Objective: To understand perfusion changes in patients with Parkinson’s disease (PD) with well-characterized mild cognitive impairment (MCI) using 3D multi-delay pseudo-continuous Arterial Spin Labeling (pCASL) MRI.

Background: About 50-80% of patients with PD will develop dementia (PDD) within 10 years of diagnosis. PD-MCI is a well-recognized non-motor manifestation that has been thought to be a strong predictor of PDD. Several attempts have been made to understand cerebral blood flow (CBF) changes in early-stage PD, and also to understand regions of interest (ROI) based CBF changes in PD-MCI using a 3D multi-delay pCASL sequence on a 1.5T MRI. However, whether a similar sequence can provide increased sensitivity and specificity to understand changes in whole-brain CBF in PD-MCI patients is currently unknown. We hypothesize that in addition to previously identified ROIs such as the caudate nucleus and frontoparietal regions, we will also identify CBF changes in the cerebellum and thalamic regions which can be explained by lower Arterial Transit Time (ATT) in PD-MCI patients.

Method: Ten patients with PD-MCI, 4 cognitively normal patients with PD, and 15 healthy controls (HC) were recruited at our center. 3D pCASL MRI was acquired on a 3T Skyra scanner with the following parameters: spatial resolution = 3.5mm³ isotropic, TR/TE = 4130/39 msec, labeling duration = 1800 msec, multiple post labeling delays (PLD) = [500, 1000, 1500, 2000, 2500] msec. CBF maps were generated from the pCASL MRI images using Johns Hopkins University’s cloud-based ASL analysis software, ASL-MRICloud https://braingps.mricloud.org/asl).

Results: Our pilot analysis revealed that HC has significantly (threshold corrected) higher arterial transit time (ATT) and lower relative CBF (rCBF) in the cerebellum compared to PD-MCI. Furthermore, rCBF was higher in HC as compared to PD-MCI in the frontal and parietal regions but there was no significant difference in ATT in those regions.

Conclusion: Our pilot analysis confirmed that CBF and ATT are affected in the PD-MCI, and in addition to frontoparietal regions, CBF and ATT are also affected in cerebellar regions. Future analysis of understanding the correlation with neuropsychological scores is currently underway.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/3d-multi-delay-pcasl-to-understand-perfusion-changes-in-patients-with-parkinsons-disease-with-mild-cognitive-impairment/