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Title: Correlation between pulsatility index (pi) in transcranial doppler (tcd) and cognitive profile of patients with alzheimer’s dementia and vascular dementia
Authors: Saraf Udit Umesh
Issue Date: Dec-2019
Publisher: SCTIMST
Abstract: The World Health Organization (WHO) predicts that by 2025, about 3/4th of the estimated 1.2 billion people aged >60 years will reside in developing countries1 . 4.6 million new cases of dementia are added every year, and the highest rate of growth is expected in South Asian countries including India. Education attainment is known to protect against dementia. Diet and lifestyle can also influence risk of dementia, and studies suggest that disorders affecting the vascular system, such as hypertension, diabetes mellitus and obesity, increase the risk for dementia, including Alzheimer's disease (AD). There is increasing evidence linking cerebral hypoperfusion and neurodegeneration, specifically in Alzheimer’s disease (AD) and vascular dementia (VaD)2 . In the Rotterdam study3 , cerebral hypoperfusion was demonstrated to be a risk or an aggravating factor in dementia. Hypoperfusion because of microangiopathy, macroangiopathy or cardiac dysfunction can promote or accelerate neurodegeneration, blood-brain barrier disruption and neuroinflammation.4 Diagnostic tools that can provide real-time functional assessment of the cerebrovascular tree can have a significant impact on our understanding of the vascular contribution to neurodegeneration at different stages of cognitive decline. Ultrasound can evaluate the cerebrovascular tree for pathological structure and functional changes contributing to cerebral hypoperfusion. Studies have shown an association between leukoaraiosis and transcranial doppler (TCD) pulsatility index (PI) in several kinds of patients.5 Despite increasing evidence supporting the utility of these methods in detection of microvascular pathology, cerebral hypoperfusion, neurovascular unit dysfunction and disease progression, non-availability for routine use and incomplete standardisation limit their use in daily routine. Studies have evaluated the utility of Middle cerebral artery-Pulsatility index (MCA PI) to differentiate between AD and VaD and have found conflicting results.6 PI has been correlated with severity of cognitive decline in few studies. Studies have also evaluated correlation of PI with decline in cognition. However, correlation of PI with detailed cognitive profile has not been evaluated. In this background, we planned our study to assess whether MCA PI can be used to differentiate between patients with AD and VaD. Also, we propose that increase in PI correlates with severity of cognitive deficit in patients with dementia.
Appears in Collections:Neurology

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