The utility of arterial spin labeling MRI in medial temporal lobe as a vascular biomarker in Alzheimer’s disease spectrum: A systematic review and meta-analysis

Efthymia Maria Kapasouri, Diomidis C. Ioannidis, Donnie Cameron, Vassilios S. Vassiliou, Michael Hornberger

Research output: Contribution to journalReview articlepeer-review

3 Citations (Scopus)


We sought to systematically review and meta-analy the role of cerebral blood flow (CBF) in the medial temporal lobe (MTL) using arterial spin labeling magnetic resonance imaging (ASL-MRI) and compare this in patients with Alzheimer’s disease (AD), individuals with mild cognitive impairment (MCI), and cognitively normal adults (CN). The prevalence of AD is increasing and leading to high healthcare costs. A potential biomarker that can identify people at risk of developing AD, whilst cognition is normal or only mildly affected, will enable risk-stratification and potential therapeutic interventions in the future. All studies investigated the role of CBF in the MTL and compared this among AD, MCI, and CN participants. A total of 26 studies were included in the systematic review and 11 in the meta-analysis. Three separate meta-analyses were conducted. Four studies compared CBF in the hippocampus of AD compared with the CN group and showed that AD participants had 2.8 mL/min/100 g lower perfusion compared with the CN group. Eight studies compared perfusion in the hippocampus of MCI vs. CN group, which showed no difference. Three studies compared perfusion in the MTL of MCI vs. CN participants and showed no statistically significant differences. CBF measured via ASL-MRI showed impairment in AD compared with the CN group in subregions of the MTL. CBF difference was significant in hippocampus between the AD and CN groups. However, MCI and CN group showed no significant difference in subregions of MTL.

Original languageEnglish
Article number2967
Issue number12
Publication statusPublished - 27 Nov 2022


  • arterial spin labeling
  • ASL
  • cerebral blood flow
  • dementia
  • medial temporal lobe
  • mild cognitive decline
  • MRI

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