Cerebral autoregulation in AD and MCI Patients and methods In this study 17 AD patients, 19 MCI patients and 20 matched healthy controls subjects (C) were investigated. The groups were matched for age, sex and level of education. Patients with AD and MCI were selected from the Memory Clinic of the Maastricht University Medical Centre (MUMC). Control subjects were recruited from an existing cohort of elderly and through colleagues and personal acquaintances. The Institutional Review Board of the MUMC approved the study and all subjects gave written informed consent. AD patients were diagnosed according to the DSM-IV criteria for dementia 1, and NINCDS-ADRDA criteria 13. Nineteen MCI patients were included. Six- teen of these subjects (84%) fulfilled the MCI criteria of Petersenet al 17, defined as a subjective cognitive complaint, objectified by an impaired cognitive per- formance; no significant impairments in daily living and no dementia. According to this definition, 11 subjects (69%) had amnestic MCI, operationalized as a score below -1.5 standard deviation on the memory domain), and 5 subjects (31%) had non-amnestic MCI, defined as a score below -1.5 standard deviation on the non- memory domain (more details are described below). Three subjects were clini- cally representative for the MCI syndrome, but did not reach the threshold of -1.5 SD on the cognitive tests. Exclusion criteria were any somatic, psychiatric or neurological disorder that may have caused the cognitive impairment. In addi- tion, patients were excluded if diagnosed with Vascular Dementia, according to NINDS/AIREN criteria 20. Also patients with diabetes and/or cardiovascular disease were excluded. Subjects with a stenosis of the common or internal carotid artery or the middle cerebral artery (MCA) of more than 50%, as detected by extracranial and/or transcranial colour-coded duplex, were excluded as were subjects without a temporal bone window. The electrocardiogram (ECG) and non-invasive ABP were measured using a Task Force Monitor (CN Systems®, Austria). A transcranial Doppler system (Multidop X4, DWL®, Sipplingen, Germany) was used to measure CBFV in the main stem of both the right and left MCA. Two 2 MHz probes were held in position by a special frame. Patients were in supine position with their eyes open during all 15-minute recordings and were breathing spontaneously. Based on analysis of available MRI images of AD (n=17) and MCI (n=15) patients scores were obtained for medial temporal lobe atrophy (MTA)22, general cortical atrophy (GCA), age-related white matter changes (ARWMC) and Fazekas score 7. All subjects underwent a neuropsychological assessment. The measured cognitive domains included general cognitive functioning (Mini Mental State Examination, MMSE) 8, memory (immediate and delayed recall of the Auditory Verbal Learning Test 30 or the story of the Rivermead Behavioral Memory Test 63
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