Carotid doppler ultrasound modifications in alzheimer disease

Abstract

Objective:

Triplex ultrasound evaluation of CCA in Alzheimer.

Methods and results:

Our study group, consisted of 52 patients (32 male, mean age 68.2+/-2.2 yr), confirmed with Alzheimer dementia (AD) according to DSM IV-R criteria, was evaluated by triplex ultrasonography at the common carotid arteries (CCA) level and, also, by a cerebral CT-scann. The results were compared with a controlled matched group of similar age. In the AD group, 62.2% of patients presented ultrasonographic modifications: a larger CCA diameter (8.2+/-0.6 mm) and an increased arterial impedance (RI 0.82+/-0.05), significantly higher (p<0.001) compared with the values obtained from the controlled group (D 7.2+/-0.5 mm; RI 0.76+/- 0.02). Also, IMTh was more echogenous, diffuse or patchy thickened, with a mean maxIMTh 1.6 +/-0.02 mm in AD group, compared with 0.8+/-0.02 mm in the controlled group. We underline the absence of arterial atherosclerotic plaques in the all length of CCAs in AD group. The augmentation of arterial impedance correlated with the presence of cortical atrophy releved by cerebral CT-scann. In the AD group with these ultrasonographic aspects, we recommended vasodilatator drugs in association with cholinomimetics.

Conclusion:

The vascular modifications (increased resistivity and decreased regional cerebral blood flow) in AD, draw attention on the early Doppler evaluation of these cathegory of patients. The ultrasonografic CCAs modifications, even in the stage of minimal cognitive deficit (when the criteria for establishing the diagnosis of dementia are not fulfilled), represent a factor of therapeutic indication for cholinomimetics, with a possible influence in the clinical and mental disease prognosis.