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Cerebral Vascular Reserve in Small Vessel Disease and Alzheimers Disease

Conditions
Dementia, Vascular
Alzheimer Disease
Interventions
Diagnostic Test: Cerebral [15O]H2O PET before and after diamox infusion
Registration Number
NCT05443308
Lead Sponsor
Bispebjerg Hospital
Brief Summary

Alzheimers disease and cerebral small vessel disease have a considerably overlap in patients and have common risk factors. The diseases are difficult to separate in individual patients and we hypothesize that a reduced cerebral vascular reserve may be a measurement of small vessel disease independent of Alzheimers disease.

Patients with presumed Alzheimers disease (n=20), cerebral small vessel disease (n=20) and healthy age-matched subjects (n=15) are examined with quantitative \[15O\]H2O positron emission tomography (PET) for measurements of brain perfusion before and after diamox infusion that dilates cerebral vessels. Additional \[15O\]H2O PET scans of the heart allows for a non-invasive input function so the cerebral vascular reserve can be measured quantitatively.

Detailed Description

Alzheimers disease and cerebral small vessel disease are increasingly common in the elderly population and constitute around 90% of new dementia cases in Denmark. The diseases have a considerably overlap in patients and have common risk factors. The cause of dementia can be difficult to separate in individual patients but a reduced cerebral vascular reserve may be a measurement of small vessel disease independent of Alzheimers disease. We hypothesized that patient with small vessel disease have reduced increase in brain perfusion after medical brain vessel dilatation. While Alzheimer patients may have reduced perfusion in rest but normal increase after medical brain vessel dilatation as compared to healthy subjects.

Patients with presumed Alzheimers disease (n=20), cerebral small vessel disease (n=20) and healthy age-matched subjects (n=15) are examined with quantitative \[15O\]H2O PET for measurements of brain perfusion before and after diamox infusion that dilates cerebral vessels. Additional \[15O\]H2O PET scans of the heart allows for a non-invasive input function so the cerebral vascular reserve can be measured quantitatively.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
50
Inclusion Criteria
  • presumed Alzheimer's Disease (group 1)
  • diagnosed with small vessel disease of the brain by MRI and presumed cognitive dysfunction (group 2)
Exclusion Criteria
  • major claustrophobia
  • major psychiatric diseases
  • other major somatic diseases
  • allergy to diamox

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Small vessel diseaseCerebral [15O]H2O PET before and after diamox infusionpatients diagnosed with small vessel disease of the brain by MRI and presumed cognitive dysfunction and no other known psychiatric or other major diseases. age \> 60 years
Healthy subjectsCerebral [15O]H2O PET before and after diamox infusionAge-matched subjects with no known vascular, psychiatric or other major diseases. age \> 60 years
Alzheimer DiseaseCerebral [15O]H2O PET before and after diamox infusionpatients with presumed Alzheimer disease and no known vascular, psychiatric or other major diseases age \> 60 years
Primary Outcome Measures
NameTimeMethod
Vascular reserve perfusion20 min after diamox infusion

Brain perfusion after diamox infusion (mL / min / 100 g tissue)

Vascular reserve change20 min after diamox infusion

Change in Brain perfusion after diamox infusion (mL / min / 100 g tissue and %) compared to before diamox infusion

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Bispebjerg

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Copenhagen, Copenhagen NV, Denmark

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