In Alzheimer’s disease, it has long been suspected that changes in the blood flow in the brain over time play a role in the course of the disease. A number of studies have been carried out worldwide that do not unequivocally demonstrate this. These studies were relatively small and may therefore lack statistical power. After all, the more data you collect, the stronger the statistic. Researchers at Radboudumc have therefore combined five comparable studies and analyzed this larger combined dataset.
Zoom in
“In our analysis, we now see a clear link between the decrease in brain blood flow and the decline in brain functions,” says PhD student Ralf Weijs. “In healthy people, the blood flow declines as we age, about 0.1 to 0.5 percent per year. However, in patients with Alzheimer’s we see a three to ten times greater decrease. In addition, memory tests show that there is a link with the decline in cognitive functions.”
Incidentally, not all areas in the brain show the same decrease in blood flow. “The decrease over the entire brain is not that great, which is why it was missed in previous individual studies,” explains Weijs. “But if we zoom in, we see that in some brain areas the blood flow does not or hardly decrease, and in other areas it clearly decreases. This suggests that the decrease in brain blood flow, seen across the brain, is the result of decreases in blood flow in certain areas. smaller brain regions, which are generally structures associated with memory and task performance, which have been linked to Alzheimer’s in previous studies.”
The chicken or the egg?
Now an important question that many Alzheimer’s researchers have been wrestling with for a long time is: does the impaired blood flow first arise and does that cause brain damage and thus Alzheimer’s? Or does the brain damage occur first and does that have a negative effect on blood flow? “This is kind of like, what came first, the chicken or the egg?” says Dick Thijssen, professor of Cardiovascular Physiology. “We are not yet sure, but our study does provide new insights.”
The researchers rule out that the decrease in blood flow is a general process, which is present in everyone to the same extent. They therefore think that the brain damage occurs first, for example due to the protein accumulation in brain cells that is typical for Alzheimer’s. This damage then leads to a decrease in blood flow. Thijssen: “If it was initially due to the blood flow, you would expect much more of the same reduction in blood supply in all brain areas, but we do not see that. The decrease is especially visible in the brain regions that are involved in Alzheimer’s.”
little movement
Clinical geriatrician Jurgen Claassen adds: “The key question remains: is the reduced blood flow a logical consequence of less demand from the damaged brain tissue? Or are the brain vessels damaged in the areas where the brain damage is active, and the blood flow in those areas decreases as a result. More and more? For the latter, more and more clues have been coming lately.”
The reduced cerebral blood flow in Alzheimer’s provides new leads for treatment. Thijssen: “We know that lifestyle factors have a major influence on the health of our blood vessels. For example, smoking, high blood pressure and little exercise have a negative effect. These are also known risk factors for Alzheimer’s. I don’t think we can prevent the disease, But we will investigate whether, for example, exercise can improve blood flow and thus slow down the disease.”
By: National Care Guide
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