生命周期内的规范性脑灌注
Normative Cerebral Perfusion Across the Lifespan
AI总结：
本研究构建了覆盖人类整个生命周期的全面规范性脑灌注模型，利用GAMLSS绘制其非线性轨迹，量化疾病相关偏差并建立典型/非典型轨迹，为脑健康评估和疾病早期识别提供框架。
摘要：
脑灌注在维持脑功能方面起着至关重要的作用，并与神经元活动紧密耦合。尽管先前的研究已经考察了脑灌注在发育和衰老过程中的轨迹，但由于样本量小和方法学不一致，其生命周期动态的精确表征受到限制。在这项研究中，我们使用包含超过12,000次高质量动脉自旋标记（ASL）MRI扫描的大型多中心数据集，构建了首个覆盖人类整个生命周期（出生至85岁）的全面规范性脑灌注模型。利用位置、尺度和形状的广义加性模型（GAMLSS），我们绘制了脑灌注在全局、网络和区域水平的非线性生长轨迹。我们观察到出生后脑灌注迅速增加，在约7.1岁时达到峰值，随后逐渐下降至成年期。性别差异明显，表现为不同的区域成熟模式，而非所有脑区的统一差异。除了规范性建模外，我们量化了神经退行性疾病和精神疾病患者与预期脑血流量（CBF）模式的个体偏差，识别了四种脑部疾病的疾病特异性灌注异常。使用纵向数据，我们建立了典型和非典型的脑灌注轨迹，强调了基于灌注的生物标志物在检测疾病进展中的预后价值。我们的研究结果为脑灌注提供了一个稳健的规范性框架，有助于精确表征整个生命周期的脑健康，并增强临床人群中神经血管功能障碍的早期识别。
英文摘要：
Cerebral perfusion plays a crucial role in maintaining brain function and is tightly coupled with neuronal activity. While previous studies have examined cerebral perfusion trajectories across development and aging, precise characterization of its lifespan dynamics has been limited by small sample sizes and methodological inconsistencies. In this study, we construct the first comprehensive normative model of cerebral perfusion across the human lifespan (birth to 85 years) using a large multi-site dataset of over 12,000 high-quality arterial spin labeling (ASL) MRI scans. Leveraging generalized additive models for location, scale, and shape (GAMLSS), we mapped nonlinear growth trajectories of cerebral perfusion at global, network, and regional levels. We observed a rapid postnatal increase in cerebral perfusion, peaking at approximately 7.1 years, followed by a gradual decline into adulthood. Sex differences were evident, with distinct regional maturation patterns rather than uniform differences across all brain regions. Beyond normative modeling, we quantified individual deviations from expected CBF patterns in neurodegenerative and psychiatric conditions, identifying disease-specific perfusion abnormalities across four brain disorders. Using longitudinal data, we established typical and atypical cerebral perfusion trajectories, highlighting the prognostic value of perfusion-based biomarkers for detecting disease progression. Our findings provide a robust normative framework for cerebral perfusion, facilitating precise characterization of brain health across the lifespan and enhancing the early identification of neurovascular dysfunction in clinical populations.
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