal lobe may be an early event driving atrophy, followed by temporoparietal and frontal hypoperfusion.